E-cigarettes

Congressional Hearings Conflate Vaping With Smoking, Legal E-Cigarettes With Black-Market THC Products

Democratic legislators ignore the tremendous harm-reducing potential of smoke-free nicotine delivery.

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The titles of two congressional hearings held yesterday give you a sense of how serious Democratic legislators are about understanding health issues related to vaping. A subcommittee of the House Energy and Commerce Committee considered "Legislation to Reverse the Youth Tobacco Epidemic," while a subcommittee of the House Appropriations Committee heard testimony about "E-Cigarettes: An Emerging Threat to Public Health." The first title assumes a "youth tobacco epidemic" that does not exist, while the second conflates black-market cannabis products, which have been implicated in the vast majority of vaping-related lung injuries reported in recent months, with legal e-cigarettes that offer smokers a much less hazardous source of nicotine.

Since 2011, according to the National Youth Tobacco Survey (NYTS), the share of high school students who say they have smoked cigarettes in the past month has fallen from 15.8 percent to 5.8 percent. In this context, the "youth tobacco epidemic" perceived by members of Congress is nonsensical.

Counterintuitively, the phrase refers not to cigarette smoking but to use of e-cigarettes, which do not contain tobacco and do not burn anything. During the same period when adolescent smoking reached record lows, the share of high school students who reported past-month e-cigarette use in the NYTS rose 18-fold, from 1.5 percent in 2011 to 27.5 percent in 2019.

While there may be legitimate reasons to be concerned about that trend, increased tobacco use is not one of them. In fact, the downward trend in smoking among teenagers and young adults accelerated as e-cigarettes became more popular, which suggests that people who otherwise would be smoking are vaping instead. Given the huge difference between the dangers posed by smoking and the dangers posed by vaping, that shift represents an unambiguous improvement in terms of health risks.

Unsurprisingly, the hearing on the nonexistent "youth tobacco epidemic" was stacked heavily against e-cigarettes. The subcommittee heard from Dorian Fuhrman, co-founder of Parents Against Vaping E-Cigarettes (PAVE); Phillip Gardiner, senior program officer at the University of California's Tobacco Related Disease Research Program; Matthew Myers, president of the Campaign for Tobacco-Free Kids; and Susanne Tanski, a pediatrician representing the American Academy of Pediatrics. All four expressed alarm at the dramatic rise in adolescent vaping and endorsed a federal ban on the flavored e-cigarettes that former smokers overwhelmingly prefer.

At the hearing, Rep. Frank Pallone (D–N.J.), chairman of the House Energy and Commerce Committee, touted his mendaciously named Reversing the Youth Tobacco Epidemic Act, which includes a ban on e-cigarette flavors. "We are facing a serious problem that needs a comprehensive solution," Pallone said in his opening statement. "We simply cannot lose another generation to a lifetime of nicotine addiction." Tanski likewise argued that "adolescents simply do not stand a chance" of avoiding addiction when they try Juul, the dominant e-cigarette brand, because it delivers nicotine in an especially alluring way.

Data from the NYTS, the same survey that has generated the panic about adolescent vaping, contradict such claims. A recent analysis of the 2018 NYTS results found that just 1 percent of high school students who had never used tobacco reported vaping on 20 or more days in the previous month. Among vapers who had never smoked, University College London health psychologist Martin Jarvis and his collaborators found, less than 4 percent reported craving nicotine; just 3 reported wanting to vape within a half-hour of waking up. Meanwhile, 62 percent said they had used e-cigarettes on 10 or fewer days in their lives. These findings are plainly inconsistent with Pallone's fear that e-cigarettes are hooking an entire generation on nicotine and Tanski's assertion that addiction is inevitable once a teenager tries Juul.

"Data from the NYTS do not support claims of a new epidemic of nicotine addiction stemming from use of e-cigarettes, nor concerns that declines in youth tobacco addiction stand to be reversed after years of progress," Jarvis et al. write. "Among current e-cigarette users who had never tried tobacco products, responses consistently pointed to minimal dependence."

Among teenagers who have smoked cigarettes, frequent vaping and signs of addiction are much more common. But as Jarvis et al. note, the evidence indicates that vaping, by and large, is replacing smoking among these e-cigarette users, which by any rational standard should count as a public health victory.

