Why Are Doctors Afraid to Recommend Vaping to Smokers?

A new survey of doctors shows the extent of the damage caused by the endless war on vaping by so-called public health groups. Presented a hypothetical scenario in which a smoking patient asks if she should try e-cigarettes to quit smoking, the majority of surveyed physicians say no.

The survey is described in a paper published in the journal Annals of the American Thoracic Society. The authors are from Vanderbilt University in Nashville, TN, and the Mayo Clinic in Rochester, MN.

The doctors were sent a questionnaire that offered a “clinical case vignette” that described a smoking patient seeking advice on quitting who asks about vaping. “A 27-year-old woman with moderate persistent asthma presents to establish care. She is on a moderate dose of combined inhaled
fluticasone and salmeterol. Her symptoms are currently well controlled. She smokes. During your interview, she asks if she should use electronic cigarettes to help her quit smoking.”

Doctors who advise against e-cigs and only offer FDA-approved cessation products are then told, “She tells you that she has tried other medications to quit before, refuses a prescription, and asks again whether she should try electronic cigarettes to quit.”

They hated smoking so much that they eventually came to hate smokers themselves.

Believe it or not, only 27 percent of the doctors then suggest the patient try vaping. — despite being told by the patient that she will not use nicotine gum or Chantix! That is as good as telling the patient that she might as well smoke.

Who do we blame for this revolting story? The doctors who refuse this patient a consumer nicotine product that might change her life — or even save it — or the organizations that have worked so hard to twist the truth about nicotine and vaping?

Dr. Michael Siegel of Boston University lays the blame squarely on the anti-nicotine zealots in the tobacco control industry. Siegel himself was once among their ranks, training with Stanton Glantz and working in the CDC Office on Smoking and Health. But what they’ve done to shape public (and medical) opinion on vaping now disgusts him.

While this is truly appalling, I do not blame the physicians. They have been misled and confused by a major campaign of deception being waged by anti-tobacco groups and some health agencies, including the FDA and the CDC. These groups have lied to physicians and deceived them about the nature of e-cigarettes, their risks, and the relative risks of smoking compared to vaping.

For example, the CDC has told physicians that e-cigarettes are simply another “form of tobacco use.” The FDA has told physicians that there is no evidence that vaping is any safer than smoking. Many anti-tobacco groups have told physicians that vaping is actually worse than smoking. Several anti-tobacco researchers have told physicians that vaping poses a higher cancer risk than smoking. Recently, some anti-tobacco researchers told physicians that vaping poses a higher risk of stroke than smoking. And many organizations have told physicians that vaping causes bronchiolitis obliterans (“popcorn lung“) without even a suggestion that smoking also causes this severe, progressive lung disease.

Interestingly, the Mayo Clinic itself (with which four of this paper’s authors are affiliated) has been a huge part of the problem. The Mayo Clinic lied to physicians about e-cigarettes, telling them that vaping is not any safer than smoking. The Mayo Clinic even went as far as to question the sanity of electronic cigarette users.

How upside-down is the world of tobacco control that they take satisfaction in brainwashing doctors — who see the ravages of smoking every day! — to think that quitting cigarettes by vaping is worse than actually smoking?

Who shoulders the blame for this? Let’s name them: Matthew Myers and the Campaign for Tobacco-Free Kids, the American Heart Association, the American Lung Association, the Truth Initiative, the American Cancer Society, the American Academy of Pediatrics, the University of California, Tom Frieden and the CDC, the FDA, and many, many others.

These groups have become a massive industry — far larger and more powerful than the vaping industry, and absolutely unified in their anti-harm reduction message. They hate smoking so much that they eventually came to hate smokers themselves — so much that they consider it a success to turn doctors against the very patients they’re sworn to care for.

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Jim McDonald