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Philadelphia local news website Philly.com ran a piece this week from medical doctor Rima Himelstein on why she thought electronic cigarettes are terrible. The piece — called Why e-cigarettes get an “F” — ran down a number of anti-electronic cigarette arguments that are even more ridiculous than we’re used to seeing.



Himelstein’s previous articles on the site pin her down pretty much as your standard “Think of the Children!” alarmist. It seems clear she gets a lot of attention from teen health topics, but given the slant on the e-cig article, it’s hard to take anything else she does seriously.

Here’s a rundown of the arguments she made and where the problems lie:

She can’t even get the National Youth Tobacco Survey numbers right. Himelstein says that the doubling of e-cig use in teens from 2011 to 2012 is extremely bad news. This survey has been bounced around excessively and really doesn’t show anything other than trial of the devices among teens. But Himelstein claims use of teens was around 1 out of 100 in the last month and 3 out of 100 in the month previous. In fact, the the survey only looked at the last month and then if use had ever occurred. In short, these numbers aren’t additive, and only account for trial rather then ongoing use.

She thinks having the same quit success rate as nicotine patches means they aren’t helping people quit . Himelstein argues that there’s no evidence that e-cigs can help people quit smoking. Then she references research that proves that they do as proof that they don’t. Some time ago, researchers found no statistically significant difference in the number of people that quit using nicotine e-cigs, nicotine patches, and non-nicotine (placebo) e-cigs. So either she doesn’t believe that there’s evidence the nicotine patch is successful or she doesn’t know what “no statistically significant difference” means. (On a small note, the study actually showed that e-cigs helped more people because e-cig users that didn’t quit smoking still reduced overall smoking frequency.)

E-cigs — she argues — have cancer-causing agents and nicotine and that’s all terrible. She almost has a point here. Like many other e-cig opponents, Himelstein ignores the weight of this argument in favor of a quick and easy It’s bad for you! jab. On one side, is the issue that carcinogens are everywhere. Sugar and meat are both carcinogenic. On the other side is the focus on smokers. E-cigs exist primarily to get smokers to transition to something less harmful (99% less harmful by most accounts). Nicotine itself is not a carcinogen — but it is addictive. If we were worried about a lifetime of addiction, coffee and caffeinated sodas would be outlawed from teen consumption too.

She’s worried because kids can buy them . This is a legitimate concern as less than half of all states have outlawed the sale of e-cigs to minors. However, the industry is largely policing itself on this issue and we’ve yet to see any shop owners willing to sell to minors. Like cigarettes, booze, and the car keys, teens find ways to get things they want. The opportunity of electronic cigarettes to help millions of smokers should not be stifled because some kids may pick them up — especially if they would be likely to smoke instead.

“Using e-cigarettes can kill,” she says. Himelstein argues that nicotine — in addition to being highly addictive can kill kids. She uses the commonly quoted amount of 10 milligrams as an amount that can be fatal to a child. Again, there’s two issues with this. First, many believe this 10 mg number to be wildly inaccurate. Fatal nicotine poisoning is actually believed to occur around 10-20 times more than that. And this requires rapid introduction of the nicotine to the blood stream. On the other hand, most vapers know to keep their supplies away from kids — especially those that might not know the consequences of drinking strange liquids. This is one more in a massive list of household items you don’t leave out for the kids to play with.

Himelstein called electronic cigarettes a rising epidemic that we should all be worried about. I would actually go the other way on this. E-cigs may just be the promising answer to an epidemic that has raged on for decades.