What’s with the obsession with vaping?
Following the reports of 530 cases of vaping-associated respiratory illnesses—12 of them fatal– the Trump administration announced plans to ban all flavored electronic cigarettes from the market. It is unfortunate since flavored cigarettes are an important factor behind many smokers switching from cigarettes to e-products.
Several states and cities have already banned the product entirely.
It is always tragic when people die or get sick. But then when you look into it, it is not obvious that the problem was not in large part manufactured by the Food and Drug Administration (FDA). This agency was fast to issue warnings and threats about the new technology and making it impossible for manufacturers to offer improved products and innovations to their customers. While making legal commerce of vaping products harder, it also failed to crack down on counterfeit products.
The result was a slowing of the development of the legal market, a growing number of smokers freaked out of their minds about switching from a product that will for sure hurt them to one that has been proven safer (not to be confused with completely safe), and an opportunity for the development of a potentially dangerous and experimental black market.
Don’t get me wrong. I am all in favor of leaving adults free to experiment with all sorts of things. But the FDA’s action has driven the experimentations underground. These should instead be in the light in order to give companies the strongest possible incentives to not kill their consumers.
And sure enough, it appears that all the problems reported so far happened in the black market and are linked to people vaping stuff like homemade fluid or cannabis products. In fact, so far the evidence we have from state and federal authorities show only that adulterated cannabis products seem involved. According to a hearing last Wednesday on the House Energy and Commerce Committee, FDA representative Norman Sharpless said that the FDA has tested 150 samples from patients. 70% contained THC. And half of those were contaminated with vitamin E oil.
Then there’s also the scale of the freak-out by governments around the U.S., and by Trump’s FDA, which make no sense. Twelve people died vaping what turned out to be illegal, and a few hundred got sick. But let’s compare these numbers with the number of people killed in the U.S by other legal stuff.
The CDC reports that roughly half a million Americans die annually from smoking. And they have been dying for years. Also, “More than 16 million Americans are living with a disease caused by smoking.”
Obviously, I am against banning cigarettes or anything else for that matter, as I believe adults should be allowed to do whatever they want with their body. But I truly wonder how government officials in, let’s say, San Francisco, justify banning vaping like they have while letting people smoke cigarettes and allow cannabis sales, including cannabis edibles (brownies, gummies, etc) at the same time. I think it is a fair question. A question that Josh Barro over at New York magazine has asked too. He wrote:
“Ideally, you should want a public policy that encourages smokers to switch to vaping; that discourages non-users of nicotine products, especially minors, from taking up any nicotine product; and that discourages vape users from switching to combustible cigarettes. San Francisco’s proposed policy (a second vote by the Board of Supervisors is required before it becomes law) fails to meet the third test because it makes traditional cigarettes easier to obtain than vapes.”
He adds: “Adult smokers who are thinking about switching to vaping, or who have already done so, might continue buying cigarettes because the city will make that the more convenient option.”
The same question goes for states like Michigan, New York and Massachusetts. Dr Michael Siegel points out the same hypocrisy on this issue in the LA Times recently.
This is all the more remarkable in that of all technologies, and of all private or public initiatives so far, vaping has done a remarkable job at getting smokers to switch away from smoking.
How about alcohol? According to the CDC, “Excessive alcohol use is responsible for 88,000 deaths in the United States each year. It also accounts for 1 of 10 deaths among working-age adults and shortens the lives of those who die by an average of 30 years.”
Thankfully, no one is talking about banning alcohol. Maybe they have learned a lesson from Prohibition.
But again, I can’t help but wonder, why all the hype about vaping, why the intensity of the government response, and the rush by some governments to actually ban part or all of the industry (showing that they haven’t learned enough about prohibition after all).
The answer to all these questions, I am told, is “the children.” The rapid increase in teenagers adopting the vaping technology and enjoying flavored products is where the panic comes from. But that can’t be the full story. First, vaping is prohibited for children. In fact, the same rules that apply to cigarettes, marijuana and alcohol apply to vaping.
