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Regulating Smoking and Vaping: A Tale of Two Vices

Vaping may be safer than smoking, but is it safe? (Pixabay)

In 2016 the-US Surgeon General Vivek Murthy released Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health. It was intended as akin to an earlier Surgeon General’s 1964 report on Smoking and Health, and included the statement that “addiction is not a character flaw – it is a chronic illness that we must approach with the same skill and compassion with which we approach heart disease, diabetes, and cancer.”

He was “relieved of his duties” on April 2-17—20 months before the end of his term—for unspecified reasons, though anti-tax conservative activist Grover Nordquist called for his removal in an online petition. Was it for his calls for compassion for people with addictions? Or his controversial-to-some opinion that gun violence deaths were a public health issue? No, Nordquist wanted him gone because he “urged a limiting of flavored vapor products, to ‘save the kids’ ”.

Cigarettes—tobacco, nicotine, cancerous smoke—are not covered by the US Drug Enforcement Agency (DEA). They fall under the purview of the US Food and Drug Administration (FDA). Scott Gottlieb, the current head of the FDA, also has called for the limiting of flavored vapor products, also to save the kids. Citing “astonishing” statistics on the increase in e-cigarette use by teens and the high numbers of e-cig users who go to become smokers, Gottlieb said, “I will not allow a generation of children to become addicted to nicotine through e-cigarettes”.

So far Nordquist hasn’t called for Gottlieb to be fired.

Many e-cigarette manufacturers and advocates argue that Juuls, vaping pens, and similar devices are safer than smoking conventional cigarettes—they heat the tobacco instead of burning it, along with the paper and added chemicals (formaldehyde et al)—and actually, help smokers wean themselves from tobacco.

That may be true for older smokers, but maybe not for younger ones. In particular, the flavored e-cigs are said to appeal to children (one parent described smelling “Fruit Loops” from her child’s room), though still containing nicotine.

Juul, which has about 70% of the e-cig market, either is convinced or can see the writing is on the wall. Even before the FDA proposed to “impose new restrictions on the sales of flavored e-cigarettes in retail stores”, Juul announced it had voluntarily “stopped selling its fruit-flavored nicotine pods to stores” (though they are still available online).

At least, for now, Juul’s menthol-flavored nicotine pods will still be in stores, and the FDA doesn’t seem to have a problem with that, although it also is planning to “ban menthol cigarettes” outright.

According to a 2018 World Health Organization report, tobacco use is responsible for more than 6 million deaths each year worldwide. A Centers for Disease Control and Prevention report found that about 440,000 Americans died from tobacco use in 2014. (For comparison, that’s more than double the number who died from prescription opioid overdoses alone from 1999 to 2016. That even dwarfs the number of alcohol poisoning and alcohol-related deaths.)

While vaping is still relatively new, there’s little evidence yet that it is as harmful as smoking. Even the CDC admits that e-cigarettes are less harmful than regular cigarettes (though they contend that they are not safe). Tony Abboud, executive director of the Vapor Technology Association, warned that banning e-cigarettes from convenience stores could drive vapers back to smoking tobacco products.

E-cigarettes also can be used for marijuana, whether you consider that a benefit or another danger.

More research is clearly needed, and some restrictions are reasonable, though not a complete ban. If vaping is demonstrably safer than smoking tobacco, it seems ridiculous to ban the less dangerous one but not the other.