New York Health Commissioner Nirav R. Shah lies about e-cigarettes

by Carl V Phillips

In a letter to the New York Times, probably fueled by anger that that newspaper did not toe the “public health” party line per usual, the Health Commissioner of the state of New York tries to criticize Joe Nocera’s wonderful pro-ecig NYT op-ed.  Having no valid complaints available, he naturally adopts the usual anti-THR tactic, lying.  He starts with,

Nocera…implies that the science related to e-cigarettes is being ignored by the public health community. It is not.

But what he then goes on to present is the little corner of the science that supports an anti-ecig position — a corner that is mostly filled with the worst junk in the field.  I suppose he might argue what he said is technically right, since the “public health” community merely ignores almost all the science, including in particular the most useful science.

Early studies of the value of e-cigarettes as a smoking-cessation device have found that they are no more effective than nicotine replacement therapies approved by the Food and Drug Administration.

Here he is employing the standard liar tactic of pretending that some fairly useless research is what we should focus on, rather than the overwhelming evidence from other sources that shows that e-cigarettes work.  Moreover he lies about even that:  there was only one such study (not plural) and it did show that e-cigarettes did better than the NRT.  Of course, they did not do nearly as much better as they do in real life, but that was because the study was pretty much useless:  poor-quality e-cigarettes, given to people who do not necessarily want them in an artificial situation are not terribly effective.

No expert real scientist puts much stock in that study.  The real science can be found in the evidence about how many people have switched, which Shah pretends does not exist.  At least he implicitly admits that NRTs are not effective.

We also know that the smoke that comes off an e-cigarette is not just “vapor,” a term probably promoted by the industry to make it sound innocuous.

The funny thing is that he is technically correct, though he probably is too innumerate to know it:  The “vapor” is, of course, mostly aerosol, with very little actual vapor.  I cannot fathom what he could possibly mean by the “just”, though — no one claims that because it is vapor (or aerosol) it poses no substantial health risk.  That would be stupid.  And I mean “public health”-level stupid.  There are obviously a lot of vapors and aerosols in the world that are very harmful.  Indeed, the word “vapor” has, in the history of public health, generally been associated with source of harm.

The real argument is, of course, that we know what the exposure actually is (consumers care about the actual chemicals, unlike “public health” that is satisfied to just assign labels).  Based on that we know that the risk is very low.  Shah lies by setting up a straw man.

I like that “probably” in there.  It is like he was saying “I would like to lie and claim that the term is a product of industry action and not popular culture, but even among the anti-THR liars I cannot find any assertion on which to base that lie, so I pretend to be honest by hedging.”

There has been an increase in use of e-cigarettes coincident with the aggressive marketing of the product. But there has been no concomitant increase in the incidence of smoking-cessation coincident with the use of e-cigarettes.

Notice the cute trick of implying (but without actually saying) that e-cigarette use is caused by marketing and not by, say, the fact that people really like them and find them to be a great way to quit smoking.  Gotta get that “demonic possession” theory of tobacco use in there.  And, of course, as anyone who knows about tobacco use knows (i.e., apparently not Shah), smoking cessation has increased at a rate that is remarkably similar to the uptake of e-cigarettes.  (Of course that does not prove causation, though there is no doubt that the “public health” types would insist that it was causation if it went in their favor to do so.)

Much remains unknown. How will smokers and former smokers use e-cigarettes: to reduce tobacco use or to maintain nicotine addiction by smoking e-cigarettes where they would normally have to abstain?

There is no doubt that many are using e-cigarettes to quit — it is a lie to say that is unknown.  It is also known that some are using them primarily because they are not so restricted.  Um, so?  It is still making them better off, without hurting their health, so what’s the problem?  Of course, he is implicitly admitting that in the mind of “public health”, making smokers happier is the problem because the purpose of place restrictions is to torture smokers into quitting.  But if you are going to restrict e-cigarettes because they can be used for this, you obviously need to restrict NRT also, since more of it is sold for this purpose than to quit smoking.  (And, of course, if we avoid bone-headed anti-harm-reduction efforts by “public health”, smokers who are using low-risk products some of the time are excellent candidates for completing the transition.)

Does the doubling of e-cigarette use by youth in the last year portend an increase in tobacco use that will reverse the significant reductions in cigarette use since 2000?

The “doubling of use” claim is a well-documented lie, of course.  But even if it were not, it obviously would do nothing to cause cigarette use.  It would tend to increase the reduction.  Of course, pretending not to be lying, Shah did not actually assert the claim that he is carefully implying.  He phrased it as a question, a classic liar tactic.

Most would agree that there is no public health value in youth nicotine addiction and that regulation by the F.D.A. as a tobacco product is necessary.

Wow, you could use that as a dictionary example of “straw man”.

The lack of science on critical questions should be cause for close regulation of e-cigarettes until these questions are better answered, rather than careless optimism with the lives of our youth.

Oooh, if we do not ban these it will kill the chiiiiildren!  Except that they are close to harmless and substitute for far more hazardous behaviors even among chiiiildren.  We have enough science to know without a doubt that there is no dire hazard here that calls for precipitous action.  Yes, some science would be helpful in making regulations.  Isn’t that what the “public health” types always crow about: science-based regulation.  So why is it they are always asking for regulation that is explicitly based on a lack of science (or more precisely, in pretending that there is a lack of science)?