American Cancer Society Publishes New Position Statement on Electronic Cigarettes

A few days ago the American Cancer Society (ACS) published their new position statement on electronic cigarettes, which has been received positively by a section of the vaping community and industry as a radical change from their previously held position, which as far back as 2009 was to advocate for the total removal of vapor products from the market while leaving traditional combustible cigarettes widely available.

While ACS now concedes, as we have all been trying to educate them on for many years, that electronic cigarettes are much safer than smoking cigarettes, it still holds to its former position that long-term effects of use are not known. This may look like a step in the right direction and an important change but let’s keep in mind that when not that long ago Professor Stanton Glantz at UC San Francisco finally conceded to those scientific facts it did not fundamentally alter the push for drastically bad policies regarding vapor products.

We are giving ACS some benefit of the doubt here but are not holding our breath. A minor concession in the right direction does not automatically mean that ACS-CAN will stop pushing for flavor bans (i.e. restrictions and prohibitions on the sale of flavored tobacco products). Unless in the coming weeks and in upcoming flavor ban hearings ACS suddenly changes its position in support of these terrible ordinances we would have to call the change in position weak and disingenuous. Similarly, we do not believe ACS will stop funding and engaging in efforts to curb the sale, use, and availability of electronic cigarettes. Nor do we believe ACS will suddenly drop their support and efforts towards raising the smoking (and vaping) ages to 21 years.

A few highlights from the position statement that you can find linked above:

“The ACS has always supported any smoker who is considering quitting, no matter what approach they use.”

Clearly, this is not true as the plethora of documented cases in which the Society has called for crippling restrictions and prohibition on vapor products is well known.

“To help smokers quit, the ACS recommends that clinicians advise their patients to use FDA-approved cessation aids that have been proven to support successful quit attempts. Many smokers choose to quit smoking without the assistance of a clinician and some opt to use e-cigarettes to accomplish this goal. The ACS recommends that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes. Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation mediations. These individuals should be encouraged to switch to the least harmful form of tobacco product possible;”

Which all sounds good and most assuredly we support clinicians who will support those who wish to use vapor products to quit smoking and then they go on with the following:

“The ACS strongly discourages the concurrent (or “dual”) use of e-cigarettes and combustible cigarettes, a behavior that is far more detrimental to a person’s health compared to the substantial health benefit of quitting smoking.”

Yet the period of dual-use varies greatly between individuals. Some may require a year or more before completing a successful switch to a safer, less harmful alternative, such as vaping. And while we are on the subject of encouraging smokers to use safer, less harmful, alternatives to smoking, the position on safer smoke-free tobacco products such as Snus appears not to have been given a “new position”.

“The American Cancer Society recommends implementing polices and public health measures known to prevent the initiation and use of all tobacco products, including appropriate taxation, retail policies (e.g., raising the minimum age of purchase to 21), tobacco and e-cigarette aerosol-free policies and funding of evidence-based prevention and cessation programs.”

This part of the policy recommendations clearly implies that ACS will continue with “business as usual”. And, of course, ACS then goes on to encourage “the FDA to regulate all tobacco products, including e-cigarettes, to the full extent of its authority” and “use its authorities to reduce the toxicity, addictiveness and appeal of tobacco products currently on the market.”

It does not specifically mention reducing the appeal of tobacco products for minors but in general. Wouldn’t you want safer, smoke-free alternatives to be more appealing to those trying to quit smoking? Or at the very least encourage their use versus making great efforts to restrict availability and access?

Technically, when reading the new and somewhat improved position statement, you could easily argue that ACS will support your quit attempts using e-cigarettes while they ensure they are taxed to the point of industry destruction, only available to those 21 years or over, are only available in tobacco flavors, and may require you to go through extreme lengths to obtain one.

Furthermore, the new position and encouragement for the FDA to continue regulations to the fullest extent imply that ACS supports products that were available before the predicate date of 2007 while still funding and engaging on fear mongering in public regarding the product category in an attempt to dissuade smokers from trying electronic cigarettes.

In late 2017, Philip Morris International (PMI) announced its desire to stop selling combustible cigarettes. This was quickly met with a letter from 95 different health groups demanding that PMI immediately stop selling cigarettes if a smoke-free world is truly its intention. ACS was one of the signatories of that letter. Should this mean we, in kind, urge ACS to immediately stop funding and supporting bad legislation?

In conclusion, a change in position, one that needed to happen sooner or later as it becomes embarrassing to continue to argue with mounting scientific evidence on the reduced harm provided via vapor products, does not automatically mean it comes with a change in efforts towards bad policies. As always, the door continues to be open to ACS to engage in meaningful and serious dialogue with us, and other harm reduction, smoke-free and vapor organizations.