E-­‐cigarettes: miracle or menace? Networks, Organizations and Society

Introduction

The electronic cigarette or ‘e-­‐cigarette’ is a rechargeable battery-­‐powered device designed to resemble a conventional tobacco cigarette. The e-­‐cigarette does not contain tar and the nicotine cartridges seem to be a much safer alternative to traditional cigarettes, which contain a much higher number of notoriously harmful chemicals. Nonetheless, nicotine is addictive and is classified as a poison (Cancer Research UK, 2013). The issue has attracted heated debate, but the question remains: “Should e-­‐ cigarettes be classed as general consumer products, tobacco products, medicines or drug-­‐delivery devices?”

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In attempting to answer the above question, this paper discusses the evolution of e-­‐ cigarettes through the lenses of technological determinism (TD) and social constructivist approach (SCOT). In the first part of the paper, the main assumptions underlying TD are considered and development of e-­‐cigarettes is illustrated as a linear process. A thorough criticism of TD is provided and e-­‐cigarettes are used to show its main limitations. The second part of the paper offers an overview of SCOT and analyzes how its main elements – RSGs, technological frames, inclusion, interpretative flexibility, closure and stabilization – can explain the development of e-­‐cigarettes. The main limitations of the theory are illustrated by providing examples from the social construction of the artifact. The final part of the paper entails a comparison between the two approaches, summarizes the key findings and offers suggestions for further discussion.

Technological Determinism The literature offers a rather poor conceptualization of technological determinism, as there are various accounts ranging from positive descriptions of an inevitable technological order based on specific laws (Bimber, 1990), to claims that technology is the fundamental driver of social change and that the course of human history is decided by technological innovations (Marx and Smith, 1994). Nevertheless, all interpretations of TD assign technology a significant role in relation to social change. From a technological determinist account, the e-­‐cigarette – a technological innovation – is seen as a given, independent and autonomous fact underlying the pattern of social change.

Timeline of e-­‐cigarettes evolution – a linear, one-­‐dimensional process of innovation

1963

2003

2004

2006

2006-­‐2007 • E-­‐cigare]es introduced to the US

2013 • E-­‐cigare]es used for any purpose

2014 • US sales reached $1billion

• First patented • The modern • E-­‐cigare]es • E-­‐cigare]es version sold for the first introduced to developed and _me Europe patened by Ruyan Group in Beijing, China

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According to TD, e-­‐cigarettes have the power to influence society

e-­‐cigare]es -­‐ a

force driving social change

Users of regular tobacco products either gave up smoking by adop_ng e-­‐ cigare]es or simply used them instead of the more harmful regular cigare]es (NALBOH, 2009). A new subculture emerged; it is a radical group of smokers who call themselves 'vapers' because of the vapor they inhale when using electronic cigare]es. 'Vapers' are obsessed with customizing and upgrading their e-­‐cigare]es. Vapers' meet regularly at conven_ons such as Vapefest or keep in touch via social media (MailOnline, 2013). Teenagers all over the world took up smoking because of e-­‐cigare]es' flavours ranging from chocolate, mint, grape, melon to strawberry and bubble gum.

Young non-­‐smokers and social smokers are smoking more because of e-­‐ cigare]es. An increasing number of women changed their regular diets such as WeightWatchers and Dukan due to e-­‐cigare]es, because their flavours are par_cularly tasty and the vapors have no calories. E-­‐cigare]es are helping smokers to save money, as they are cheaper than regular tobacco products (MailOnline, 2014). E-­‐cigare]es are enhancing the status and glamour of celebri_es' lifestyle; Uma Thurman, Robert Pamnson, Leonardo DiCaprio and Julia Louis-­‐Dreyfus are only a few of those who took up e-­‐smoking. E-­‐cigare]es will drive down the prices of life insurance and other financial products, as they pose less or no harm to health. Nevertheless, e-­‐cigare]es can also change the way that insurance companies operate, for instance having to introduce nico_ne tests (Dyson, 2013). Smoking causes an es_mated 100,000 deaths in the UK alone; e-­‐cigare]es have the power to save those lives.

Criticism of TD

As seen in the timeline above, TD entails a linear, one-­‐dimensional view of innovation and suggests that social and political interventions in technological development are impossible (Bijker, 2001). It is pertinent to argue that TD is politically debilitating and that technology is not a given fact in itself, but it is rather shaped by the actors involved in the concrete process (Jæger, 2001). For instance, if U.S. District Court ruled in favour of the agency’s (U.S. Food and Drug Administration) import ban on e-­‐cigarettes, distributors of e-­‐cigarettes – Smoking Everywhere and Sottera – would not be allowed to have their products brought into the country and thus, U.S. consumers might not 4

even have a chance to experience the novel technology (see Appendix for the controversy’s background).

