By Yaël Ossowski and Bill Wirtz
19. September 2019
Creative entrepreneurs and innovators launched a category of nicotine delivery products called vaping devices (also known as e-cigarettes) to give people a less harmful method of consuming nicotine, the stimulant alkaloid smokers are actually addicted to. These devices heat up a mixture of liquid that is then inhaled, the byproduct being water vapor.
While the life-saving potential of nicotine vaping devices has been recognized by many public health authorities, several recent high-profile hospitalizations and illnesses have put vaping on trial, inviting scrutiny and calls for outright bans on the technology.
This policy note dispels the myths that surround vaping, offers factual scientific and health evidence, and gives recommendations to uphold public health all the while reducing harm.
Traditional cigarettes, when burned, create more than 7,000 chemicals, 69 of which have been identified as potential carcinogens.
Vape devices, on the other hand, contain completely different ingredients.
The two main ingredients used in vape liquids are propylene glycol (PG) and vegetable glycerin (VG), both used to form the vapor and add flavor to it. Added to these two ingredients is a third, usually a common food flavoring found in cakes, oils, and other food items that help give the vape liquid its taste. All of these aforementioned compounds are common food ingredients that are deemed healthy and safe by regulatory bodies including the FDA.
The other variable ingredient in vape liquid is nicotine, the stimulant alkaloid. Though not all liquids contain this addictive chemical, it is widely seen as the main draw for former smokers looking to quit smoking. When compared to other alternatives in getting people to quit, including Nicotine Replace Therapy (NRT) patches and drugs, vaping has been found to be more effective.
The U.K.’s top health body, Public Health England, has repeatedly said that vaping and e-cigarettes are 95 percent less harmful than smoking.
The same conclusion has been drawn by the New Zealand Ministry of Health and Health Canada, which have both launched public initiatives imploring smokers to turn to vaping .
Less than 14% of U.S. adults are now smokers, the lowest rate ever recorded. This coincides with the lowest teen smoking rates in recorded history.
For vaping, the latest CDC figures show that 20.8% of high schoolers have vaped at least once in the last 30 days. But nearly half of those were vaping cannabis rather than nicotine, usually products that were procured illegally.
This is certainly a problem to address, but not a crisis as framed by public health officials. And considering no data was collected prior to 2015 on vaping overall, a collection of new data cannot be statistically concluded to warrant a crisis.
We should not tolerate teen vaping and any rise in numbers is concerning, but we cannot at the same time deprive millions of adult smokers of alternatives because of activities that are already illegal. The same lessons have been learned from the counter-productive prohibition of alcohol in the 20th century.
Much cause for concern of late has been a flurry of reports of illness and hospitalizations blamed on traditional vaping devices and liquids. The CDC has reported nearly 380 cases of lung illnesses related to vaping. Sensational headlines and opinion articles have convinced leaders in several states and even President Donald Trump to consider banning vaping flavors outright.
But careful analysis of the reported cases reveals that a vast majority of the patients with symptoms were found to have used illicit vape cartridges mixed with the cannabis compound THC.
A study in the New England Journal of Medicine that examined cases in Illinois and Wisconsin found that 84% of hospitalized patients report using illicit THC vaping cartridges prior to their illness. No illnesses have yet been tied to store-bought vaping pods or liquids containing nicotine.
To that end, two Wisconsin brothers were recently arrested in connection with a multi-million dollar operation that mixed various chemicals (including Vitamin E) with THC in cartridges meant for vaping devices, which they then sold illegally. Authorities have identified this large scheme spread across much of the midwest as a culprit in the recent lung illnesses there.
What this reveals is that illicit vaping products sold on black markets, rather than licensed retailers, have actually caused the most severe of the lung illnesses reported in the media.
As such, a ban on regulated devices and liquids, whether with flavors or not, would not address the problem as it currently exists.
In response to the reported illnesses and hospitalizations tied in the media to vaping, policymakers have called for immediate bans on flavored vaping products, the first of which being Michigan.
The main drive behind these proposed bans is protecting minors, who are allegedly drawn to the myriad of vape flavors. But considering all minors who use these products are acquiring them outside the legal market, it is clear that the most immediate impact will be on responsible adult vapers who prefer these flavors.
A legal and regulated market is the best method for rooting out bad products and actors. A ban on flavors will only drive those who wish to use flavored vaping products to the black market, or back to cigarettes. Recent studies have shown that if vaping products are outlawed, current vapors are more likely to return to smoking. That would be very consequential for public health.
The best deterrent to vaping by minors is to enforce strict age-restrictions at storefronts, much like exists with alcohol and tobacco products, as well as investing in education in schools on the effects of nicotine on adolescent brains.
Making products that are currently legal and available for adults illegal will cause more harm to both adults and minors, creating the incentives mentioned above that currently exist for the illicit market in vape cartridges containing cannabis and dangerous additives.
Contrary to the sensationalistic media reports, adults who use vaping and e-cigarettes as a means to quit smoking are vastly improving their chances of living long, healthy, and productive lives.
The innovations in harm reduction tools in recent years have produced vaping and e-cigarette products that are demonstrably less harmful than traditional cigarettes.
At the same time, the rise in use of these products by teens is cause for concern, but not at the risk of outlawing the entire category used by responsible adult former smokers.
Let’s enforce existing laws. Nearly half of tobacco and vape shops don’t ID young customers. This perpetuates the problem and has turned the public against vaping for consenting adults trying to improve their life expectancy.
In order to curb vaping by minors and illicit vaping products that are connected to recent illnesses, the Consumer Choice Center recommends the following:
