Vaping Bans Are Bad for Public Health
Months after numerous states reactively banned or overly regulated e-cigarettes, researchers at Rice University’s Baker Institute for Public Policy conducted a study and concluded that vaping offers significant health advantages over smokable tobacco, and that bans are an inappropriate response to a limited problem at the expense of society at large.
Unlike cigarettes and other conventional methods of smoking, vaping reduces or eliminates the tars and smoke that cause various cancers and illnesses. Vaping remains controversial, however, largely due to last year’s rampant news coverage of “E-Cigarette and Vaping-Associated Lung Illnesses” (EVALI). While the number of EVALI cases are drastically lower than those of smoking-related diseases, there is fear that e-cigs are a sort of unregulated gateway drug to smoking that can kill along the way. A commonly proposed solution: a prohibition on vaping products to head off an industry in its infancy. But as the Baker Institute study makes clear, that’s a misguided plan.
To understand why vaping can be such a positive for public health, one should first look at the report’s findings of who in the U.S. vape. Just 15 percent of e-cig users of all ages never smoked cigarettes before, which means that for 85 percent of vapers, e-cigs act as a substitute for cigarettes. Demographics do complicate this number somewhat. Education, income, race, sexuality, gender identity, and mental and physical health all play significant roles in a person’s likelihood of vaping without smoking before.
Adolescent nicotine addiction is certainly a valid concern, and prevention is the catalyst behind much anti-vaping legislation, as usage can affect the development of brain functions for decision-making, social cognition and personality expression. But while young adults are the age group most likely to have never smoked traditional cigarettes prior to vaping, most vapers aged 18 to 24 have smoked cigarettes.
That also explains a widely shared but somewhat misrepresented find from the National Academies of Science, Engineering, and Medicine (NASEM). While NASEM found evidence that vaping increases a teen’s risk of smoking, it also acknowledged the risk factors that contribute to a teen choosing to vape are overwhelmingly similar to those that contribute to a teen choosing to smoke. In a world with e-cigs, a teen may add vaping to a series of risky experiences he or she seeks out, which may very well include smoking. In these cases, vaping is associated with, but not a gateway to, smoking.
Given these complexities, a total ban on vaping is a rather poorly targeted measure to prevent nonsmokers from using e-cigs. Moreover, it comes at the expense of the majority of vapers who seek to improve their health by reducing or quitting smoking.
The Baker Institute report also highlights ways in which a ban is harmful structurally. See, prohibitions expand black markets. Not only does vaping have an established black market already, but it almost entirely consists of products containing THC and vitamin E acetate, which are the core contributors to EVALI cases and deaths. In other words, it is black market vapes causing the health problems that made front-page news, and a ban will only push more consumers toward those unsafe black market products.
And of course, every ban requires enforcement, and punishment for drug use often causes more harm than it prevents. Vaping students have been suspended, expelled, and criminally charged, and the researchers warn that the damage to students from these measures will be greater than any harm from vaping. And these measures disproportionately impact poor and minority students.
Instead, policymakers ought to seek to make vaping attractive to smokers and unattractive to nonsmokers. The researchers point to a few key principles in pursuit of that goal. First, governments shouldn’t regulate vaping more than smoking, else they encourage more smoking. Notably, the researchers don’t recommend flavor bans, as flavors have demonstrated success in helping smokers switch. Second, teen users shouldn’t face criminal liability. Rather, any regulation should be directed toward businesses that sell to underage users.
Finally, the researchers encourage some realism––it was activism that made smoking unattractive, and it was massive marketing efforts that put e-cigs in teen hands. Likewise, it will take extensive education campaigns to discourage non-smoking and non-vaping Americans from nicotine use.
Lawmakers must get the policy right. For the sake of 16 million Americans still suffering from smoking-related cancers and illnesses, a perfectly nicotine-free vision can’t become the enemy of a public health good.
John Kristof is a fiscal policy analyst based in Indianapolis and a contributor with Young Voices. Follow him on Twitter @jmkristof.