My name is Julie Woessner. I am a resident of Wildwood, Missouri, and I serve on the Board of Directors of CASAA, the Consumer Advocates for Smoke-Free Alternatives Association. CASAA is an all-volunteer, nation-wide, non-profit organization that works to ensure the availability of reduced-harm alternatives to smoking and to provide truthful and accurate information about those alternatives so that people can make informed decisions.
I have no conflicts of interest to declare.
On behalf of the Missouri members of CASAA, I would like to thank the Committee for giving me the opportunity to testify in favor of that portion of HB 2103 that would protect the use of e-cigarettes in public places. I have with me approximately 135 Witness Appearance forms from Missouri residents, all supporting the bills provisions regarding e-cigarette use. CASAA specifically takes no position on that portion of HB 2103 that relates to smoking.
I am a former 30-year, 2-pack a day smoker. I had tried many, many times to quit smoking, all unsuccessful. Each failed attempt left me feeling more demoralized, defeated, and ashamed. After a disastrous bout with Chantix in 2008, I finally quit trying to quit. I believed what I was toldthat I needed to Quit or Dieand I therefore resigned myself to dying as a smoker. I picked up an e-cigarette in January of 2009 not in an effort to quit, but, rather, to cut back on what had become a 2 ½ pack a day habit. I was shocked that within days, I had completely replaced smoking with e-cigarettes.
After the first month, my smokers cough was gone, and my sense of taste and smell had improved. Within 3 months, I was able to take deep breaths without pain, and I no longer got winded when walking up stairs. My doctor confirmed that not only had my blood pressure decreased, but my lung capacity had increased.
Perhaps the most remarkable thing about my story is that it is not at all unusual. More than a million people have found that e-cigarettes are an acceptable alternative to smoking and have made the switch, either completely eliminating smoking or dramatically reducing the number of cigarettes smoked.
The evidence that e-cigarettes work isnt simply anecdotal. An Italian researcher, Dr. Riccardo Polosa, recently reported that he recruited 40 hard-core smokers for a study. By hard-core, I mean smokers who had no desire to quit and who had, in fact, turned down a free spot in a smoking cessation program. Dr. Polosa gave these not interested in quitting smokers e-cigarettes, and within 6 months, more than half the participants had reduced the number of cigarettes smoked by more than 50%. Nearly a quarter had completely quit smoking. When you compare the results of this study to the success rates of 7% at 6 months and 2% at 20 months for traditional FDA-approved nicotine replacement therapies such as the gum and patch, you begin to realize just how stunning these results are.
In spite of this, the tobacco control and health care communities have been decidedly hostile towards e-cigarettes, some going so far as to falsely claim that e-cigarettes are as dangerous or more dangerous than smoking. The truth is that e-cigarettes are far, far less risky than smoking. In fact, the American Association of Public Health Physicians has stated that e-cigarettes likely pose less than 2% of the risk of smoking. This makes sense given that the greatest risk associated with cigarette smoking isnt the tobacco itself or even the nicotine. Rather, it is lighting the cigarette, burning the tobacco, and then inhaling the products of combustion.
When you burn a tobacco cigarette, enough energy is created through combustion to break chemical bonds, allowing new chemicals to form. E-cigarettes, on the other hand, work through the process of vaporization. While combustion creates thousands of chemical changes, vaporization creates none. Rather, a liquid is heated just to the point of creating a physical change (vapor), much like boiled water creates steam.
When e-cigarette users claim, Its vapor, not smoke, it isnt just semantics.
Last week, you heard Dr. Potts testify that e-cigarette users are still addicted to nicotine. This is not entirely accurate. Many e-cigarette users have reduced or eliminated their dependence on nicotine. One of the tremendous benefits of e-cigarettes is that users can select the nicotine strength to find out what works best for them. Some eventually eliminate nicotine completely. However, most continue to use nicotine, often at reduced levels, finding that using nicotine in e-cigarettes is what allows them to remain smoking abstinent.
Nicotine, while addictive, does not cause cancer and it isnt what makes smoking so extraordinarily dangerous. In fact, the effects of nicotine on the body are more akin to caffeine. So with all due respect, I would ask Dr. Potts why he feels that his concern about my nicotine addiction is more important than my concern about developing cancer, emphysema, COPD, or any of the many health issues associated with smokingnot nicotine use.
Dr. Potts also suggested that because e-cigarettes come in flavors other than tobacco, they are being marketed to children. However, surveys show that the average e-cigarette user is a middle-aged, long-term smoker. More than 80% of the users are over age 30 and smoked 10 or more years. More than 1/3 are older than 50 and have smoked for 30 or more years. A significant number of e-cigarette users enjoy flavors other than tobacco, many finding that the variety of flavors is at least in part what makes e-cigarettes a more appealing alternative to smoking. I would also note that Nicorette gum and lozenges come in flavors such as Cinnamon Surge Cherry, and Fruit Chill, yet no one accuses GlaxoSmithKline of marketing to children.
For the record, my favorite flavors are peach and maple, and Ill be turning 50 in December.
The reason why this legislation protecting the public use of e-cigarettes is necessary is because various members of the tobacco control and health care community, whether through ignorance or design, have attempted to include e-cigarettes in smoking bans. For example, model smoke-free ordinances produced by the Americans for Nonsmokers Rights include e-cigarettes in spite of the fact that e-cigarettes create no smoke and pose no known risk to bystanders.
Personally, I would love to see more brick and mortar e-cigarette stores in Missouri. It would not only be good for Missouris economy, but it would also be a boon to public health. But one big stumbling block for businesses in our state is the fear that money will be invested to open a store, only to have a municipality arbitrarily ban public use of e-cigarettes despite no proof of harm.
Pages 6 through 10 of the CASAA booklet provided to Committee members include a number of quotes from respected experts regarding e-cigarettes and, in particular, their use indoors. I will not repeat them all, but I would like to highlight two:
Dr. Brad Rodu, Professor of Medicine at the University of Louisville:
There is substantial and compelling scientific research documenting that consuming the ingredients in e-cigarettes (nicotine, propylene glycol, water and flavors) is vastly safer than burning tobacco and inhaling 3000+ toxic by-products. Claiming that e-cigarettes are dangerous for non-smokers is about as credible as claiming that air travel is dangerous for people who never set foot in an airplane.
Dr. Joel Nitzkin, former Chair of the Tobacco Control Task Force of the American Association of Public Health Physicians, notes:
"Smoking bans have been universally justified on the basis of the risk posed by environmental tobacco smoke to non-smokers. Most of the air pollution due to cigarettes is due to sidestream smoke the smoke that curls off the end of the cigarette when no one is puffing on it. E-cigarettes have no sidestream smoke. E-cigarettes also have none of the toxic products of combustion produced by conventional cigarettes. It is therefore unreasonable to ban them on the basis of risk to non-smokers.
The truth is that allowing e-cigarette use indoors will actually benefit public health. If anything, sound public health policy surely would encourage smokers to replace or reduce their cigarette consumption, not create obstacles to it. Allowing e-cigarette use indoors provides a powerful incentive to switch to a far safer alternative.
Since there is absolutely no proof that e-cigarettes pose any danger to either the user or to bystanders, the decision as to whether e-cigarettes can be used should be left up to the business and property owners, not the government. The language proposed by HB 2103 regarding e-cigarettes ensures this will be the case.
Thank you for your time and consideration. I would be happy to answer any questions you might have.
