Smoking remains an enormous public health problem in the U.S. Cigarette smoking is the leading cause of preventable death in this country. According to some studies, more than half of longtime smokers will die from smoking-related complications. David Abrams, a professor at New York University’s College of Global Public Health, estimates that 1,300 people die from smoking every day.
E-cigarettes offer a partial solution to this perennial health crisis. They deliver the nicotine that attracts people to cigarettes (and addicts them), but not the tar and other carcinogens that kill them. They say “people smoke for the nicotine, but die from the tar.” A method that supplies nicotine the way cigarettes do without the tar etc. represents a life-saving breakthrough.
How life-saving? A recent study by a team of Georgetown University cancer researchers concluded that 6.6 American lives million lives could be saved (that is 6.6 million Americans would live substantially longer) if ten percent of American smokers switched to e-cigarettes every year for the next ten years. Using a more pessimistic set of assumptions, the study put the number of lives saved at 1.6 million. (According to Sally Satel of AEI, writing in the Wall Street Journal, two million Americans have already quit smoking thanks to e-cigarettes).
The modern Democratic party has never been the friend of the tobacco industry or of smoking. Thus, I would have expected leading Democrats to be receptive to e-cigarettes.
They base their opposition on the problem of teenage “vaping.” Vaping refers to how e-cigarettes are consumed. A thumbnail-size cartridge called a pod, filled with juice containing a cigarette pack’s worth of nicotine, is inserted into a small vaporizer. (The juice is flavored, e.g. mango, peppermint, cucumber). Then, one inhales.
Vaping apparently has become quite popular among teenagers. The phenomenon is also called “juuling,” after JUUL, by far the leading company in the e-cigarette business.
Vaping will hook teenagers on nicotine, just as smoking always has. And it will hook some teenagers who would not otherwise have been hooked (because they would not have taken up smoking).
Popular though vaping has become, those who advance it as an argument against e-cigarettes may be exaggerating the phenomenon. AEI’s Sally Satel cites the 2017 Monitoring the Future survey, which found that almost 1 in 5 high school seniors reported getting drunk within the previous month, while 22.9% used cannabis during the same time frame. Only 11% said they had vaped. Two major government surveys show that regular e-cigarette use by people who have never smoked is under 1%, Satel adds.
In any event, teenagers hooked by vaping will not suffer the severe, deadly health effects produced by cigarettes. Addiction is never good, but it does not, in itself, constitute a health crisis. Many Americans are addicted to caffeine and/or sugar.
Moreover, there should be ways to combat teenage vaping. The sale of e-cigarettes to teenagers is illegal. A crack-down on such sales would be good starting point.
Recently, the FDA announced one. It will conduct a “large-scale, undercover nationwide blitz to crack down on the sale of e-cigarettes—specifically juul products—to minors.” Warning letters have been issued to forty retailers.
The FDA also sent a public letter had also been sent to JUUL, requesting every internal document pertaining to the company’s marketing strategy, product design, and “health, toxicological, behavioral, and physiologic effects, including appeal or addictive potential for youth.” JUUL itself has pledged $30 million to fight underage vaping.
Here we see what seems like the most sensible approach to the e-cigarette issue. Market vapes to adult smokers while vigorously enforcing age restrictions.
It’s possible that age restrictions cannot be enforced with much success. And even if they are, the problem of addicting extra people to nicotine extends beyond the teenage years.
But the benefits of getting adults to stop smoking cigarettes overwhelm the drawbacks of addicting extra people to nicotine, it seems to me. The Georgetown study that found 1.6 to 6.6 American lives saved by e-cigarettes took into account both harm from e-cigarettes and amount of youth uptake in nicotine consumption.
I agree with Satel that “overheated worries about youth vaping are threatening to obscure the massive potential benefits to the nation’s 38 million cigarette smokers.” I also agree with Michael Siegel, a preventive-medicine physician who worked in epidemiology at the C.D.C. before joining Boston University’s School of Public Health. He worries:
We will look back at this moment and see that we had this unbelievable discovery, this technology that had the potential to put the final nail in the coffin in cigarette smoking in this country—and because of this ideology that nicotine itself should be prohibited, that anything that looks like smoking is bad, we will squander this opportunity, and we’ll have gone back to where we were.
We will if Schumer, Durbin, and like-minded liberal Democrats have their way.