Bans could do "more harm than good" by leading people back to smoking, according to experts.
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| © Getty A stock image shows a man holding an e-cigarette in one hand, and four cigarettes in the other. |
Experts have warned restrictions on e-cigarettes aimed at protecting public health amid a rise of vaping-related lung illnesses in the U.S. "may do more harm than good."
In an article published in the journal Science, scientists argued banning vaping products would deprive people of a tool which—despite its problems—could help them quit smoking. Every year, smoking kills more than 480,000 Americans, according to the U.S. Centers for Disease Control and Prevention (CDC).
"The most conservative estimates suggest that were vaping nicotine to replace most smoking over the next 10 years, 1.6 million premature deaths would be avoided and 20.8 million quality adjusted years of life would be saved in the United States alone," they wrote.
This summer saw a U.S.-wide spike in lung injuries related to vaping, dubbed EVALI. As of Dec. 3, a total of 48 people had died and 2,291 EVALI-related hospitalizations had been reported to the U.S. Centers for Disease Control and Prevention (CDC).
It's not clear what is causing the condition, but vitamin E acetate which is added to products containing THC—the main psychoactive compound in cannabis—is a "chemical of concern," according to the CDC. The public health body has warned against vaping THC or liquids from informal sources like friends, family, or in-person or online dealers.
Some lawmakers have responded to EVALI by banning sales of certain e-cigarette products, including Massachusetts; San Francisco; and Michigan. And the Trump administration has proposed a ban on flavoured e-cigarette liquid, which is yet to materialise.
Meanwhile, the "rapid rise" of teens vaping has also sparked widespread concern among health professionals, partly because nicotine can harm the developing brain. Research cited by the article authors showed the proportion of high schoolers who said they had vaped in past 30 days had spiked from 11.7 percent in 2017 to 27.5 percent in 2019.
But they argued policies to tackle both issues need to take a harm-reduction approach.
Evidence suggests that although e-cigarette products aren't totally safe, they appear to be "safer than combustible products," the scientists said. They also appear to be more appealing and effective than other nicotine replacement treatments.
"Restricting access and appeal among less harmful vaping products out of an abundance of caution while leaving deadly combustible products on the market does not protect public health." they said. "It threatens to derail a trend that could hasten the demise of cigarettes, poised to take a billion lives this century."
The team used the U.K. as a positive example. There, vaping is promoted as a safe alternative to smoking, but THC products are banned, and regulations are have been put in place to prevent nicotine use in young people while helping adult smokers to quit.
"Although it may be decades before we fully understand the long-term consequences of vaping nicotine without smoke, many argue that we know enough and stress that too many smokers die every day we delay taking reasonable and rational action based on the science to date," the experts said.
They said vaping flavors, with our without nicotine, may appeal to young people but also to adult smokers who help them switch.
The authors said fully regulated nicotine vaping products should be made available to adults who want to quit, while problems associated with THC vaping should be tackled. Young people's access to e-cigarettes, should be limited, they said, and marketing which targets this group banned.
Amy Lauren Fairchild, Professor of Health Services Policy and Management at The Ohio State University, who co-wrote the article, told Newsweek: "We believe that combustible products should be the most aggressively regulated to protect public health and that noncombustible products, like vaping products, should be promoted as substitutes for current smokers."
She continued: "We understand that the acute lung injuries and deaths are alarming and demand both action and attention. But we are also concerned that in a rush to act, policymakers are not carefully weighing the considerable and complex evidence base that must inform decision-making.
Asked what smokers who want to quit by vaping but are worried by EVALI should do, she said: "Smokers should always consider the relative risks when making decisions.
"Although vaping nicotine is not safe, major systematic reviews in both this country and the U.K. have determined that it is a far safer alternative to smoking combustible products obtained on the legal retail market," he said.
"There will always be some unknown risks when it comes to vaping. But we do know, thanks to the vigilance of the CDC and FDA, that the current mystery seems to be explained by vitamin E acetate mostly associated with illicit THC products. Unknown risks should always be weighed against the known, deadly serious risks of smoking."
It's not clear what is causing the condition, but vitamin E acetate which is added to products containing THC—the main psychoactive compound in cannabis—is a "chemical of concern," according to the CDC. The public health body has warned against vaping THC or liquids from informal sources like friends, family, or in-person or online dealers.
Some lawmakers have responded to EVALI by banning sales of certain e-cigarette products, including Massachusetts; San Francisco; and Michigan. And the Trump administration has proposed a ban on flavoured e-cigarette liquid, which is yet to materialise.
Meanwhile, the "rapid rise" of teens vaping has also sparked widespread concern among health professionals, partly because nicotine can harm the developing brain. Research cited by the article authors showed the proportion of high schoolers who said they had vaped in past 30 days had spiked from 11.7 percent in 2017 to 27.5 percent in 2019.
But they argued policies to tackle both issues need to take a harm-reduction approach.
Evidence suggests that although e-cigarette products aren't totally safe, they appear to be "safer than combustible products," the scientists said. They also appear to be more appealing and effective than other nicotine replacement treatments.
"Restricting access and appeal among less harmful vaping products out of an abundance of caution while leaving deadly combustible products on the market does not protect public health." they said. "It threatens to derail a trend that could hasten the demise of cigarettes, poised to take a billion lives this century."
The team used the U.K. as a positive example. There, vaping is promoted as a safe alternative to smoking, but THC products are banned, and regulations are have been put in place to prevent nicotine use in young people while helping adult smokers to quit.
"Although it may be decades before we fully understand the long-term consequences of vaping nicotine without smoke, many argue that we know enough and stress that too many smokers die every day we delay taking reasonable and rational action based on the science to date," the experts said.
They said vaping flavors, with our without nicotine, may appeal to young people but also to adult smokers who help them switch.
The authors said fully regulated nicotine vaping products should be made available to adults who want to quit, while problems associated with THC vaping should be tackled. Young people's access to e-cigarettes, should be limited, they said, and marketing which targets this group banned.
Amy Lauren Fairchild, Professor of Health Services Policy and Management at The Ohio State University, who co-wrote the article, told Newsweek: "We believe that combustible products should be the most aggressively regulated to protect public health and that noncombustible products, like vaping products, should be promoted as substitutes for current smokers."
She continued: "We understand that the acute lung injuries and deaths are alarming and demand both action and attention. But we are also concerned that in a rush to act, policymakers are not carefully weighing the considerable and complex evidence base that must inform decision-making.
Asked what smokers who want to quit by vaping but are worried by EVALI should do, she said: "Smokers should always consider the relative risks when making decisions.
"Although vaping nicotine is not safe, major systematic reviews in both this country and the U.K. have determined that it is a far safer alternative to smoking combustible products obtained on the legal retail market," he said.
"There will always be some unknown risks when it comes to vaping. But we do know, thanks to the vigilance of the CDC and FDA, that the current mystery seems to be explained by vitamin E acetate mostly associated with illicit THC products. Unknown risks should always be weighed against the known, deadly serious risks of smoking."
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