Another limitation of TD is that it fails to acknowledge human agency and free will, since devices – such as e-­‐cigarettes – do not force the society to adopt them. By viewing e-­‐ cigarettes as a ‘black box’, TD neglects any comprehensive account of the structures, workings and social origins of technological innovation. Critics of TD would argue that e-­‐ cigarettes cannot be viewed as ‘neutral’ or ‘value-­‐free’, as it not the technology that counts but the way people choose to use it (Chandler, 1995). MacKenzie and Wajcman (1985) agree that technologies cannot be politically neutral, as they are sometimes designed, deliberately or not, to open certain social options and to close others, and some technologies may be more compatible with some social patterns than with others. Consumers in less developed countries (LDCs) might be the last to experience e-­‐ cigarettes and even when they do, there might be other factors that coerce them into a distinct social pattern compared to their wealthier counterparts. Thus, technology cannot be detached from the particular social context in which it emerged. Technological determinists argue that a technological development is finished once it leaves the laboratory or the drawing board of the engineer (Jæger, 2001). Thus, they fail to account the way a technology is appropriated by its users and how it is further shaped by society. The e-­‐cigarette was developed as an alternative to traditional tobacco products, and yet, there are women using it to lose weight, while teenagers have adopted it to legitimize their status or enhance the glamour of their lifestyle.

The Social Construction of Electronic Cigarettes

SCOT embraces that technology is socially constructed and contests all technological determinist accounts by seeking to open the ‘black box’. According to Jæger (2001), the understanding is now shift from a technical-­‐natural paradigm to a sociological-­‐social science paradigm and thus, greater emphasis is placed on human beings rather than on machines. Phase 1. Sociological Deconstruction of Technology

Relevant Social Groups (RSGs) Technical artifacts – the e-­‐cigarette – are not static and they are reshaped and redesigned by various social groups. The actors within a RSG share the same set of

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meanings about a specific artifact, but their perceptions can change over time and thus, the structure of RSGs can also change (Bijker, 2001).

Various actors in 2004 E-­‐cigare]e companies &

Note how the RSGs have changed over time, from 2004 – when the e-­‐cigarette was first introduced on the market – to 2009; some of the groups have gained a higher degree of inclusion, such as Public Health Organizations, while bringing more actors under the same roof: Public Health Organizations in 2004 were only represented by FDA, whereas in 2009 they consisted of FDA, American Lung Association, American Cancer Society, American Heart Association, Campaign for Tobacco-­‐Free Kids and World Health Organization (NALBOH, 2009).

Customers (smokers) Public Health Organiza_ons (FDA) Electronic Cigare]e Associa_on

RSGs

Tobacco companies

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Various actors in 2011

Technological Frames Pharmaceu_c al companies E-­‐cigare]e distributors U.S. Court & European Commission MEPs

E-­‐cigare]e companies & Electronic Cigare]e Associa_on

Tobacco companies

Public Health Organiza_ons (FDA)

RSGs Customers (smokers)

Customers (non-­‐ smokers) Insurance companies

This concept applies to the interactions between various actors, which may or may not result in common interpretations of the technology (Bijker and Pinch, 1987). If the interaction results in sharing the same interpretation of e-­‐cigarettes, than a technological frame is built and a relevant group established. E-­‐cigarette companies are perceiving the artifact as a means to make profits; the market for e-­‐cigarettes has great potential for expansion and profit generation and thus, more companies are investing and developing their own version of e-­‐cigarettes – White Cloud, Smoore, ESON, Innokin, Hangsen and Gamucci (Strauss, 2012).

Traditional tobacco companies – BAT, Phillip Morris, Imperial Tobacco – initially viewed e-­‐cigarettes as a ‘fad’ that was supposed to die away after few months; their interpretation changed as the artifact started eroding into their profits and market share. Note how various interactions between actors led BAT change its technological frame and instead of perceiving e-­‐cigarettes as a threat, the company turned it into an opportunity and launched its own e-­‐cigarette brand, Vype.

