Uneducating Americans on Vaping

Since the FDA began regulating vaping products as "tobacco" products, American ignorance about vaping's realtive risks has gotten worse.

Food and Drug Administration regulation of tobacco products is supposed to help protect public health. Yet since the FDA endeavored to regulate electronic cigarette and other vaping products through its tobacco regulation program, Americans' understanding of the relative risks posed by various types of tobacco products has gotten worse. Today fewer Americans understand that vaping poses less risk than smoking, and this ignorance could have significant consequences for public health.

In the new issue of Regulation, Jacob James Rich and I discuss this problem in our article "Uneducating Americans on Vaping." Here is how the article begins:

Cigarette smoking continues to be a leading cause of avoidable death in the United States. Nearly half a million Americans die each year from smoking‐​related diseases according to the Centers for Disease Control and Prevention. Understandably, this makes reducing smoking and discouraging youth smoking significant public health priorities.

Fortunately, there are less dangerous ways for smokers to satisfy their nicotine habits than smoking cigarettes. Electronic cigarettes and other vaping products (so‐​called "electronic nicotine delivery devices" or ENDS) appear to be a substantially safer substitute for combustible cigarettes. Such products can even help some smokers quit altogether. Yet too few people know this, and the ignorance appears to be getting worse.

Since the Food and Drug Administration began regulating ENDS as "tobacco products," public understanding of the relative risks of various tobacco products has declined. The FDA and many other expert authorities accept that there is a "continuum of risk" and that vaping is less dangerous than smoking. Yet, a majority of Americans do not understand this to be true. Smokers in particular do not realize there are less dangerous alternatives to combustible cigarettes—alternatives that could save their lives.

What explains widespread and worsening understanding of the relative risks of vaping? And what can be done about it? Improved messaging and public statements from public health authorities could help, but we are unconvinced such efforts would be enough. The ability of government messaging to inform consumers is inherently limited, particularly when public trust in institutions is flagging. As we explain below, educating Americans about the relative risks of tobacco products may require rethinking the way we classify and regulate such products and in particular allowing those with an economic interest in educating Americans about the relative risks of nicotine products to do so.

And our conclusion:

Public health experts are rightly concerned about the long‐​term consequences of ENDS use, but leading medical journals continue to highlight the urgent need to accurately communicate to the public that these products are substantially safer to consume than conventional cigarettes. Relying upon government public health authorities to convey timely, accurate, and accessible information to consumers about the relative risks of nicotine products has failed. Americans are less informed about the relative risks of ENDS as compared to combustible cigarettes than ever before, and this lack of understanding has public health consequences.

Were ENDS manufacturers allowed to make truthful and substantiated health claims about their products, they would be free to engage in market‐​driven competitive discovery of how to inform smokers of the potential health benefits of switching to their products. These incentives would also motivate the manufacturers to make their information more salient and digestible to potential customers. The existing regulatory framework and the FDA's interpretation of its own regulatory authority make such market‐​driven consumer education unlawful, however. As a consequence, public health advocates are deprived of a potentially powerful tool in the campaign to reduce the health consequences of smoking.

Comments

[Stephen Lathrop]

An argument Adler offers in favor of vaping is that it is marginally better as an aid to quit smoking cigarettes, when compared to other methods like nicotine gum which have proved almost pathetically ineffective. So, a small improvement on a bad method—in exchange for a massive, open-ended restart for a nicotine addiction industry which had previously been on a path toward oblivion.

Adler does not merely discuss, "Uneducating Americans on Vaping," he demonstrates it.

[Kazinski]

While smoking is dangerous to your health the data on nicotine by itself is a lot less clear.

According to The Scientific American “Scientists don't doubt nicotine is addictive, but some wonder if a daily dose could be as benign as the caffeine many of us get from a morning coffee.”

https://www.scientificamerican.com/article/is-nicotine-all-bad/

If the health risks are as benign as coffee and the benefits are even half as impressive as caffeine why should the government have any role in restricting its use?

Why are we legalizing marijuana across the country, decriminalizing opioids and meth in a lot of jurisdictions, and yet doubling down on the moral panic over nicotine?

