by Carl V Phillips
This blog closed last year with a countdown of the worst liars of the year. This year, I decided to go for a more positive note.
We know that every time a smoker switches to e-cigarettes, there is a good chance she is saving herself from an eventual smoking-caused premature death. But this also means that, for someone who has quit smoking thanks to e-cigarettes, there is a chance she has already avoided premature death. Several months ago, a journalist posed this interesting questions to me: How many lives have already been saved thanks to e-cigarettes (h/t Maxim Lott). It is a very tough question, but I finally figured out how to estimate it based on the methodology I used in my 2009 paper, “Debunking the claim that abstinence is usually healthier for smokers than switching to a low-risk alternative, and other observations about anti-tobacco-harm-reduction arguments.” I have completed a working paper that calculates the estimate, which appears at EP-ology.
In the 2009 paper I showed that a favorite claim of tobacco harm reduction opponents, that adopting THR is less healthy than quitting smoking via total abstinence from tobacco products, is actually wrong. Unless the quitting to total abstinence were going to occur immediately, switching to a low-risk alternative is usually lower risk than trying to quit completely, even if the alternative has non-zero risk. This is because even a few more months of smoking before quitting poses greater risk than a lifetime of using the alternative product. In the same spirit, the new paper shows that even if some miracle occurs and everyone decides to just quit smoking in 2015, there have already been a lot of lives saved by e-cigarettes.
Specifically, I estimate that between 10,000 and 20,000 Americans are alive to ring in the new year only because of e-cigarettes. (The point estimate in the paper is 16,000, but it cannot be a precise estimate for reasons that are explained in the paper and should be obvious.)
These are people who would have already died from smoking had they not switched. A similar number have already been saved from dying from smoking even though they would not have died already (e.g., had they not switched when they did, they would have gotten lung cancer and, though still alive today, would be doomed to die from it). The numbers for other populations with similar numbers of switchers like the UK will be similar.
Assuming that miracle of 2015 does not occur (and it won’t, of course), the number of people who have already switched to e-cigarettes who will eventually be saved from dying from smoking will be in the order of 400,000 (based on numbers in the paper). That is a much larger number. But there is something particularly compelling about the number who have already been saved.
Think about it: If the FDA had succeeded in banning e-cigarettes in 2009, over 10,000 Americans who are now alive would be dead. I is in the order of four to six times as many people as were killed on 9-11, killed by the stroke of a regulator’s pen (and saved by Judge Richard Leon overturning the ban). Even if everyone quit smoking in 2015, or if e-cigarettes somehow were allowed back onto the market then, those people would still already be dead.
The fight to keep e-cigarettes legal and appealing, and to promote THR more generally, is obviously far from over. There is a lot of work to be done to stop those who would choose to let smokers die rather than have an attractive alternative. But for the moment, we can celebrate the new year on this positive note.
So, I wish Happy New Year to all, and especially to the many thousands who would not have seen this day were it not for tobacco harm reduction.