Second, the consumption of alcohol is much higher for the under-18 population than is vaping. According to the CDC, “people aged 12 to 20 years drink 11% of all alcohol consumed in the United States, 30% of high school students report drinking some alcohol in the last month, and 14 percent binge drank.” Quite dramatically, “excessive drinking is responsible for more than 4,300 deaths among underage youth each year.”
How about cigarettes? Teen smoking is down, which is awesome. As Kevin Williamson explained over at National Review, “ teen smoking rates are at historic lows — which is excellent news, and news that ought to make us at least a little suspicious of claims that vaping is going to lead to a new epidemic of cigarette smoking among young people.”
Data also show that the reduction of teen smoking has also accelerated significantly since the creation of vaping. And considering that vaping has been found to be much less harmful than smoking I would say this is a good thing.
That said, according to the CDC, “If cigarette smoking continues at the current rate among youth in this country, 5.6 million of today’s Americans younger than 18 will die early from a smoking-related illness. That’s about 1 of every 13 Americans aged 17 years or younger who are alive today.” So it still exists. Besides, as Michelle Minton of CEI, an expert who follows this issue very closely, tells me by email that the tragedy is that “These kids (who’ve been indoctrinated into thinking e-cigs are no safer than smoking) if they become smoking adults will be far less likely to try e-cigs as a cessation method. “
And Williamson adds this: “Of course people vape recreationally, and minors who are not legally able to buy vaping products get their hands on them and use them, albeit at relatively low frequency: Teenage marijuana use, for example, is about 35 percent more frequent than teenage vaping. And marijuana is of course much more heavily regulated than vaping.”
What’s more Minton points out that “Also, the number of never tobacco using teens who habitually vape is under 1%.”
It calls into question once again the government’s reaction to youth vaping. I wonder if Dr. Siegel gets this right when he writes:
“Still, the government’s response could be regarded as disproportionate to the problem as there is currently no evidence these illnesses are the result of legal e-cigarettes. While smoking is associated with lower levels of income and education, youth e-cigarette use is highest among teens from more affluent families.
What’s more, since smoking has largely been eliminated from public places and the workplace, too often we erroneously think of it as a problem that has been “solved,” making it easy for policymakers to overlook, despite the fact that it persists in poorer communities.”
The disparity in cigarette use by race is also interesting. While only 15 percent of cigarette smokers are non-Hispanic white, the CDC reports, others report that “non-Hispanic white smokers were nearly four times more likely to switch exclusively to vaping than their non-Hispanic black or Hispanic counterparts, while higher-income smokers were twice as likely as lower-income smokers to switch”. In other words, the parents of upper class kids (likely white) very rarely get to see people smoke in the circles they run in, but they hear about their kids and kids’ friends who are smoking.
Williamson puts it this way: “Smoking is a problem for people who shop at Walmart, but our public policies are made by the people who shop at Whole Foods. (Or who have their servants shop at Whole Foods.) And those people do not want to see young people in their communities doing something that even looks like smoking.”
The freak-out could also be a product of people’s fear of new technologies. Here’s a fun article reminding us of various technology hysteria of the past. Unfortunately, in this case I see a trend developing that should be of concern to all of us—even those who despise vaping.
Vaping is not going away. It’s not. Too many people who vape, and their family and friends, understand the benefits to their health of switching away from tobacco. That means that state bans, and a possible FDA ban come 2020, will only make the black market problem worse.
In addition, the repeated calls (from Juul and former FDA’s head Scott Gottlieb—aka Marlboro Man—and others) to have the FDA crack down on this black market could effectively turn into protectionism of the few legal incumbents. This will not be good for innovation or consumers.
The cigarette industry, meanwhile, has everything to gain from the current troubles faced by their main competitor. Many in the tobacco industry have invested in the e-cigarette market and they will profit from either vaping’s demise or its success.