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E-Cigarette Opponents Do More Harm by Snubbing Big Tobacco

Joe Nocera

(Bloomberg Opinion) -- A quarter century ago, a man named Steve Parrish was the ugly voice of the tobacco industry. The tobacco wars were raging: States were suing the cigarette companies, whistle-blowers were leaking damning documents to the media and David Kessler, the commissioner of the Food and Drug Administration, was trying to regulate tobacco products.

Parrish was a senior executive at Altria at the time, and his job was to strike back. He would go on television and hurl insults at Kessler. He would insist that cigarettes weren’t addictive. He would denounce the mounting lawsuits in strident language.

Eventually, though, Parrish realized that Big Tobacco had no choice but to negotiate with its opponents. And once he sat down with the other side, a funny thing happened. His anger dissipated when he realized that Big Tobacco’s critics were reasonable people with legitimate concerns — and that Altria, stuck in its bunker for so long, had been wrong to dismiss them. “All we knew was our own rhetoric,” he told me years later. Ultimately, those negotiations led the tobacco companies to agree to pay the states $246 billion and accept tighter restrictions on cigarette marketing.

I bring this up because of something that took place last week. On Wednesday morning, Vital Strategies, a leading global public health organization, sponsored a talk titled “Hope Meets Reality: E-Cigarettes, a Public Health Harm or Harm Reduction?” The event was a one-sided assault on e-cigarettes.

One speaker was Matthew Myers, the president of the Campaign for Tobacco-Free Kids. Myers has been a critic of e-cigarettes from the start — but he’s been in overdrive ever since Juul became the e-cigarette of choice for teenagers. Its manufacturer, Juul Labs Inc., faces a host of legal woes, including a joint investigation by 39 attorneys general announced on Tuesday. (Both Vital Strategies and the Campaign for Tobacco-Free Kids are supported financially by Bloomberg Philanthropies.)

After his talk, Myers was joined on stage by another e-cigarette critic, Joanna Cohen, the director of the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health. The two of them took turns bashing e-cigarettes. Myers complained about “the few zealous people” who continued to argue that e-cigarettes could save lives; Cohen claimed that “there was some evidence of nicotine’s effect on the cardiovascular system.” And so on.

Among those who had registered to attend the talk was Moira Gilchrist, the vice president for scientific and public communications at Philip Morris International. That’s right: She’s part of Big Tobacco. Gilchrist is in charge of the company’s harm-reduction efforts. The scientists she leads devise nicotine products that won’t kill consumers the way cigarettes do.

Virtually everyone in the public health community is skeptical that Philip Morris is serious about transitioning the company to products that don’t rely on deadly combustible tobacco. But Gilchrist is a true believer. She joined the company a dozen years ago after working at a leading cancer charity in the U.K., she told me the other day. “This is not something we are doing for show,” she said. “This is our commercial future.”

A few days before the Vital Strategies talk, Gilchrist received a note from the group disinviting her. “In accordance with our non-engagement policy, tobacco industry representatives will not be granted access,” it read.  In an accompanying statement, Vital Strategies elaborated:

 

Let us be clear: There is a fundamental and irreconcilable conflict of interest between public health and the tobacco industry. And as an organization whose mission is to ensure everyone is protected by a strong public health system, we at Vital Strategies align ourselves with the World Health Organization, governments around the world, and the global health community in upholding a firm non-engagement policy with the tobacco industry.

As it turns out, the talk was streamed, and Gilchrist was able to watch it. When we spoke the next day, she told me that there were things that Myers and Cohen had said that she would have liked to challenge if she had been allowed in the room.

For instance, the case that nicotine harms the cardiovascular system has been made most prominently by Stanton Glantz, an anti-tobacco zealot who is a professor at the University of California, San Francisco. One widely quoted Glantz study published last year purported to show that e-cigarettes doubled the risk of heart attacks. But last week, the Journal of the American Heart Association retracted that study because its data was “unreliable.”

As for Myers, one of the key points he made in his talk was that there was no evidence that smokeless nicotine devices were causing large numbers of adults to quit smoking but  there was lots of evidence that they were hooking teenagers. Of course, part of the reason adult smokers aren’t racing to take up e-cigarettes is that the public health community has heaped such abuse on them that many adults don’t realize they are safer than cigarettes.

Philip Morris doesn’t make an e-cigarette like Juul. Its product, called IQOS, delivers nicotine by heating tobacco rather than burning it. And as Gilchrist pointed out when we spoke, there is plenty of evidence that it is moving smokers away from cigarettes. In Japan, IQOS has nearly 18% of the market — not the smokeless market, but the tobacco market, including cigarettes. (“We have seen the most remarkable drop in cigarette sales,” she said.) In Russia it has 5% of the market. In Portugal 7.2%.

Last spring, the FDA approved the device for sale in the U.S., ruling that it is “appropriate for the protection of public health” because it contains fewer toxins than cigarettes. Philip Morris has now submitted data to the agency as it seeks a designation that would allow it to market IQOS as less harmful than cigarettes — something e-cigarettes are not allowed to do. That would be a tremendously big deal.

Gilchrist told me that there were many things public health advocates believe that Philip Morris also believes: that e-cigarettes should be kept away from youths, for instance, and that the products should be heavily regulated, based on sound science. But, she added, “what I see is that the public health organizations are using youth use as a reason to deprive 40 million U.S. smokers from having access to these products.” She added:

This is the future of this company. We have the product, the science, and the will to make it work. For us, there is one path forward and it is smoke-free products. The question is whether public health wants to make it more difficult for us or less difficult.

I understand why the public health community doesn’t want to legitimize the tobacco companies by meeting with them; they did a lot of shameful things in the past, and they still sell a product that kills about half its users. The memory of those old sins makes public health officials skeptical that tobacco executives like Gilchrist are sincere when they say they want a cigarette-free future.

But the only way we’re going to solve the e-cigarette conundrum — namely, how do we keep the products away from youths while urging adult smokers to make the switch? — is if the two sides sit down and start talking. I think the public health officials would see — just as Parrish saw two decades ago — that those on the other side genuinely want to find a solution. At that point, the two sides could fairly easily come up with proposals that would work for everyone. The refusal to engage with the tobacco companies is actually harming public health.

As I’ve noted before, one of the people who negotiated with Parrish all those years ago was Myers. It took a lot of guts; when his allies in the public health community discovered that he was involved in the tobacco settlement talks, he was roundly denounced. But he stuck with it and helped change the cigarette landscape for the better. If only he were willing to do it again, he could hasten the end of cigarettes.

(Corrects the given name of Stanton Glantz, a professor at the University of California, San Francisco, in the 11th paragraph. A previous update added an announcement of an investigation into Juul Labs Inc. in the fifth paragraph. )

To contact the author of this story: Joe Nocera at jnocera3@bloomberg.net

To contact the editor responsible for this story: Daniel Niemi at dniemi1@bloomberg.net

This column does not necessarily reflect the opinion of Bloomberg LP and its owners.

Joe Nocera is a Bloomberg Opinion columnist covering business. He has written business columns for Esquire, GQ and the New York Times, and is the former editorial director of Fortune. His latest project is the Bloomberg-Wondery podcast "The Shrink Next Door."

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