E-cigarettes

Scary Stories About Vaping Aren't Helping Anyone

Feel free to reject the advice of this terrible new book.

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Quit Vaping: Your Four-Step, 28-Day Program To Stop Smoking E-Cigarettes, by Brad Lamm, Penguin, 256 pages, $16

They say a lie will go 'round the world while truth is pulling its boots on, but today's debates over vaping may make you wonder if truth should even bother tying its laces. No matter how thoroughly they've been debunked, scare stories about the widespread lethality of e-cigarettes keep seizing the imaginations of journalists, politicians, and concerned parents.

The latest example is Quit Vaping, a new book by the Los Angeles–based "certified intervention specialist" Brad Lamm. Just looking at the front cover, you can see signs that Lamm's approach may be less than scientifically rigorous. There's the line boasting a foreword by Mehmet Oz, better known as Dr. Oz, a TV host notorious for promoting purportedly miraculous dietary supplements. Then there's the subtitle: Your Four-Step, 28-Day Program To Stop Smoking E-Cigarettes. No one "smokes" an e-cigarette—the absence of smoke is the whole point of the device—and this obvious misunderstanding foreshadows worse to come.

One shouldn't judge a book by its cover, but in this case the text lives up to expectations. The opening section, "Lies and Facts," offers a preponderance of the former. Initially I attempted to keep track of misleading statements and critical omissions by marking them with Post-its. By page 30, such a thicket had accumulated that I gave up. Adequately critiquing Lamm's selective reading of the scientific literature would be like trying to perform a live fact-check of a Trump campaign rally; the torrent of error is too much for any one person to handle. This section is a greatest hits collection of anti-vaping stories, recounting every possible danger and dismissing every possible benefit. In that sense, it provides a useful look at how coverage of the topic has become increasingly fear-based.

The moral panic over vaping is driven by two primary narratives: that e-cigarette use is an epidemic among teenagers and that the practice has deadly consequences. Worried parents are clearly a target audience for Lamm's book, and he does nothing to assuage their fears. He advises them to "know the signs" that their child may be a vape addict—signs including acne, secretiveness, irritability, and frequent snacking. As anyone who has known or been a teenager might attest, these are not exactly discriminating diagnostic criteria. And despite the endless press coverage of an adolescent Juul craze, sober analyses of the data generally conclude that most youth vaping is experimental, that habitual use among young people who have not tried tobacco is rare, and that rates of teen smoking are at their lowest levels in recorded history. There are a few genuine reasons for concern, but the kids are largely all right.

The fear that vapers are poisoning themselves en masse got a boost from a mysterious lung illness that emerged in summer 2019. Although it's clear now that contaminants in black market cannabis cartridges were the primary culprit, officials at the Centers for Disease Control and Prevention (CDC) were determined to blame nicotine e-cigarettes. Even the acronym the CDC gave to the disease—EVALI, short for "E-Cigarette or Vaping product use Associated Lung Injury"—prematurely implicated e-cigs. Anti-smoking groups latched onto the story, eager to prove at last that vapers who believed they'd found a safer way of consuming nicotine were deluding themselves.

Yet it was obvious even then that the true causes of the outbreak lay elsewhere. By early September, scientists had identified vitamin E acetate, a THC oil thickener, as a potentially dangerous additive, and by the end of that month the cannabis website Leafly had meticulously documented the ingredient's spread through the marijuana supply chain. In January 2020, the CDC finally acknowledged the overwhelming evidence and revised its guidance to focus on cannabis products.

Despite this, Lamm's book relies on tales of horrific pulmonary illness to portray nicotine vaping as dreadfully lethal—perhaps even more lethal than the smoking it was invented to replace. "Smoking kills people slowly, over many years," Lamm writes. "As we've seen, vaping can kill quickly, within months or a year." As further proof of this conjecture, he cites a couple of cases in which users were killed by exploding vape batteries. These are dramatic tales, but they underscore how rare it is to find instances of e-cigarettes killing their users; though he doesn't mention it, more than 300 Americans die every year in smoking-related fires.

Smoking is the most relevant comparison because smoking and vaping are substitutes for one another. More than 400,000 annual deaths are attributed to smoking in the United States; globally, the figure climbs to 7 million. All but the most ardently ideological opponents will acknowledge, when pressed, that vaping appears to be much safer than smoking. The Royal College of Physicians optimistically estimates that switching from smoking to vaping could reduce risk by 95 percent; another model, offered by David Levy of the Georgetown University Medical Center, predicts that widespread switching could prevent more than 6 million premature deaths in the United States.

Lamm breezily dismisses such benefits as "Big Vape lies." He ignores, among other studies, a randomized control trial published in The New England Journal of Medicine finding that vaping was twice as effective for helping people stop smoking as are pharmaceutical nicotine replacement therapies. He also ignores the stories of millions of ex-smokers who now puff vapor instead.

Lamm notes, accurately, that the Food and Drug Administration has not formally approved e-cigarettes as an aid to quitting smoking. He applies far less scrutiny to his own guidance on how to stop using e-cigarettes, which comprises the rest of Quit Vaping. He offers some reasonable advice, such as avoiding habits and social situations that one associates with vaping. The effectiveness of his "H2M" (for "hand-to-mouth") technique is more dubious. H2M calls for making a fist and breathing into it whenever the reader is struck by the urge to vape, thus satisfying oral fixation. Needless to say, no government agency has approved H2M as an effective means of quitting.

Some of Lamm's other tips are pure California woo: detoxing by avoiding "mucus-producing foods," eating an alkaline diet, chowing down on cruciferous vegetables, and sipping spicy ginger tea. Eating more veggies is rarely a bad idea, but there's a glaring inconsistency to dismissing the substantial body of evidence that favors vaping while preaching the healing powers of Brussels sprouts and oregano.

