Pharma is already funding studies that try to show electronic cigarettes have a negative impact. There is a big pot of money for this, because they will lose tens of billions of dollars if ecigs become popular. As an example, just one researcher was paid $850,000 for projects that included watching YouTube videos of vapers, to attempt to show that by inhaling for longer than is used for a tobacco cigarette, vaping must be harmful to the lungs (or some such other ridiculous contention).
On the other hand it is more difficult and expensive to try to demonstrate that ecigs are not harmful. The ultimate test would be a long-term clinical study that showed the relative harm caused by smoking and ecig use in naive users, that is, people who had never done either. Such a trial would not get past ethics committees (at least in the West) and would take decades anyway.
There is also the very important point to be made that concrete evidence or even proof makes no difference to the lies and propaganda published on behalf of commercial rivals, particularly that financed by the pharmaceutical industry and supported by its paid agents in government. Take the Snus data from Sweden, for example: apart from the large amount of epidemiology, over 150 clinical studies from almost three decades show overwhelming evidence that Snus consumption in Sweden is statistically harmless (see Lee & Hamlin's large scale meta-analyses for example). It can be demonstrated that Snus usage does not elevate risk for any disease, and that the health outcomes for Swedish smokers who switch to Snus, or those who quit totally, are the same. The epidemiology (national health statistics) also shows that Sweden has the lowest smoking-related mortality in the developed world by a wide margin; that Sweden has a smoking-related death rate about half the EU average; and that Sweden has the lowest male lung cancer and oral cancer rate in the EU (more men than women use Snus). The statistics also show that Snus consumption has resulted in a reduction of smoking prevalence in Sweden of 45% (male/female averaged), and 55% for men - only about 11% of Swedes now smoke, with an almost unbelievably low figure of around 8% of Swedish men. The death rate from smoking diseases is falling in parallel with the increased usage of Snus. As Snus consumption rose in the last two decades, oral cancer rates fell (Snus cannot be shown to elevate risk for oral cancer, therefore a smoker switching to Snus dramatically reduces risk for oral cancer).
However you would not know any of this from the lies about Snus promulgated by pharmaceutical industry agents such as the FDA. You can be absolutely sure that if/when the same data is available for e-cigarettes, in 25 year's time, it will be denied equally strongly. Too many people will lose too much money if Snus and ecigs are freely available to consumers and if the truth about them is officially promulgated.
Consider this: about 6% of smokers have switched to ecigs already in the US and UK. A 25% market share is inevitable now, the question is simply by what year (perhaps by 2020)? Then we need to ask: what will the eventual reduction in smoking prevalence be? The Swedish data tells us that Snus caused a 45% reduction in smoking there; but we know that ecigs are far more popular with smokers than Snus (and especially with female smokers, who are more reluctant to use Snus, an oral tobacco product). There was a 55% reduction in smoking among men in Sweden, so it is not unreasonable to say that:
a. A similar reduction will occur for both male and female with ecigs; and
b. That ecig uptake will be even higher than that for Snus - perhaps 60%, perhaps even more.
Now consider the problems that creates:
a. The pharmaceutical industry earns $100 billion a year or more from the drug sales for treatment of sick smokers (chemotherapy drugs, COPD drugs, cardiac drugs, vascular drugs, and other treatments and income channels). That income would take a 60% cut.
b. They also earn about $3 billion a year from NRTs and other smoking cessation treatments. This might take an even bigger hit since eventually people will transfer those purchases to ecigs.
c. Some tobacco companies won't have any ecig or Snus plans even when they start to suffer sales shrinkage. They were the first industry to pay for anti-ecig propaganda and there is no reason to believe such opposition has totally ceased - there are reasons why it is reasonable to think that some tobacco money is still flowing into anti-ecig pressure.
d. Governments earn huge sums from tobacco tax. When that starts to vaporise, expect even more official resistance to ecigs - or monster taxes with no justification. The money has to come from somewhere.
And another thing: now that we know beyond a shadow of a doubt that Snus is the best way to quit cigarettes, and is the safest and most effective way by several orders of magnitude compared to pharmaceutical interventions, exactly how many doctors will advise you (even off the record) to give Snus a try instead of the ineffective or dangerous pharmacotherapies? How many have heard of the Swedish Miracle, or are willing to promote consumer choices instead of pharmaceutical interventions?
Why would you think that in 25 years time doctors will give any sort of different advice concerning e-cigarettes, even if by that stage, like Snus, we know they are highly effective and safe?
Although it's tempting to think that at some stage the medical profession might have figured out that lifestyle changes save many more lives than drug therapies, don't expect it it to become standard medical practice. There is a huge dichotomy between doctors' experiences and official policy: many GPs in the UK will tell you that 80% of patients they see are in their surgery because of lifestyle choices - people are ill because of the way they live. The fix is fairly obvious and it isn't a medical one. Nevertheless a doctor has to offer a pill because that is their job. Until that basic reversal of logic changes to something a lot more sensible, then don't expect things to improve. The medical profession is officially told to offer pills because that is the official solution; anything else is heresy.
Look, until recently doctors didn't even have to know much about nutrition: when the first large-scale tests of people for nicotine in the blood showed that everyone tests positive for nicotine, it was assumed that everyone must therefore be exposed to ETS (2nd hand smoke). The researchers didn't know much about nutrition and didn't realise that nicotine is an entirely normal and natural part of everyone's diet (and that if no nicotine is detected, the diet is likely to be deficient).
Medical knowledge has made immense strides in the last hundred years but let's face it, it's still in the Stone Age, comparatively speaking. If you posited that any more than 1% of the total knowledge of medicine is known at this point in time, you would probably be guilty of the wildest fantasy. That is the basic scale of the issue.
Don't blame doctors, they do the best they can with what they've got and especially under the regime in place - but we have a very, very long way to go. About 99% in fact.
