by Carl V Phillips
Frequently the scientist in me is appalled by the drivel coming from “public health” regulators and “researchers” about tobacco products. Every now and then, the more general scholar in me is equally appalled.
In the 2000s, a popular trope was to denigrate tobacco harm reduction with the non-analogy that switching to a low-risk alternative to cigarettes was “like jumping from a 10th story window rather than 20th”. The exact floor counts varied, but heights were always chosen such that either fall was almost inevitably fatal, which not only overstated the near-zero risk from smokeless tobacco, but also overstated the risk from smoking.
My colleagues and I got so annoyed about this that we wrote this paper, in which we did a little research and concluded that a lifetime of smoking creates about the same probability of premature death as a (non-suicidal) jump from a fourth floor window or a bit lower (this ignores the fact that a death from the fall would be almost immediate, whereas the death from smoking would occur very late in life). By contrast, the mortality risk from smokeless tobacco was in the neighborhood of the risk from a jump of less than two stories — there is a tiny possibility it will be fatal, but it is extremely unlikely. We pointed out that many of us have intentionally taken such a jump.
Most of the ANTZ have long stopped making that stupid claim, though Glantz recently resurrected it (he is not just a liar, but a paleo-liar). But another ANTZ lie-by-analogy has recently become so common that it is part of the official statements of the U.S. FDA: that the current availability of e-cigarettes “is like the Wild West”.
The thing about this is that it is not so far from true, because the frontier West was not actually all that wild. There was pretty decent rule of law. Property rights and contracts were reasonably solid (often to the unfair advantage of the capitalists, but that is not unusual). There were not gunfights in the street. There were close to zero bank robberies. There was gun control. Indeed, the level of wildness was far less than that of many urban neighborhoods over the last few decades. (For more details, search “was the wild west really wild” or for a more scholarly approach, see DiLorenzo 2010.)
It is true that workplace safety was poor, medicine was primitive, and the pharmaceutical industry was sketchy. Life under some modern regulations would have been better. But that was equally true of the contemporary situation back East. Moreover, of course, what was really needed to fix these problems was modern technology — regulation without better technology would have been fairly worthless.
There are modern places in the world that are as wild as that fictional U.S. Wild West the ANTZ seem to believe really existed. Some of them are nearby. In northern Mexico and U.S. border towns over the last decade, drug wars have resulted in horrifying violence. Those wars are caused by the aggressively-enforced prohibition of those drugs, which makes the available profits high and means that business disputes are settled by extra-state violence. Without prohibition, the wars and their spillovers would not occur. Moreover, by preventing effective checks on product quality (whether it is provided via useful regulation, brand equity, or third-party monitoring), prohibition also lowers the quality of the product, which results in needless mortality and morbidity among consumers.
So what does this mean for e-cigarette regulation?
1. If e-cigarettes are really like the frontier American West, that is not a bad thing. The reality of that world was trying to carve out a new source of happiness and prosperity. Not everyone who tried succeeded, but the overall collective results are pretty impressive. It was a world of endeavor, not wildness. Things were not perfect from the perspective of health and safety, but they were typical of the everyday hazards of the era.
2. The regulations that the wildwestistas are touting (or, in the case of some of them, formally introducing) would do little more than impose de facto prohibition. This is the recipe for turning a situation that resembles the historical West into one that looks more like the truly wild world of black markets. It would severely impede the technological development and brand equity that are far more important for improving health and safety than is any conceivable regulation. While it seems unlikely that the (inevitable) black market for e-cigarettes would resemble the world of drug wars, this is only because there is unlikely to be any serious enforcement (notice that the world of cigarette smuggling has only started to see much violence recently, as enforcement has stepped up). Of course, the other aforementioned disadvantages of black markets will still occur.
3. Anyone who makes the “Wild West” claim in support of regulation apparently gets their understanding of history from fictional movies. While we can take some solace in the fact that they are not in charge of foreign and military policy, do we really want to trust people who cannot distinguish truth from fiction? These people are so used to spouting whatever propaganda seems to support their cause, regardless of its accuracy, that they probably no longer understand the difference between fiction and science. They have no idea that what they are really saying is “things are not too bad”. Nor are they seemingly aware that the regulations they are touting are the only conceivable way to turn the current good situation into one that is as bad as the fantasy world they think really existed.