Connecticut lawmakers are considering a variety of bills to address the recent increases in teen vaping, including banning flavored vapor products. E-cigarettes have quickly become one of the most controversial debates in public health because their significant public health benefits — as a replacement for traditional cigarettes — are being offset by concerns surrounding teen vaping.
On the federal level, the Food and Drug Administration is trying to thread a needle. It wants to keep e-cigarettes available on the market to help adult smokers quit traditional cigarettes. But there’s increasing pressure to keep these products out of the hands of kids.
Research from groups like the Royal College of Physicians finds e-cigarettes are substantially safer than traditional cigarettes. Though most e-cigarettes contain nicotine, that’s not what sends 480,000 Americans to an early grave with lung cancer and other diseases every year. Instead, it’s the smoke that comes from lighting tobacco on fire that is most harmful to humans. Detach nicotine from cigarettes and you give smokers the nicotine they desire without the smoke that may kill them. According to researchers at Georgetown University, “up to 6.6 million cigarette smokers will live substantially longer if cigarette smoking is replaced by vaping over a 10-year period.”
“Old policies need to be supplemented with policies that encourage substituting e-cigarettes for the far more deadly cigarettes,” said David Levy, Ph.D., professor of oncology at Georgetown Lombardi Comprehensive Cancer Center. “There would be tremendous health benefits including reduced disease disability to smokers, reduced pain and suffering, and reduced exposure to second-hand smoke.”
Unfortunately, the potential health gains e-cigarettes could help deliver are being threatened by the uptick in youth vaping. To combat this worrying rise in teen vaping, Connecticut legislators are contemplating a ban on all e-cigarette flavors that allegedly target kids
But such a ban would have a more significant impact on adults trying to quit smoking than preventing teens from vaping.
A 2017 study by researchers from the Yale School of Public Health published by the National Bureau of Economic found “a ban on flavored e-cigarettes would drive smokers to combustible cigarettes, which have been found to be the more harmful way of getting nicotine.” The authors concluded that banning flavors “reduces the appeal of e-cigarettes to those who are seeking to quit (smoking); e-cigarettes have proven useful as a cessation device for these individuals, and we find that quitters have a preference for flavored e-cigarettes.”
Other things aimed at reducing smoking, like nicotine replacement therapies, have been useful for some smokers but notoriously ineffective for the vast majority of smokers who are trying to quit. E-cigarettes have been proven time and again to be effective at helping smokers quit. In January, The New England Journal of Medicine published a randomized control trial considered the gold standard in academic research concluding, “e-cigarettes were more effective for smoking cessation than nicotine-replacement therapy.”
Before legislators proceed on banning flavors, they should remember that the big picture trends on youth tobacco use in Connecticut are encouraging. Yes, from 2011 to 2017 the number of high school students using e-cigarettes rose from 2.4 percent to 14.7 percent, according to the Connecticut Youth Tobacco Survey. But, in 2011, the survey showed 14 percent of high schoolers were smoking cigarettes. By 2017, the number of high school students smoking cigarettes had plummeted to 3.5 percent.
Yes, the rise of youth vaping is troubling and measures should certainly be taken to require the e-cigarette industry to crack down on sales to minors. However, state lawmakers should also keep the overall public health picture in mind. Banning e-cigarette flavors would risk significantly reducing the important, proven health improvements e-cigarettes can deliver to smokers and society.
This column first appeared in the Connecticut Post.