The only witness at the Energy and Commerce subcommittee hearing who highlighted the harm-reducing potential of e-cigarettes was Boston University public health professor Michael Siegel, a physician and longtime anti-smoking activist. Siegel warned that Pallone's proposed ban on flavored e-cigarettes, like a similar ban that the Food and Drug Administration (FDA) plans to impose, would "create a new black market for flavored e-liquids," products of unknown provenance and composition that pose special hazards and may be contributing, along with illegal THC vapes, to the recent outbreak of acute respiratory illnesses, which involved about 1,300 cases and 26 deaths as of October 8.

Siegel also emphasized the impact that Pallone's ban would have on smokers who have switched to vaping. "More than 2.5 million adult smokers in the U.S. have quit smoking completely by switching to electronic cigarettes, and most of these ex-smokers rely on flavored e-liquids to keep them off of real cigarettes," he said. "If flavored e-cigarettes are banned, there is no question in my mind that many of these ex-smokers will return to cigarette smoking. Most of those who don't will turn to a new, potentially dangerous black market that would be created by this legislation."

The House Appropriations subcommittee hearing was similarly slanted against e-cigarettes. Four of the five witnesses emphasized the hazards of vaping without clearly distinguishing between THC and nicotine products or between legal and black-market products. But a careful reading of testimony by one of those witnesses shows why such distinctions are important.

Anne Schuchat, principal deputy director of the U.S. Centers for Disease Control and Prevention (CDC), reported that in cases where the information was available, just 13 percent of patients with respiratory symptoms have said they vaped only nicotine. She also noted that "information about the use of e-cigarettes or other vaping products relies largely on self-report, and interviewees may be hesitant to share information about their use of substances such as marijuana." In other words, the role of black-market cannabis products may be even bigger than the CDC's numbers suggest.

"Based on these findings, we believe THC-containing products may contain chemicals or components that are contributing to this outbreak, and that most of these products appear to be obtained from informal sources like friends and family [or] off the street," Schuchat said. "However, because nicotine-containing products have been reported to be used, either alone or in conjunction with THC-containing products, we cannot exclude the possibility that nicotine-containing products may have a role. No one product, brand, chemical, or additive has been determined to be the cause of these lung injuries."

That muddled message is dangerous for two reasons. First, it does not give cannabis consumers a clear warning about the hazards of black-market THC vapes. Second, it scares current and former smokers away from potentially lifesaving products by implying that legal, nicotine-delivering e-cigarettes might be deadly. The CDC and the FDA both caution that former smokers who have switched to vaping should not return to their old habits, which are indisputably more dangerous. But the CDC's evidence-free suggestion that products like Juul might play a role in these lung diseases undermines that crucial point.

Meanwhile, Meredith Berkman, another co-founder of the anti-vaping group PAVE, explicitly linked the "terrifying" outbreak of lung disease to "the vaping epidemic" among teenagers who use e-cigarettes like Juul, even though such products have been used by millions of Americans for years without reports of life-threatening respiratory symptoms. Renée D. Coleman-Mitchell, commissioner of the Connecticut Department of Public Health, drew the same connection, again without any evidence that legal e-cigarettes are responsible for these illnesses. Stanford University pediatrician Bonnie Halpern-Felsher likewise cited "the current concern over the vaping-related lung illnesses and deaths that may or may not be caused by nicotine e-cigarettes."

Washington, D.C., psychiatrist Sally Satel, a resident scholar at the American Enterprise Institute, was the only witness who avoided conflating the hazards of black-market products with the hazards of legal e-cigarettes. "The lung injury problem is a story of the dangers of the black market, not of vaping," she noted. "Consumers have been using commercially available vaping devices and nicotine products for 10 years without a single recorded death or any surge of illnesses…until this summer. What we are observing today is consistent with a relatively acute contamination."

Implying that all vaping products are equally dangerous, Satel warned, "is a hazard to smokers who have already switched to e-cigarettes and now risk return to smoking combustible cigarettes." She also noted the problems with banning flavored e-cigarettes. "A ban on flavors is completely irrelevant to the outbreak of lung disease," she said. "Eliminating flavored nicotine e-liquids will not prevent further cases of lung disease because those products had nothing to do with the outbreak." Worse, Satel added, "a sizeable number of vapers will resume smoking" once the products they prefer are no longer legally available, while "others will seek out counterfeit enterprises" offering mystery e-liquids that may contain dangerous additives or contaminants.

"Vaping products are intended to help smokers relinquish cigarettes," Satel said. "They help adult smokers to quit smoking and are substantially less dangerous than smoking. As with any public health intervention, the unintended consequences of regulatory policies aimed at teen vaping must be kept in the forefront of our thinking. To appreciate why curbing adult access has such significant public health implications, we need to acknowledge the vast health benefits of vaping for smokers….We can protect teens through more aggressive barriers to access. At the same time, we can save smokers' lives and combat the leading cause of preventable death in the world by preserving adult smokers' access to a valuable smoking-cessation method."