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Customers’ voice is not heard throughout the story, but ‘vapers’ are strong advocates of e-­‐cigarettes and their regular events and conventions – ‘Vapefest’ – are gaining momentum and elicit people’s curiosity and the media’s attention. Thus, ‘vapers’ are raising awareness that e-­‐cigarettes can be used as accessories to enhance one’s style just like a purse or a necklace does. Public Health Organizations, especially the U.S. Food and Drug Administration, interpret the artifact as posing a risk to people’s health, both smokers and non-­‐smokers. The FDA’s main concern regards the therapeutic benefits that e-­‐cigarettes might have on consumers and thus, perceives the product as a drug. Regulatory bodies such as the U.S. District Court only have a say in the social construction of the e-­‐cigarette because of FDA’s attempt to prove that the technology falls under its drug-­‐device jurisdiction. In Europe, members of the European Parliament (MEPs) and those of the European Commission have divergent interpretations of the artifact. The European Commission wants e-­‐cigarettes to be regulated as medicines, whereas MEPs interpret them as tobacco products (BBC News, 2012). Inclusion The concept refers to the dynamic character of technological development. The degree of an actor’s inclusion is not constant, but it varies on behalf of concrete events. In the case of e-­‐cigarettes, the U.S. District Court would have had a lower degree of inclusion if FDA had not filed suit against e-­‐cigarette distributors. Also, if the Court were to amend e-­‐cigarettes as drug-­‐delivery devices instead of tobacco products, than traditional tobacco companies would not perceive e-­‐cigarettes as a direct threat, since all drug-­‐ devices must receive FDA’s pre-­‐market approval and can only be sold under strict conditions.

Interpretative Flexibility This concept describes that not only do people in different situations interpret the meaning of a particular technology in different ways, but different people also use a technology for different purposes (Jæger, 2001). For instance, current smokers can perceive an e-­‐cigarette as an alternative to traditional cigarettes or as a means to quit smoking, while some teenagers associate e-­‐cigarettes with the glamour and lifestyle of celebrities, since Leonardo DiCaprio and Uma Thurman were spotted using one during the Golden Globes. Having their idols as role models, teenagers might interpret this

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technology as ‘cool’ and are influenced to use one in order to gain status and imitate the lifestyle of the ‘rich and famous’.

Controversy: Tobacco Products or Drugs? The evolutions of the e-­‐cigarette is similar to Bijker’s socially constructed fluorescent lamp, as there are two RSGs involved in the process, namely the FDA and distributors of e-­‐cigarettes – Sottera and Smoking Everywhere (Chowdhury, 2011). FDA perceived the technology as an unapproved drug-­‐delivery device (see Appendix for a background of the controversy). E-­‐cigarette distributors interpret the artifact as a tobacco product and as a means of making profits. If the e-­‐cigarettes were regulated as drugs, all distributors required the FDA’s pre-­‐market approval, which would have resulted in either fewer or even none e-­‐cigarette brands entering the U.S. market. On one hand, FDA’s main concern is the increased number of consumers who would buy e-­‐cigarettes for therapeutic benefits. In other words, FDA viewed the artifact as a more accessible and cheaper alternative to drugs that would be made available to everyone if they were to be regulated under the tobacco product jurisdiction. On the other hand, if the e-­‐ cigarettes were to be regulated as tobacco products, this would only increase nicotine addiction. This is what Bijker (1992) defines as a ‘load controversy’ between the two artifacts.

Phase2. The Social Construction of Technology Stabilization and Closure Bijker and Pinch (1987) define closure as that point when the interpretative flexibility of an artifact diminishes and consensus about the dominant meaning of the artifact is reached among the various RSGs. In the case of e-­‐cigarettes, the controversy is built around two groups with competing divergent technological frames, the e-­‐cigarette distributors and the FDA. Despite the amalgamation of vested interests, a consensus is reached somewhere in the middle between the two divergent interpretations. When the Court ruled that e-­‐ cigarettes would be regulated under FDA’s tobacco jurisdiction and left in place the injunction that prevented FDA from banning e-­‐cigarette imports and from regulating them as drug-­‐devices, the two groups had to find common ground. Although e-­‐ cigarettes do not require FDA’s pre-­‐market approval to be sold, the agency has the authority to ensure that appropriate age and marketing restrictions are in place. The agency also requires all manufacturers and distributors to disclose all ingredients and

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educate consumers about potentially harmful constituents. Although FDA, which would have been better off with e-­‐cigarettes under its drug jurisdiction, cannot view this as a full victory, it can use its drug device authority if e-­‐cigarettes companies make any therapeutic claims about their products. E-­‐cigarette companies had to adjust their initial frames and practices and view regulations not only as a way to legitimize their business, but also as a means to prove that e-­‐cigarette provide a much safer alternative to traditional tobacco products.

