Have We Hit Peak Vape Panic?
The war on e-cigarettes just escalated.
By Spencer Bokat-Lindell
Mr. Bokat-Lindell is a writer in The New York Times Opinion section.
Sept. 5, 2019
This article is part of the Debatable newsletter. You can sign up here to receive it Tuesdays and Thursdays.
What just happened: Gov. Gretchen Whitmer risked triggering a run on college convenience stores Wednesday when she announced that Michigan would become the first state to ban the sale of flavored e-cigarettes. Days after the Michigan Department of Health and Human Services reported a “vaping crisis among youth,” created by manufacturers luring young people into addiction to their potentially harmful products, Ms. W hitmer invoked her emergency powers. “We can’t wait on Washington, D.C.,” she said on MSNBC. “We have to take action right now.”
The debate: Is vaping really a public health crisis, or are its dangers being blown out of proportion?
WHAT YOU NEED TO KNOW
E-cigarettes first entered the market more than 15 years ago as a safer alternative to smoking , since they vaporize liquid nicotine through a heating element to deliver the addictive drug without the cancer- causing tar. But as the devices got sleeker and the flavors more confectionary, their popularity among teens who may never have smoked to begin with skyrocketed, creating what the surgeon general declared an “epidemic”: One in five high schoolers and one in 20 middle schoolers vape, as of 2018, according to the Centers for Disease Control and Prevention .
The trend has produced understandable concern, given evidence that nicotine can harm the developing brain. What’s more, preliminary research has shown that other substances in vaping liquid may damage blood vessels. But according to Robert H. Shmerling at Harvard Health Publishing, there is still “no information available about long-term health impact.”
In the absence of such information, the need for it has only increased. San Francisco also announced a ban on the sale of e-cigarettes in June , while schools have tried to curb the habit by installing vape detectors, removing bathroom doors and even drug testing students for nicotine. And in the past few months, a mysterious respiratory illness that appears to be linked to a chemical contaminant in cannabis vaping products has afflicted at least 215 people and killed two.
WHAT PEOPLE ARE SAYING
Vaping saves lives
Draconian crackdowns on e-cigarette use is an irrational response that will do far more harm than good, write Sally Satel, a resident scholar at the American Enterprise Institute, and Erica Sandberg, a consumer-finance reporter, in USA Today.
E-cigarettes are nearly twice as effective at getting smokers to stop than other forms of nicotine-replacement therapy, the writers say. There’s a moral obligation to offer them, then, because cigarette smoking is still the leading cause of preventable death in the United States, killing more than 480,000 people every year.
“Harm reduction,” they write, “is alive and well for people addicted to heroin and fentanyl.” Some cities provide clean needle exchanges and overdose prevention medication. But when it comes to nicotine addiction, legislators are implementing policies of harm maximization:
Banning sale of e-cigarettes virtually guarantees that many vapers will go back to their Marlboros. It also puts teen vapers — the very impetus for the ban — at increased risk for smoking.
“I cannot overemphasize how insane this policy is,” writes Michael Siegel, a professor of community health sciences at Boston University. “If you think that these tens of thousands of vapers are going to quit nicotine cold turkey, then you don’t know anything about nicotine addiction.”
Big Tobacco has become Big Vape
While vaping may be a healthier alternative for people who already smoke, the e-cigarette industry has used nefarious marketing to hook a generation of teenagers , who are effectively serving as guinea pigs for testing vaping’s health effects, writes Jeneen Interlandi, a Times editorial board member.
E-cigarette companies seem to be borrowing from last century’s tobacco executives who knowingly appealed to teenagers with kid-friendly advertisements and smoother smokes. A memo from the staff of a House of Representatives subcommittee in July claimed that Juul, an e-cigarette company with more than 70 percent of the industry’s sales, targeted minors as young as 8, offered money to schools for the right to talk to students and recruited online influencers to market its products to teens. The company also developed flavors, such as mango and crème brûlée, that it voluntarily pulled from stores last fall under government and public pressure.