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  1. Did you really expect a Congressional hearing to shed light on a subject instead of providing a stage for a bunch of shrill, cheap theatrics?

    1. Got to get that soundbite for the fundraising. What is more important to you debate and reason or getting the R/D party more money so they can win the MOST IMPORTANT ELECTION IN HISTORY*!

      *hint that is the next election after the last most important election in history.

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  2. I hear baseball players are vaping their steroids instead of chewing tobacco now. We should get another congressional inquiry together.

  3. There is no connection to reality in Washington. I hate these slimy lying bastards. Thanks for the excellent reporting, but the game was rigged from the start. I’ve begun researching making my own juice.

    1. My father in law does this. He bought a giant jug of nicotine that he keeps in a basement fridge, and mixes his own. He also bought all the fixings to make his own coils and other “consumables” because he was convinced 2 years ago that they were going to outlaw vaping. What a shock. He was right!

      1. They want to ban flavors but you can buy a huge jug of nicotine which is extremely poisonous.

  4. WE NEED MOAR LAWZ!

    1. Did you study Lawz? You’re a genius!

  5. Vilify, regulate, and tax. As a matter of logistics, you cannot tax without regulating, and you cannot regulate without vilifying. These hearings, along with a handful of states taking executive action to ban vaping products, are structured to create the perception of an emergency in need of a solution.

    Prior to the “crisis,” the general perception was that vaping was a safer, healthier alternative to combustible cigarettes. Now, virtually overnight, a perception has developed that vaping is just as dangerous, if not more so, than combustible cigarettes. With that equivocation firmly rooted in the public consciousness, despite its obvious falsity, regulation will be easier to enact.

    “Sure, people should have a choice, but I guess its harmful enough, I think, so I don’t really mind the taxes. After all, the government is looking out for us, and it’s for a good cause and, you know, people shouldn’t really be doing something so bad anyway.”

    This blasé attitude, emerging from a campaign of vilification, will ensure, if nothing else, that even if people object to the enactment of new regulations and taxes over the vaping industry, they will *still* be accepting of them. “Better safe than sorry,” will be the refrain, and most people will hardly give it another thought.

    Vilify, regulate, and tax.

  6. Why do peopel go to these hearings and let these idiots demonize them?

    Melt down. Call them imbeciles on camera and then explain why they are idiots, and they’re killing people.

    And before all you pearl clutchers come at me, THEY ARE KILLING PEOPLE WITH THESE DECISIONS. And they’re not going to let you come away looking good no matter what you say. So speak truth to their power you fucking pussies.

    1. Guys, listen up, Tulpa has something super serious to say.

    2. >>Call them imbeciles on camera and then explain why they are idiots

      someone should yes. Congress never calls me lol.

    3. I’m not a big Corey Lewandowski fan, but his testimony to Congress was the blueprint for how to handle this. “That’s not a question it’s a rant” should be a standard reply.

  7. It’s of paramount importance to remind everyone here that Democrats are the party of ending the drug war.

    1. Unions demand repeal and replace!

      1. And the party of the working class. We can’t forget that either.

        1. And the party of science . . .

          1. And the party of guilt and grievance.

  8. In other news, Juul announced today that they would stop selling their flavored pods. They stopped selling mango, cucumber, fruit, creme, etc. They will only sell the tobacco, mint, and menthol flavors.

    The news was immediately met by goalpost shifting. In the AP article, they announced that only 10% of Juul’s sales are fruit flavor. Instead, mint/menthol account for most of the sales and are most popular with teens. Therefore, since Juul will continue to sell them, clearly they aren’t interested in reducing underage vaping.

    I’m pretty confused by that since all politicians have been assuring me that the fruity flavors were popular with kids so it was important to only sell tobacco/mint/menthol to ensure only adults were interested.

    1. I got a hint for you:
      They are lying about everything in order to take complete control of the economy, the the nation.

  9. Well, we let them say men are women, and women are men.
    We let them say hundred of dollars in fees and background checks are not an infringement.
    We let them say a simple ID check is an unconstitutional barrier to voting.
    We let them say child sacrifice is womens health.
    We let them say believing in either of the two largest religions in the world is contemptible bigotry.
    We let them say taking our stuff without even so much as an arrest is not a fourth or fifth amendment violation.
    We let them say restrictions on time and place and content are not restrictions on speech.
    We let them say the natural warming and cooling cycles of nature are a man made crisis.
    Why would they expect us to NOT let them get away with saying a product with no tobacco is a tobacco product?