Criticisms of SCOT Actors – if one solely focuses on following the actors, the researcher ignores the sociological, cultural and economic processes, while some of the macro-­‐societal structures – such as class, gender and race – are excluded from the story (Winner, 1993). By acknowledging the macro-­‐structures, the researcher might feel forced to incorporate the changes as explanations of why the actors changed their interpretation of e-­‐cigarettes during the story. Such causal explanations of why an actor interprets the e-­‐cigarette the way he/she does means missing the point of SCOT approach. Another issue with actors is that SCOT does not specify when one should stop finding RSGs. The researcher – it is up to the researcher to register all the facts correctly and decide what is important and what is inferior and thus, the researcher runs the danger of being overwhelmed with too much information. It is also up to the researcher’s own intuition to choose the essential controversies to be analyzed and outline the most important elements of each technological frame. For instance, I chose the controversy between e-­‐ cigarette distributors and FDA because I found it essential. However, I could have chosen the debate between MEPs and the European Commission, who also had different interpretations of the artifact. This implies that the analysis I have just conducted might be quite different if another researcher described the technological development. The result would also be different if the other researcher chose other controversy that he or she might find important (Jæger, 2001).

Power relations – SCOT is blind to societal power relations, as it does not ascribe a greater influence to one group than to others. Bijker (1995) responds to this criticism by combining the concept of power and that of technological frames and suggests that stabilization and closure – when the interpretation of technology is fixed – represent power. However, in the case of the e-­‐cigarette, the power position lies with the better-­‐ organized actors, such as distributors, FDA and MEPs, and it is them who have the semiotic power to fix the interpretation of technology. In addition, since the theory does not ascribe grater power to some RSGs than to others, there is no condition that 10

precludes the exclusion of some groups either. Again, it is the researcher’s responsibility to trace all actors and excluding some of them on grounds of irrelevancy is a politically unacceptable project.

Conclusion and further suggestions While TD has been criticized for being too simplistic (Williams and Edge, 1996), the unwillingness of social constructivist scholars to acknowledge the effects of technology has also attracted critique (Winner, 1993). For instance, treating e-­‐cigarettes as a major causal agent of the emergence of ‘vapers’ can be problematic, as it fails to consider human agency. Despite addressing TD’s limitations, SCOT’s focus is too entrenched in the creation and shaping of technology, leaving a gap in understanding the impact of the technological construction on society during and after the process described by SCOT theorists (Winner, 1993). E-­‐cigarettes do impact society, since they pose a threat to traditional tobacco companies, which have to find new markets. Opportunities lie within those groups who are socially excluded either to a lack of resources to acquire e-­‐ cigarettes or the technology has yet to reach them. It would be interesting to analyze the evolution of e-­‐cigarettes from an ANT perspective and discuss the interactions between different actants, human and non-­‐human alike. By acknowledging the broader social context, one can further examine how public policy – or lack of – in less developed countries can influence and further shape the e-­‐cigarette. In conclusion, it is more appropriate to view technology as one of the various and equally significant variables in the complex process of technological development. One must not view the two approaches as mutually exclusive, but rather as constituents of a singe entity, in which technological and human factors have the same importance.

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Appendix Background of the controversy (Source: Chowdhury, 2011)

September 2008 FDA ceased the importation of certain e-­‐ cigarette shipments from China

July 2009 FDA issued a warning against e-­‐cigarettes after the analysis carried on Soterra’s and Smoking Everywhere’s products showed that the liquid nicotine consisted of diethylene glycol and tobacco-­‐specific carcinogens Any mention of what toxins and carcinogens are typically found in traditional tobacco cigarettes were conspicuously missing from FDA’s analysis

2009 Sottera & Smoking Everywhere – two U.S. distributors of e-­‐cigarettes filed suit against FDA, seeking to enjoin its decision from denying entry of their products into the country

Distributors argued that since e-­‐cigarettes contain liquid nicotine, which is derived from tobacco, their e-­‐cigarettes fall within FDA’s tobacco product jurisdiction and not within its drug device authority

District Court ruled in favour of the distributors because e-­‐cigarettes were not marketed to prevent, mitigate or treat the withdrawal symptoms of nicotine addiction, and did not affect the structure and function of the body any more than conventional cigarettes

FDA continued to claim that e-­‐cigarettes should be treated as drugs

December 2010 The Court held that FDA lacks the authority to regulate e-­‐cigarettes as drug-­‐delivery devices FDA filed a petition contending that the panel’s ruling would “erode incentives for companies to develop nicotine replacement therapies, and would exacerbate the problem of nicotine addiction and undercut an important tobacco control measure”

January 2011 FDA’s request dismissed and the Court left in place the injunction that prevented FDA from banning e-­‐cigarette imports and from regulating them as drug-­‐devices

