Answer: Everything — they are one in the same!

I recently spoke to my daughter’s 7th grade science class on the dangers of smoking cigarettes and electronic cigarettes. Of course, I had to come up with a metaphor that would capture their attention — and tell a story — ZOMBIES!

We can all imagine zombies trying to get into our home — which we have fortified to protect us from the walking dead. The zombies are the tobacco industry. The fortified home is legislation to protect us from getting bitten and becoming one of them — nicotine addicted walking dead.

However, now the zombies have become body snatchers. They look normal — like us, but their nicotine bite is just as addictive. The body snatchers are the tobacco industry peddling e-cigarettes. They lull us into believing they are the “safe alternative” (the harm reduction argument) or that smokers will quit smoking (the smoking cessation argument).

Therefore, they argue, we should allow ANYONE to smoke e-cigarettes ANYWHERE. Their arguments are a smoke screen (they would say vapor)! They could care less about smokers’ health, or anyone else’s health.

Here is what they really want:

Change social norms so that e-cigarettes are acceptable (like smoking in the 1950s)

Free e-cigarette advertising by having ubiquitous use of their product

Recruit youth into lifelong nicotine addiction

Keep and get many more addicted to their product

Make tons more money since e-cigarettes is likely less deadly than cigarettes

Here is what nicotine addiction is like (from Dr. Neal Benowitz, UCSF):

“With repeated exposure to nicotine, tolerance develops. Nicotine withdrawal causes anxiety and stress, both of which are powerful incentives to take up smoking again. … Cessation of smoking causes the emergence of withdrawal symptoms: irritability, depressed mood, restlessness, and anxiety. The intensity of these mood disturbances is similar to that found in psychiatric outpatients. Anhedonia — the feeling that there is little pleasure in life — can also occur with withdrawal from nicotine — like other drugs of abuse. … Smoking is a highly efficient form of drug administration. Inhaled nicotine enters the circulation rapidly through the lungs and moves into the brain within seconds. Rapid rates of absorption and entry into the brain cause a strongly felt “rush” and reinforce the effects of the drug. … There is considerable peak-to-trough oscillation in blood levels of nicotine from cigarette to cigarette. Nevertheless, it accumulates in the body over the course of 6 to 9 hours of regular smoking and results in 24 hours of exposure.” (N Engl J Med. 2010 Jun 17;362(24):2295-303. doi: 10.1056/NEJMra0809890.)

Why would anyone want anyone to become addicted to nicotine? Only if you can make ‘lots of money from it, I suppose. You would also have to be heartless — a zombie!

In the 1930s to 1950s smoking and tobacco products proliferated without regulations or science about the long-term effects of smoking cigarettes. What resulted was 42% of adults as active smokers in 1965, and an entire generation ravaged by the effects of cigarettes for the last several decades.

Our communities took action beginning in the 1990s and turned that trend around (12.5% of San Francisco adults smoke). Now we are faced with a new challenge that might similarly increase nicotine addiction and health harm to the community. We have a chance to act now to limit exposure to these products. Remember— the real issue is the promotion of nicotine addiction — plain and simple! Are we going to let the Zombie Industry promote nicotine addiction in our communities and to our children? We can prevent a new public health disaster?

Protect social norms that make smoking and nicotine addiction unacceptable

Protect our communities, families, and children from free e-cigarette advertising

Protect us from nicotine addiction promotion

Protect us from these zombies

The San Francisco Board of Supervisors did not buy the bogus arguments from the Zombie Industry. On March 18, 2014, they joined a growing list of cities across the country enacting legislation to extend protection from zombies to include protection from body snatchers. See “S.F. supes vote for same smoking laws for e-cigarettes” (San Francisco Chronicle, March 18, 2014)

Kudos to the San Francisco Board of Supervisors!

From the San Francisco Board of Supervisors: Health Code – Restrictions on Sale and Use of Electronic Cigarettes; Sponsors: Mar; Avalos, Chiu, Yee and Cohen: Ordinance amending the Health Code to

prohibit the use of electronic cigarettes where smoking is otherwise prohibited;

require a tobacco permit for the sale of electronic cigarettes; and

prohibit the sale of electronic cigarettes where the sale of tobacco products is otherwise prohibited.

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Many thanks to the University of California scientists and providers, health organizations (e.g., San Francisco Medical Society), and youth organizations that provided testimony supporting the regulation of e-cigarettes!