Tobacco Control Advocates Claim Vaping Policies Are Unbalanced, May Cause Harm

Undue emphasis on unproven risks to youth may have undermined efforts to control smoking, costing lives in the process.


A new article in the American Journal of Public Health signed by fifteen past presidents of the Society for Research on Nicotine & Tobacco calls for a recalibration of U.S. policy on e-cigarettes and other nicotine-containing vaping products. The article, "Balancing Consideration of the Risks and Benefits of E-Cigarettes," reviews the relevant scientific literature on the potential risks and benefits of e-cigarettes and concludes that U.S. policy is out of whack.

Here is the abstract:

The topic of e-cigarettes is controversial. Opponents focus on e-cigarettes' risks for young people, while supporters emphasize the potential for e-cigarettes to assist smokers in quitting smoking. Most US health organizations, media coverage, and policymakers have focused primarily on risks to youths. Because of their messaging, much of the public—including most smokers—now consider e-cigarette use as dangerous as or more dangerous than smoking. By contrast, the National Academies of Science, Engineering, and Medicine concluded that e-cigarette use is likely far less hazardous than smoking. Policies intended to reduce adolescent vaping may also reduce adult smokers' use of e-cigarettes in quit attempts.

Because evidence indicates that e-cigarette use can increase the odds of quitting smoking, many scientists, including this essay's authors, encourage the health community, media, and policymakers to more carefully weigh vaping's potential to reduce adult smoking-attributable mortality.

We review the health risks of e-cigarette use, the likelihood that vaping increases smoking cessation, concerns about youth vaping, and the need to balance valid concerns about risks to youths with the potential benefits of increasing adult smoking cessation.

Among other things, the article summarizes evidence suggesting that the misplaced focus of U.S. health agencies (including the FDA and CDC), combined with slanted media reporting, has resulted in widespread public ignorance about the potential risks and benefits of vaping, particularly among those for who whom vaping would be beneficial: current smokers. Perversely, producers and retailers of vaping products cannot do their part to inform smokers that e-cigarettes pose fewer health risks and could help them quit smoking, as providing such information to consumers would violate federal law (as I discuss in this article). The paper also notes extensive research (about which I have blogged here before) finding that well-intentioned restrictions on e-cigarettes can increase smoking rates, including among youth.

Here is the paper's conclusion:

We share the very legitimate concerns about youth vaping with the entire field of public health. Our goal is to put those concerns in perspective. We agree with former Surgeon General C. Everett Koop who, in 1998, urged that "[A]s we take every action to save our children from the ravages of tobacco, we should demonstrate that our commitment to those who are already addicted . . . will never expire." The latter appears at risk today.

While evidence suggests that vaping is currently increasing smoking cessation, the impact could be much larger if the public health community paid serious attention to vaping's potential to help adult smokers, smokers received accurate information about the relative risks of vaping and smoking, and policies were designed with the potential effects on smokers in mind. That is not happening. The need to pay attention to adult smokers is particularly important from a social justice perspective. African Americans suffer disproportionately from smoking-related deaths, a disparity that, a new clinical trial shows, vaping could reduce. Today's smokers come disproportionately from lower education and income groups, the LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) community, and populations suffering from mental health conditions and from other drug addictions. Smoking accounts for a significant proportion of the large life expectancy difference between affluent and poorer Americans. For smokers with serious psychological  distress, two thirds of their 15-year loss of life expectancy compared with nonsmokers without serious psychological distress may be attributable to their smoking. Vaping might assist more of these smokers to quit.

To the more privileged members of society, today's smokers may be nearly invisible. Indeed, many affluent, educated US persons may believe the problem of smoking has been largely "solved." They do not smoke. Their friends and colleagues do not smoke. There is no smoking in their workplaces, nor in the restaurants and bars they frequent. Yet 1 of every 7 US adults remains a smoker today.

Smoking will claim the lives of 480 000 of our fellow citizens this year alone.

NEXT: As Eviction Moratorium Case Returns to SCOTUS, Landlords Use Biden's Words Against Him

Editor's Note: We invite comments and request that they be civil and on-topic. We do not moderate or assume any responsibility for comments, which are owned by the readers who post them. Comments do not represent the views of or Reason Foundation. We reserve the right to delete any comment for any reason at any time. Report abuses.

  1. Only where people vaping and smoking crosses on non-vaping and smoking person’s rights is there any legitimacy in regulation.

    1. I smoked 4 packs a day for 28 years. Vaping saved me. I’ll be damned if I let the merely good be the enemy of the perfect.

      Yes nicotine is highly addictive. Alone, however, the damage it causes is on par with caffeine. I can live with that.

      I don’t buy the whole sweet targets children argument. Have you looked around? Do you mean to tell me many it not most adults don’t have a huge sweet tooth? It’s so absurd as to be laughable.

      These days I let everyone assume I have medical MJ and they leave me alone.

    2. Apparently you haven’t gotten the message that the mere existence of vapers (and smokers) infringes on the rights of those who do not vape or smoke. You could extend that to people who use any product deemed uneccessary for survival (alcohol, chocolate, even cars). When you have a collectivist worldview, anything that takes away resources from solving social injustices, infringes on the rights of the poor and marginalized. In other words, I should be donating the money I spend on beer and tobacco to the poor instead of for my own enjoyment .

    3. Current smokers can quit. It happens all the time. Policy which puts that burden on current smokers is far wiser than policy which reopens the door for addiction-based business models to recruit and create new addicts, and thus continue indefinitely.

      1. Current smokers can quit. It happens all the time. Policy which puts that burden on current smokers is far wiser …

        Statistically current smokers can’t quit, and it [quitting] happens rarely. The establishment’s consensus is smokers are deplorable who should suffer the effects and die early, as you so enthusiastically demonstrate.

        1. Yes, we believe that people who make bad choices should bear the brunt of the consequences of their choices, in large part because that’s how responsibility works and in large other part because overall people tend to make better choices when they bear the consequences of those choices. That isn’t hard, mean, or controversial.

          1. Now do equal protection and AIDS policy . . . . or children’s gender (re)assignment and vaping. Nothing personal, but the hypocrisy is rank.

            More hypocrisy is the government intervening in the personal-choice only when it’s popular in the bureaucrat class’ viewpoint; which often suspiciously coincides with additional difficulties layered onto a disfavored class.

    4. Marketing addiction to children—even if it proved medically harmless—is a financial crime against them. I think that justifies regulation.

      1. Ahh the good old days of a few years ago, when a giant vaping company, owned by a tobacco company, feigned social responsibility to “protecting teens”, by pulling sales from 97,000 “regular stores”, giving giant scary posters for 7-11s to put up, and bragging on continuous radio ads how good they were protecting teens, inviting crushing regulation onto themselves and, gee, vaping industry as a whole, net effect bringing cigarette sales back up.

        Good times. Would have made a good arc in House of Cards.

        Now let’s continue clubbing vaping like the trained seals they want us to be.

      2. Marketing addiction to children—even if it proved medically harmless …

        Now do Facebook, TicToc, and Twitter.

        Your ‘for the children’ rants are BS; you choose children because they can’t vote.

  2. One of the Trump Administrations major mistakes, along with not de-scheduling marijuana.

  3. Generally, once you get past the tobacco industry astroturf, this is a temperance movement. They’re not concerned people will be harmed by vaping, they’re concerned people will enjoy it.

Please to post comments