If Quit Vaping were an isolated example, it would be easy to ignore its Goopification of the vape debate. Regrettably, the conflation of tainted cannabis cartridges and nicotine e-cigarettes is endemic in other media. "After deaths, ban on flavored vapes to be passed by New York City," read a November headline in The New York Times; remarkably, and inexcusably, the article never so much as mentioned cannabis. A February cover story in New York magazine featured the dismissive headline, "Who thought sucking on a battery was a good idea?" Despite being nominally about the long-term risks of vaping nicotine, it devoted nearly half of its 6,000 words to EVALI, illicit marijuana dealers, and critically ill teenagers.

Such alarmist coverage has worsened misperceptions about vaping. A recent Morning Consult poll found that the percentage of American adults who believe e-cigarettes cause fatal lung illness rose by eight points between September 2019 and January 2020. Over the same period, the percentage correctly identifying THC vape liquids as the cause fell by six points. Compared to 2018, the percentage rating e-cigarettes "very harmful" rose 27 points, to 65 percent of the population.

This is a cruel disservice to cigarette smokers, many of whom could benefit from accurate information, access to lower-risk options, and the freedom to make their own decisions. Instead, e-cigarette bans are proliferating, sometimes to the point of involving police enforcement and the threat of jail time. Such excessive reactions illustrate how thoroughly Americans have lost their minds over e-cigarettes even as real cigarettes continue to kill more people every day than vaping has killed ever. The tragic story of EVALI has exposed more about the dangers of the drug war than it has about vaping; the moral panic over e-cigarettes reveals how stubbornly we insist on repeating its mistakes.

NEXT: Black Civilians Arm Themselves To Protest Racial Violence and Protect Black-Owned Businesses

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  2. So, reefer er, vaping madness in paperback?

  3. We might as well face it: this is shaping up as the Century of Fear.

    Despite living safer and more secure lives than ever before in human history, we are hearing one narrative after another about the impending doom and end of civilization, if not our species (and maybe the entire planet). We have seen the slow, incessant burn (get it?) of the warming climate, the shorter but peg-the-meter corona virus panic, and a parade of minor wolf cries, like vaping.

    Humans have always been notoriously bad at understanding risk, further encumbered by few math and logic skills. We have always used emotion and intuitive thinking, and been susceptible to rhetoric and propaganda.

    So what could be new about 21st century society? I suggest that we have indeed changed in our induced sense of fragility. Anyone younger than 30 (or maybe 40 or 50) was raised in a protected if not coddled and smothering environment, told over and over about all sorts of exaggerated threats, and warned about weaknesses in themselves and everything around them. We gave up promoting resiliency and strength, in favor of fragility and vulnerability.

    Now why would we do that?

    1. Time for another clown panic!

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    2. this is shaping up as the Century of Fear.

      I’m afraid you’re right.

      1. ICWUDT and it frightens me.

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          1. It is amazing how the Vape Hunt was so misguided… than we see how so many nations have dealt with COVID and its unfortunate how we all start to loose faith in media. We had out company https://www.dragonvape.ca interviewed by so many news outlets during the Evali scare and 99% of the outlets only used 20 seconds of our interviews.

    3. At the same time that GenY/Z was raised to be scared of their own shadow, they were told repeatedly how awesome they were-the best and smartest kids ever who are going to change the world. Then they wake up one day drowning in debt for worthless college educations and now without a job. But instead they are told they need to be protected from big evil vape because they are still children (the esteemed WHO now considers anyone under 25 to be a child because their brains aren’t fully developed).

    4. Great comment fully agree

    5. Not because of a conspiracy. It is human nature. We fear death and harm, and so want to shield our young from the painful aspects of this world, and in doing so, we make them more vulnerable to fear. This cycle has been getting worst through the past 3 generations. Of course, the non stop 24-7 media, whether it’s left or right, wants to indulge this to justify and expand their existence. So, what do you suggest? A Spartan lifestyle? Get off our devices, turn off our TVs, and do things? If people discovered how to end human life to 200 years, wouldn’t we become even more risk averse and irrational about risk?

  4. Smoking is the most relevant comparison because smoking and vaping are substitutes for one another.

    Hey, are Benzedrex inhalers still a thing?

  5. I manage a small family-owned business where I allow vaping indoors in contravention of state law. The savings in productivity by the hour and fewer sick days is incalculable. We’re healthier and happier.

    I hear the dumbest shit across the counter…

    “My cousin knows a guy who vaped one of them things and got a bad cough, and when they took him to the hospital they found a hunk of metal the size of a dime in his lung!”

    “My aunt’s dog died of an asthma attack because she vaped indoors!”

    “You know them things gots antifreeze in ’em?”

    Now I’m going to have to hear this book title cited ad nauseum from chuckling bubbas who haven’t read it (or any book) but saw it on their faceyspaces feed.

    Almost my entire staff are ex-smokers who now vape. A department head offered free equipment and supplies to all subordinates–he probably prevented several smoking-related deaths and certainly goosed profit significantly. Smoking was highly prevalent in my industry but has nearly vanished thanks to vapes.

    The author deserves to die in a cigarette-caused wildfire.

    1. My guess is that this book will meet the same fate as the dozens if not hundreds of self-help books on quitting smoking, or other habits: collecting dust. Some well-meaning parents might buy it for their 20 something, but they will never read it.

    2. “My cousin knows a guy who vaped one of them things and got a bad cough, and when they took him to the hospital they found a hunk of metal the size of a dime in his lung!”

      Even if that story were true, as far as it goes, there is no way he got the dime sized piece of metal in his lungs from vaping.

  6. Ah the days before COVID, when mango vapes were a crisis.

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