These practices, Ms. Interlandi says, are especially concerning in light of evidence that young people who have never smoked may be more likely to start after using e-cigarettes. “E-cigs have brought smoking back into vogue for teenagers,” she writes. “As a result, the cost of this new cure may be another generation exposed to the same addiction we are still fighting”:
I take full responsibility for choosing to smoke. But I wish that someone would have made it harder for 15-year-old me to do so. I hope the powers that be will do at least that much for the teenagers of today.
Our regulatory institutions have failed
Sydney Lupkin and Anna Maria Barry-Jester of Kaiser Health News write in The Daily Beast that lung doctors have been seeing signs of vaping’s potential dangers for years but didn’t know how or where to register their concerns with the proper regulatory authorities. That’s because the Food and Drug Administration didn’t start regulating e-cigarettes until 2016, and oversight remains patchy:
Because e-cigarettes aren’t classified as drugs or medical devices, which have well-established F.D.A. databases to track adverse events, doctors say there has been no clear way to report and track health problems related to vaping products.
In fact, the vaping products sold legally online and in stores haven’t even passed the F.D.A.’s rigorous safety review process; the deadline for companies to submit applications was originally last year , but it has since been pushed back to 2020. The former F.D.A. Commissioner David Kessler has said:
It’s a little mind boggling how illegal — or unregulated — products can be out there without adequate monitoring. It’s a classic example of chasing the horse after it’s out of the barn, and the federal government needs to catch up.
We are overreacting
Jacob Grier, a libertarian writer and professional bartender , has written in Slate that vaping is fomenting an irrational moral panic, stemming from the stigma that the public campaign against cigarettes so successfully created for smoking. For one thing, cigarette use among high school students fell by nearly half between 2011 and 2018, according to the C.D.C., which weakens the argument that vaping is a gateway habit.
But public health concerns aside, Mr. Grier argues that our approach to nicotine needs to be less paternalistic. We respect the preferences of adult alcohol users and, increasingly, marijuana users, regardless of whether those products may appeal to minors. Why should adults who vape be treated any differently? He writes:
To avoid the mistakes of previous prohibitions and drug wars, it’s necessary to recognize them not as pathological addicts but as equal citizens. … That begins with respecting the rights of consenting adults to take control of their own bodies — and not using the panic over teenage use to justify treating an entire nation like children.
The collective fever over vaping is fueled by the suspicion that somewhere, power is being abused — whether it’s the power of corporations to deceive and poison the public for profit or the power of the state to restrict bodily autonomy with puritanical, self-defeating drug laws.
Both of these suspicions find justification in history. But we don’t know whether indulging either of them, in the absence of robust oversight or conclusive research, necessarily makes for good policy. As Jia Tolentino has written in The New Yorker, “the potential public health benefit of the e-cigarette is being eclipsed by the unsettling prospect of a generation of children who may really love to vape.” Michigan just made the risky bet, then, that there is a greater public health benefit to taking the vapes away.
CUTTING THROUGH THE SMOKE
The former F.D.A. Commissioner David A. Kessler explores how Juul lures young people. [ The New York Times]
Jia Tolentino goes long on the promise of vaping and the rise of Juul. [ The New Yorker]
Sheila Kaplan and Matt Richtel investigate the mysterious vaping illness that’s “becoming an epidemic.” [ The New York Times]
Do you have a point of view we missed? Email us at [email protected] Please note your name, age and location in your response, which may be included in the next newsletter.
WHAT YOU’RE SAYING
Here’s what readers had to say about the last debate: Do we need the Green New Deal?
Alan Dater of Vermont says that we should “forget about new technologies that will capture carbon” and “use the best technology we already have, trees.” Madeleine Gregory and Sarah Emerson examined whether that’s possible in Vice.
David Garfield of Colorado, who has a Ph.D. in physical chemistry from the University of California, Berkeley, wrote in to say that carbon capture, while necessary, is in no world a sufficient solution to climate change. “If we don’t drastically and rapidly reduce fossil fuel combustion, we can’t possibly capture enough CO₂ to change the climate change trajectory. … This is not a question of ‘or’, meaning stop burning fossil fuels or capture carbon from the atmosphere. It is an ‘and’. We need both.”
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The war on e-cigarettes just escalated.