In service of their ideological agenda, the "abstinence-only" nicotine religion is perfectly happy to withhold potentially life-saving e-cigarettes from smokers. If a few million smokers have to die along the way, those are casualties they're willing to accept in pursuit of their nicotine-free utopia.
There is a stunning lack of practicality in modern-day America. This is reflected not only by our hyperpartisan politics -- in which politicians refuse to endorse good ideas if they come from the "other side" -- but in the never-ending culture wars.
Previously, the culture wars focused on topics such as gay marriage and abortion, but recently, it has shifted to things like sugar, "chemicals," obesity, and smoking. There is a large contingent of Americans who believe they have the right to dictate what you put into your body. Worse, some pass moral judgment on people who do not share their lifestyle. Smokers aren't simply engaging in harmful behavior; instead, they're fundamentally bad people.
Such beliefs appear to be gaining popularity. A YouGov poll showed that 16% of young Americans (aged 18-29) are far likelier than older Americans (aged 30+) to believe that non-smokers are morally superior to smokers. That's a bigoted religious belief, plain and simple.
When bigotry enters the picture, there's no place for rationality. With this framing in mind, understanding the opposition to e-cigarettes becomes much clearer.
In an Ideological War, Data Do Not Matter
There has been a concerted effort among activists to destroy the e-cigarette industry. E-cigarettes deliver vaporized nicotine. Like caffeine, nicotine is addictive but relatively harmless. Some studies, however, have suggested that there are other harmful chemicals in the vapor.
For instance, a recent paper in Tobacco Control concluded that one type of smoking cessation device, known as iQOS, releases glycolonitrile (formaldehyde cyanohydrin), a toxic substance, and a few other potentially concerning byproducts. However, the paper simply detected the presence of these chemicals and did not determine their actual concentrations. This is a problem, because the dose matters. Chemistry techniques are extremely sensitive; we can detect just about any chemical anywhere. Rice contains trace levels of arsenic and toast has acrylamide, but that doesn't mean people should stop eating them.
Tests mandated by the FDA and performed by the manufacturer of iQOS, Philip Morris International (PMI), dispute the paper's findings. They claim that there is no glycolonitrile produced by their product at all. They also freely admit that iQOS is not risk-free, but that it contains 95% fewer toxicants than regular cigarettes*.
Compare all this to what we know about cigarettes. There are about 7,357 chemicals in cigarette smoke, 70 of which are confirmed carcinogens. Even if the Tobacco Control paper is correct, then iQOS has reduced the number of chemicals from 7,357 to about 5. That's a major victory.
Abstinence-Only Nicotine Education
But that's not how ideological activists see it. In their opinion, e-cigarettes are a "gateway" to real cigarettes, a preposterous idea that wasn't true for marijuana and isn't true for e-cigarettes. Bizarrely, activists favor an "abstinence-only" approach to nicotine, a policy they outright reject for sex or drugs like marijuana. Why? Because it doesn't work, but they think it will for nicotine.
This makes absolutely no sense, until one remembers that this is a religious war. The "no nicotine" religion is perfectly happy to withhold potentially life-saving e-cigarettes from smokers in service of their ideological agenda. If a few million smokers have to die along the way, those are casualties they are willing to accept in pursuit of their nicotine-free utopia.
*Note: In an earlier version of this article, I wrote: "By extension, iQOS should be 95% safer than regular cigarettes, which is a conclusion that has also been drawn by the UK's National Health Service." That is a mistake. The NHS says that vaping devices are 95% safer than cigarettes, but the report does not discuss heat-not-burn (HnB) tobacco products, which is what iQOS is. My apologies.