Should the government discourage a technology that can save your life because someone else might suffer ill, though nonlethal, effects from using the same technology foolishly? That’s the crux of Washington’s debate over electronic cigarettes (also known as “vaping”).
E-cigarettes appear to be the most effective means for weaning smokers from the cancer-causing combustible tobacco. Fruity-flavored vapor boosts the likelihood of quitting smoking altogether. And publicity is important for persuading smokers to shift to vaping. Yet moves are afoot to limit publicity for e-cigarettes and limit access to fruity flavors because they might lure youthful users.
The Centers for Disease Control describes cigarette smoking as the world’s leading cause of preventable death. Dr. Alton Ochsner first made the connection between tobacco smoke and lung cancer in 1939, and mountains of evidence have confirmed the hazards. Yet 14 percent of the population still chooses to smoke (or lacks the willpower to stop).
In 2016, over 15 percent of adults reported having tried e-cigarettes. Previously, smokers were merely advised to reduce cigarette consumption and fight the withdrawal symptoms of nicotine addiction, aided, perhaps, by largely ineffective nicotine gum or patches.
E-cigarettes offer a different cessation strategy. Sophisticated electronics satisfy smokers’ cravings for nicotine and pleasure from inhaling. But the delivery mechanism – vapor rather than smoke – virtually eliminates, rather than merely reduces, inhaled carcinogens. Whether the ex-smoker vapes indefinitely or eventually gives up all tobacco products (including e-cigarettes), carcinogen intake plunges instantaneously.
Unfortunately, some teenagers and others will begin vaping when they might otherwise have abstained from nicotine altogether. Of course, absent e-cigarettes, some youthful vapers would have turned instead to cigarettes. The follies of youth are notoriously resistant to legislative remedies.
Recently, the Food and Drug Administration, and specifically Commissioner Scott Gottlieb, have moved to limit aspects of vaping deemed most attractive to younger nonsmokers – namely, those fruity flavors and the products’ presence on social media.
But herein lies the trade-off. While a clever Facebook page or tweet might indeed attract teenagers’ attention, it might also persuade older smokers to drop smoking and start vaping. (Gottlieb himself said, “I’ve talked to ex-smokers, who’ve told me … it was the flavors that helped them make that transition off combustible cigarettes.”) Mint-, cucumber- or mango-flavored vapor might attract teenagers, but those flavors also appear to ease smokers off cigarettes more effectively. By some accounts, the flavors eventually make the smell of burning tobacco repugnant to some ex-smokers. Furthermore, a study published in online medical journal BMC Medicine indicates that smokers who spend time with vapers are likelier to try quitting smoking.
Given the toxicity of combustible tobacco, publicity and flavor mean lives saved – perhaps a lot of lives.
Gottlieb’s concerns aren’t unfounded. A recent FDA study shows high school e-cigarette usage rising rapidly, with youthful users showing a strong preference for fruity vapor. But the good news is that high school cigarette smoking has plummeted. Nicotine addiction remains an unwise and unhealthy choice, but it’s preferable to nicotine addiction plus lung cancer.
We don’t ban bright-colored automobiles or car ads because some teenagers drive stupidly. The sensible response to e-cigarettes is restrictions on youth behavior and enforcement of those restrictions by legal authorities – and by parents.
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