If you need further evidence that the tobacco-control movement has lost its way, consider this December 1 story from The Guardian: “‘I’ve lost my children to vaping’: the tragic stories behind the soaring rates of youth addiction.” Aside from some outdated 2019 teen vaping statistics, the author cited no scientific evidence of any sort. A 2022 study found that two-thirds of Australian teenagers haven't even tried an e-cigarette. The Guardian article was instead built around two anecdotes from parents who are struggling to help their kids quit vaping.
ACSH adamantly opposes underage nicotine consumption, and as a parent, I can imagine how disconcerting it must be to watch your son or daughter develop any addiction. That said, one of these parents—a physician no less—let his emotions get the best of him. Here's how he opted to get his 14-year-old son off e-cigarettes:
“Jason has resorted to giving his son two cigarettes a day to replace the vape. He knows tobacco is harmful and comes with significant health consequences, but is facing a quandary that is common to many health practitioners and parents when young people come to them and say they are addicted to vaping.” [emphasis mine]
You no doubt see the obvious problem here: giving teenagers cancer-causing cigarettes is beyond preposterous. But let's walk through the troubling logic of this anti-vaping intervention. The story tragically illustrates why tobacco policy is broken in so many countries.
Everything is backwards
First things first, e-cigarettes should be viewed as smoking-cessation tools. This perspective is widespread among ex-smokers, myself included. However, even researchers who are critical of vaping recognize that flavored nicotine used in these devices appeals to adult smokers who want to quit. Moreover, a large body of evidence—summarized by the highly respected Cochrane Collaboration in November—provides “high‐certainty evidence” that vaping is more effective than standard nicotine replacement therapy (gums, patches, etc.) for smoking cessation.
Jason's approach is therefore backwards and badly contradicts the available evidence. He's using a very harmful product to break his son's addiction to a much safer product. As “a general practitioner used to treating those addicted to tobacco,” this physician should know better than to give his child cigarettes. He isn't alone in his confusion, though.
Pervasive anti-vaping propaganda
As we've collected more data on the safety and efficacy of vaping, the general public has developed an increasingly distorted view of e-cigarettes—thinking they are “as harmful as or more harmful than cigarettes,” according to a recent study published in the JAMA Open Network.
This distorted understanding of e-cigarettes is driven by public-health agencies and reporters who consistently mislead consumers about the relative risks of vaping and smoking. Remember the 2019 EVALI “epidemic”? Both the CDC and US media pushed the narrative that vaping caused severe lung damage that hospitalized 2,000 people and killed 68 of them. In reality, those tragic cases were caused by black-market devices containing vitamin E acetate used to vape THC or CBD, chemicals found in marijuana. [1]
The victims of this anti-vaping messaging aren't just a father and his son. Widespread nonsense about the perceived risks of vaping has increased smoking in recent years. According to a July 2022 study:
... [T]he percentage of people who exclusively used traditional cigarettes almost doubled between 2019 and 2020 among those who perceived e-cigarettes as more harmful, jumping from 8.4% in 2019 to 16.3% in 2020 … Since e-cigarettes entered the US market in 2006, public health experts have questioned claims from manufacturers that the products work as a harm reduction tool to help traditional cigarette smokers to quit.
The good news is that a significant number of physicians across different specialties are beginning to abandon the anti-vaping dogma pushed by tobacco-control activists; these doctors are actually recommending e-cigarettes as cessation tools to their smoking patients. Hopefully, one-on-one interactions can counteract some of the propaganda that pervades the public discourse around vaping.
The more immediate question we need to answer was posed by The Guardian: “How do you help a teenager … addicted to high quantities of nicotine ... to quit?” The solution is complex, but we start by recognizing and addressing the causes of youth nicotine use. According to a 2016 review, there are some 98 predictors of underage tobacco consumption. Most of these variables are behavioral issues affecting individual teenagers or their families; very few predictors have anything to do with the flavor profiles of e-cigarettes.
Naturally, federal regulators and anti-smoking groups have invested most of their resources into restricting access to flavored nicotine products. These people have much in common with the drunk who only looks for his keys under the streetlight:
A policeman sees a drunk man searching for something under a streetlight and asks what the drunk has lost. He says he lost his keys and they both look under the streetlight together. After a few minutes the policeman asks if he is sure he lost them here, and the drunk replies, no, and that he lost them in the park. The policeman asks why he is searching here, and the drunk replies, "this is where the light is.”
As long as that mindset dominates tobacco-control policy, widespread confusion about vaping will probably persist.
[1] Read Dr. Bloom's piece Can Chemistry Explain 'Vaping Lung?' to learn more about the EVALI scare.
Cameron English
Director of Bioscience
Cameron English is a writer, editor and co-host of the Science Facts and Fallacies Podcast. Before joining ACSH, he was managing editor at the Genetic Literacy Project.
