Some Florida lawmakers are proposing to define all e-cigarettes as tobacco products. This proposal not only contributes to the already widespread misunderstanding of the risks and benefits of e-cigarettes, but it also could serve as a stepping stone to a crackdown on vaping which threatens public health.
According to Food and Drug Administration (FDA) chief Scott Gottlieb, if every adult smoker in America switched to e-cigarettes, it would provide a “tremendous public health gain.”
Over the past few years, a global consensus has emerged that e-cigarettes are significantly safer than traditional cigarettes. Not only that, but according to a recently published study in the New England Journal of Medicine, smokers who tried to quit using e-cigarettes were almost twice as likely to succeed as those who used nicotine replacement therapies (NRT) like the patch or the gum.
Despite this, the public is grossly misinformed about the relative risks of e-cigarettes. According to one 2018 poll, 43 percent of adults wrongly believed e-cigarettes to be more harmful than cigarettes. A separate analysis showed more than half of adults think nicotine is the substance causing most smoking-related cancer.
These numbers represent a dangerous failure of public health communication. While addictive, it’s not the nicotine that sends 480,000 Americans a year to an early grave. It is the process of setting tobacco on fire and inhaling the resulting smoke.
As the great public health researcher Michael Russell said: “People smoke for nicotine, but they die from the tar.” Detach nicotine from smoke and not only do you have a safer product, you have a product that draws smokers away from their deadly habit.
Throwing e-cigarettes into the same category as cigarettes would deter future quitters. Indeed, the logic of such a proposal would be to tax and regulate e-cigarettes in the same manner as their tobacco-filled rivals, resulting in an almost comedic situation where instead of levying traditional “sin” taxes on cigarettes, Florida could end up introducing a “virtue” tax penalizing smokers who have switched to vaping. Such taxes would be especially harmful to low-income Floridians who are disproportionately more likely to smoke.
Florida’s smoking rate declined from 19.3 percent in 2012 to 16.1 percent in 2018, yet almost 30,000 Floridians die every year from smoking-related disease, more than four times the number who died from drug overdoses last year.
According to modeling conducted by David Levy and colleagues at Georgetown University Medical Center, replacement of cigarette use by e-cigarette use over ten years would yield 6.6 million fewer premature deaths with 86.7 million fewer life years lost.
In the face of such massive public health gains, it would be irresponsible to put vapor products on the same playing field as cigarettes. Of course, all retailers selling e-cigarettes must play by the rules and only sell to adults.
Tightening up online age-verification processes and more stringent punishments for retailers selling to minors are reasonable measures to which no one objects. But the key to public health is truth and trust.
Adult smokers have the right to know there are safer alternatives and they won’t face a penalty for using them. If lawmakers want to make it easier for adults to quit smoking, they must not only allow adults access to safer nicotine alternatives but actively inform smokers of the benefits of switching.
A version of this article first appeared in the South Florida Sun-Sentinel .