[Dilan Esper]

Stephen, "nicotine addiction" isn't the reason we heavily regulate smoking. It's because the addiction is to a substance that causes lung cancer and emphysema and other serious and mortal health conditions.

So when you create a product that allows people the pleasure of nicotine consumption (including the added pleasure of morally offending Stephen Lathrop with their choices) without the health risks of smoking, that is an unalloyed good. The regulatory system does not exist to impose your warped morality on the rest of the population and deny them pleasures simply because it allows you to enjoy the pleasure of being a moral scold.

[Gandydancer]

“leading medical journals continue to highlight the URGENT need to accurately communicate to the public that these products…”

The country is approaching the brink of war with the most-armed nuclear power on the planet and is in general going to hell in a handbasket and yet Adler thinks THIS is urgent? The “Libertarian” obsession with drug taking is beyond ridiculous, but I guess he’s getting paid by someone to set his (and our) hair on fire.

[Kazinski]

Well as a parent of a former smoker and current vaper I think it’s important to keep vaping legal.

Perhaps we should send Russia some vaping products so they can take a break and calm down a little.

[Gandydancer]

My impression is that they still smoke a lot and can get all the nicotine hey want that way.

But in any case I am uninterested in regulating vaping or advertising the alleged benefits of vaping. Or of cigarettes, for that matter, But the question isn't an urgent one.

[Tom for equal rights]

There is no question that vaping is bad.

However, the attempts to ban and/or restrict vaping show the FDA lacks an understanding of the basic concept of marginal cost vs marginal benefit. Likewise, the EPA and the CDC have shown a deficiency in understanding and applying the concept

[Brett Bellmore]

Well, no question for SOME value of "bad". It's not as harmless as nicotine gum, perhaps, but essentially all of the public bad health news about vaping is due to black market vaping formulations where something other than the nicotine was causing the health damage.

[Rev. Arthur L. Kirkland]

That headline is deft — the vaping Americans are the uneducated Americans.

One more reason to avoid being a half-educated clinger.

[Frank Drackman]

"Coach", I know you've been "Indisposed" for awhile
but the peoples doing the Vaping aren't who you think they are.
You really need to get umm kinder, kinder, kinder, gentler, gentler, Genter, the Gentleman from PA Senator Fetterman to sign your commutation package, I'm sure your guilty as (redacted) and obviously unrepentant, but you're taking a cell that could be used for someone with a working member.

Frank

[Frank Drackman]

The whole Vaping nonsense just confirms some peoples can't stand other peoples enjoying themselves.
1: There's no "Smoke"
2: There's no "Tobacco"
3: Why did J-hovah give us Nicotine Receptors if they weren't supposed to recept Nicotine? (OK, he gave us Opiate receptors too, and a good thing, if you've ever stubbed your toe)
4: So why is Marriage-a-Juan-A smoke not treated the same?? Been to California lately? the whole state reaks.

Frank

[Brett Bellmore]

4: It's the tobacco settlements; Vaping reduces state revenue from the tobacco settlements, so a lot of players in government prefer that people hooked on nicotine get their fix in the old fashioned, carcinogenic way. Which even has the benefit of reducing pension costs!

By contrast, legalization of pot produced tax revenues, so those same guys were in favor of it.

[Safety Wars]

I am a Certified Safety Professional for over 30 years. I have never had a smoker who was under 25 fail the pulmonary function/spirometry test for wearing respirators and other medical equipment. But since vaping became popular it happens about 60% of the time. These people have no other obvious health issues other than vaping. They lay off it for a few weeks and then they are able to pass all the tests. I think more research needs to be done on this to better understand the impacts of e-cigs.

[Big Jay McNeely]

This argument only tackles the vaping problem from the side of smokers who are seeking mechanisms with which to quit. It also ignores the fact that, as vaping can be done in classrooms, public restrooms, and in inconspicuous ways that do not result in the individual in question smelling of tobacco for the rest of the day, there is logically a greater pool of potential users for e-cigarettes than for cigarettes. However many cigarette smokers vaping may help, it creates more individuals who become addicted to vaping who would not have become addicted to cigarettes. This, in my opinion, is the largest concern for vaping legislation.