    1. The soda tax in major cities hits all bottled beverages including green tea with no added sugar, an antioxidant health drink in Japan. Democrats..a federal jobs program for law grad control freak, utopian collective sociopaths.

  10. One of the vaping products gets their nicotine from eggplant leaves. No tobacco at all. Legislators’ heads exploding.

    1. They already have nicotine in their crosshairs-soon to be available by prescription only

      1. Unfortunately, there is only a small chemical distinction between nicotine and caffeine. Why outlaw only the one?

  11. You don’t honestly think that these idiots either know or care about any differences, do you?

  12. I wonder how many of the politicians who want to ban flavored vaping fluid “because it delivers nicotine in an especially alluring way“ are also in favor of allowing the sale of chocolate, candy and confections infused with cannabis. If flavored vaping fluid constitutes “marketing to children,” wouldn’t the same be true of sweet-tasting edibles?

    It would be nice if politicians at least pretended to be intellectually consistent.

    1. Hell, most of these articles aren’t even clear as to whether flavor-only vape is being deprecated as well. My understanding is that a significant fraction of vaping is done with neither THC, CBD, nor nicotine.

  13. “adolescents simply do not stand a chance” of avoiding addiction when they try Juul, the dominant e-cigarette brand, because it delivers nicotine in an especially alluring way.”

    Just make the packages read “Only For Use By Fags and Posers”. See? Much less alluring to teens. Then that Truth advertising campaign can run commercials of teens vaping and then showing them covered in kaposi’s sarcoma while wearing a leather harness, aviator sunglasses, and a leather motorcycle cap.
    You just have to find a way to reach the teens and speak their language.

    1. Alas, we all “simply do not stand a chance”, and are only victims waiting to be harvested.

      Everything is so terrible and unfair.

  14. And, of course, Big Tobacco has no involvement in this at all.

  15. My stupid generation loves vaping and loves government control. Well, the government is about to assert control over vaping, good and hard.

  16. The party of science(ism) ignores science for feelz yet again- I am shocked, just shocked I tell ya…Proggies want problems, not solutions. Another thing: in many states you now have to be 21 to buy vapes, so if they are concerned about the flavors, they should also ban flavored booze and beers, but then we are all children as far as they’re concerned

    1. We are all victims.

  17. Pallone said “we simply cannot lose another generation to a lifetime of nicotine addiction.” That’s right kids, drink up, pop all the government-approved pills you want, and prepare to kill and be killed in the great wars we have planned for you!

    Likewise, it should go without saying that if you “see something, say something.” If you suspect your friends of vaping, contact your local DARE officer, Stasi representative or the nearest fusion center immediately.

    1. While we are at it lets ban alcohol again, once chocolate was considered a dangerous drug

  18. Where’s love-constitution ???

    Where’s the debate on what enumerated authority the federal government even HAS in regulating ANY U.S. product.. Last I read in the Constitution that power was only granted when two states get into a conflict.

  19. article demonstrating once again that Reason writers’ favorite word to use for affectation purposes is “conflate”

  20. Dems are fucking idiots with everything…why should this be any different. I’m beginning to think one of the qualifications to be a Dem is you must be retarded.

    1. Yes-because the mentally challenged are more than happy to let others think for them-pretty much the essence of progressivism

  21. One can vape oneself to sleep, then vape again whenever one wakes up during the night then vape in the morning

    1. Sounds just like another favorite teenage boy activity, but so far no reports of vaping causing blindness or hairy hands

  22. Jacob: You should make the point that Canada isn’t experiencing a vaping crisis, which indicates that it is bad black market products here that are doing the damage. So does the absence or paucity of injury reports from other countries.

    Another fact that suggests the influence of bad black market products on the crisis is the patchiness of injury reports on the CDC’s map of U.S. states’ reports. As of a week ago, California showed over 100 injuries, while its three neighboring states (and Washington) showed none. This likely results from black market production and distribution in California being concentrated locally and not having spread far since the beginning of the outbreak.

    1. In typically arrogant American fashion, the political and medical establishment here NEVER looks at what is happening in other countries if it might undermine their agenda

  23. It’s not about health and safety it’s about government losing all that sweet tobacco tax money.

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  25. I wonder if departments of the federal government were named fruity flavors congress would then take action to ban them. FDA is now Melon Twist, Homeland Security is now Strawberry Belts, EPA is now Starstruck Watermelon…..get to banning!!

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