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References 1. B Poland, R. S. 2006. The social context of smoking: the next frontier in tobacco control?. 15 (1), p. 59. Available from: doi: 10.1136/tc.2004.009886. 2. BBC News -­‐ MEPs tighten anti-­‐tobacco laws aimed at young smokers. 2014. BBC News -­‐ MEPs tighten anti-­‐tobacco laws aimed at young smokers. [ONLINE] Available at: http://www.bbc.co.uk/news/world-­‐europe-­‐24439474. 3. Bijker, W. E. (1992) -­‐ The Social Construction of Fluorescent Lighting, or How an Artifact Was Invented in Its Diffusion Stage 4. Bijker, W. E. (1995). Of Bicycles, Bakelites, and Bulbs: Toward a Theory of Sociotechnical Change. Cambridge, MA: The MIT Press. 5. Bijker, W. E. (2001). Social Construction of Technology. In N. J. Smelser & P. B. Baltes (Eds.), International Encyclopedia of the Social & Behavioral Sciences (Vol. 23, pp. 15522-­‐ 15527). Oxford: Elsevier Science Ltd 6. Bijker, W. E., & Pinch, T. (2002). SCOT Answers, Other Questions: A Reply to Nick Clayton.Technology and Culture, 43, 361-­‐369. 7. Bimber, B. (1990), ‘Karl Marx and the Three Faces of Technological Determinism’, Social Studies of Science, Vol.20(2):333-­‐351 8. Cancer Research UK (2013). The Marketing of Electronic Cigarettes in the UK [online] Available at: https://www.cancerresearchuk.org/sites/default/files/cruk_marketing_of_electronic_cigs _nov_2013.pdf 9. Chowdhury, A. (2011). The Evolution of the Electronic Cigarette [online] Available at: http://www.khlaw.com/Files/10084_The%20Evolution%20of%20the%20Electronic%20Cig arette.pdf 10. Dyson, R. (2013), Electronic cigarettes: will they make life insurance cheaper? -­‐ Telegraph. [online] Available at: http://www.telegraph.co.uk/finance/personalfinance/insurance/lifeassurance/10410835/ Electronic-­‐cigarettes-­‐will-­‐they-­‐make-­‐life-­‐insurance-­‐cheaper.html [Accessed: 20 Jan 2014]. 11. Jæger, B. (2001) ‘Strengths and Weaknesses of Constructivistic Studies of Technology ’, found on Blackboard 12. Mail Online. 2013. The emerging subculture of 'vapers' who puff on tricked out, customized electronic cigarettes and insist the new technology will save smokers' lives.

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[online] Available at: http://www.dailymail.co.uk/news/article-­‐2324697/Meet-­‐vapers-­‐E-­‐ cigarette-­‐craze-­‐inspires-­‐bizarre-­‐new-­‐sub-­‐culture.html 13. Mail Online. 2014. People who think e-­‐cigs are healthier are more likely to smoke them. [online] Available at: http://www.dailymail.co.uk/health/article-­‐2535895/People-­‐think-­‐e-­‐ cigarettes-­‐healthier-­‐cigarettes-­‐likely-­‐smoke-­‐new-­‐research-­‐suggests.html 14. NALBOH (2009) found online at http://publichealthlawcenter.org/sites/default/files/resources/article-­‐cork-­‐ecigarettes-­‐ 12-­‐09.pdf 15. Pinch, T. J., & Bijker, W. E. (1987). The social construction of facts and artifacts: Or how the sociology of science and the sociology of technology might benefit each other. In W. E. Bijker, T. P. Hughes, & T. Pinch (Eds.), The social construction of technological systems (pp. 17-­‐50). Cambridge, MA: The MIT Press. 16. Smith, M, & Marx, L. (1994) Does Technology Drive History? Cambridge: MIT Press. 17. Strauss, K. 2012. Why Electronic Cigarettes Are About to Explode. [online] Available at: http://www.forbes.com/sites/karstenstrauss/2012/10/24/why-­‐electronic-­‐cigarettes-­‐ about-­‐to-­‐explode/ 18. Webmd.boots.com. 2014. Electronic cigarette and e-­‐cigarettes FAQs. [online] Available at: http://www.webmd.boots.com/smoking-­‐cessation/electronic-­‐cigarettes-­‐faqs 19. Williams, R., & Edge, D. (1996). The social shaping of technology. Research Policy, 25, 865-­‐ 899. 20. Winner, L. (1986). The whale and the reactor: A search for limits in an age of high technology. Chicago, IL: The University of Chicago Press. 21. Winner, L. (1993). Upon opening the black box and finding it empty: Social constructivism and the philosophy of technology. Science, Technology, and Human Values, 18(3), 362-­‐ 378.

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