Setting the Record Straight on Vaping
There’s a lot to unpack from this recent piece in The Federalist written by my friend and former White House advisor, Katy Talento, which endorses government plans to limit access to e-cigarette devices and flavors. I’ll take her main arguments — which are the ones most commonly made to support vaping bans — one at a time.Vaping Is Just as Bad as SmokingKaty belittles the idea that vaping is a public health win. Yet harm reduction is a valid goal, and vaping has helped millions quit traditional, combustible cigarettes. This is in part because vaping allows people to continue to mimic the physical act of smoking (which is particularly important to women) but with a device that delivers the nicotine in a safer, non-carcinogenic way.Don’t take my word for it. Consider the positions of Public Health England, the Royal College of Physicians, and Cancer Research U.K., all of which endorse e-cigarettes as an effective smoking cessation tool. A recent study published in the New England Journal of Medicine confirms the efficacy of these devices, finding that smokers who used e-cigarettes were twice as likely as those who used other smoking cessation tools to successfully quit smoking. And these public health organizations estimate that vaping is 95 percent less harmful than smoking. Even the FDA admits that vaping is safer than traditional smoking.Vaping and NicotineKaty describes how e-cigarettes work and writes that vape liquid is a “concoction of chemicals containing high-concentration of nicotine.” Yet in reality, vape liquid typically includes a combination of three main ingredients: propylene glycol, vegetable glycerin, and flavorings, all of which are approved for use in food, cosmetics, and pharmaceuticals. And with many but not all e-cigarette devices, nicotine is optional. If a user chooses to include nicotine in their vape liquid, most e-cigarettes are designed to allow the user to control how much nicotine they are vaping.Many former smokers report being able to quit smoking and vaping entirely because of this dose control — easing off by slowly lowering the amount of nicotine they vape until eventually they can stop completely (In a podcast I did with Liz Mair, she tells a compelling story about using e-cigarettes to stop smoking, and eventually stop vaping too).“Big Vape” Is Just the New Big TobaccoKaty claims the teen vaping issue is due to the nefarious actions of “Big Vape.” Yet, while there are larger e-cigarette companies, like Juul and Phillip Morris (which manufactures an e-cigarette device called IQOS, only sold outside the U.S.), the e-cigarette industry in the United States is largely made up of small, individually run vape shops. In fact, currently, there are about 10,000 of these small retail outfits (that are not connected to nor supported by “Big Vape”). These small businesses employ more than 90,000 people and most of these shops manufacture their own e-liquids and flavors.Most will close if e-cigarette and flavor bans are enacted.Flavors Are Just for KidsAccording to multiple studies, fruit flavors are the preferred flavor of all e-cigarette users — and most importantly, the preferred flavor of former smokers who have switched to e-cigarettes. Candy or dessert flavors are the next most popular. Tobacco flavor is generally found to be the least preferred flavor in all age groups. In other words, vape liquid manufacturers are producing fruit flavors to respond to consumer demand, not to bait kids into illegally vaping.Of course, as with any industry, there are bad actors and those who act in bad faith. And yes, there have been vape liquid manufacturers who have packaged flavors to attract youth. That’s terrible and shouldn’t happen. But those products were taken off the shelf by the FDA.Selling e-cigarette products to kids is already illegal and many vape companies actually agree that the legal age to purchase e-cigarettes should be increased from 18, the legal age in most states, to 21. (I do not hold this view, but “Big Vape” does.)Epidemic Levels of VapingKaty writes, “Every kid, including yours, has tried vaping.” She’s correct that lots of kids “try” vaping. But the good news is that very few make it a habit. The CDC has found that only about 5.7 percent of teens (that includes 18 and 19 year olds) habitually vape (I analyzed the CDC data at length here).It’s certainly worth examining what we can do to reduce this small number of habitual teen e-cigarette users and advise teens not to vape. But it’s folly to introduce prohibition policies on a product that has helped millions of adults quit the much more dangerous habit of smoking. How is that not a public health failure?Vaping Is a Gateway to Traditional Cigarette Use for TeensKaty suggests that vaping is a gateway to smoking traditional cigarettes, saying that “studies show that kids vape first, and then switch to conventional cigarettes.” Except that’s not at all what the study says. Instead, the study says, “kids who vape the highest level of nicotine are the most likely to switch to cigarettes.” That’s troubling, but hardly surprising given the highly addictive nature of nicotine, which makes them vulnerable to nicotine addiction.Moreover, as Katy mentions elsewhere, there has been a major decline in teen cigarette smoking and cigarette smoking across the board. In fact, teen smoking is at a historic low. That’s despite — and perhaps even because of — the increase in vaping. If vaping were a gateway to smoking, surely teen smoking rates would increase. They have not.Throwing Innovation out with the Vape LiquidCalls to ban vaping are largely being driven by the recent outbreak of lung disease overwhelmingly associated with people using black market THC-tainted vape liquid. Bans on vaping products, such as bans on popular, FDA-regulated flavors, won’t solve that problem, but rather will grow the already thriving black market for vape products.It’s unfortunate that Katy ends her piece by suggesting that those who warn about the dangers of prohibition policies are being paid off by “Big Vape” to do so. Groups tend to get funding from a wide variety of financial backers, including corporations. But corporations tend to support organizations that share their principles already. For example, the group I work for has received some small support (about 1 percent of our budget) from corporations related to vaping. Yet I wrote on these issues long before we received that support and would continue to, absent their contribution. Rather than impugning motives, it would be far better to focus on the merits of the policy.We Can’t Outlaw All Bad ChoicesOf course, we all wish that people would make healthier choices, such as not smoking or engaging in addictive behaviors. But we don’t ban junk food or alcohol for adults, nor do we limit access to retail stores to help those with shopping addictions (thank God!). The government should focus on enforcing the restrictions on selling vaping products to minors and work diligently to warn the public against illegal, black-market vaping products. But the government has no business wiping out an industry that actually has saved lives and will, if left in the marketplace, save millions more.
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