Vaping saves lives - regulation should keep that in mind

Great Debates
1

E-cigarettes are less dangerous than cigarettes but are equally effective at delivering nicotine. Levy et al. estimate that if smokers switched to e-cigarettes millions of life-years would be saved, even taking into account plausible rates of non-smokers who start to vape. (It’s worth noting that the authors are all cancer researchers, statisticians and epidemiologists concerned with reducing cancer deaths.)

[INDENT]A Status Quo Scenario, developed to project smoking rates and health outcomes in the absence of vaping, is compared with Substitution models, whereby cigarette use is largely replaced by vaping over a 10-year period. We test an Optimistic and a Pessimistic Scenario, differing in terms of the relative harms of e-cigarettes compared with cigarettes and the impact on overall initiation, cessation and switching. Projected mortality outcomes by age and sex under the Status Quo and E-Cigarette Substitution Scenarios are compared from 2016 to 2100 to determine public health impacts.

Compared with the Status Quo, replacement of cigarette by e-cigarette use over a 10-year period yields 6.6 million fewer premature deaths with 86.7 million fewer life years lost in the Optimistic Scenario. Under the Pessimistic Scenario, 1.6 million premature deaths are averted with 20.8 million fewer life years lost. The largest gains are among younger cohorts, with a 0.5 gain in average life expectancy projected for the age 15 years cohort in 2016.

[/INDENT]

Now, obviously vaping is not preferable to not smoking or vaping. It’s still bad for you. But it’s a lot less bad than smoking, and regulations to make vaping less attractive will, naturally, make it less attractive for smokers as well:

Our results have important policy implications for flavor bans. According to our predictions, 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 (Goniewicz et al., 2017; Shahab et al., 2017). In addition, such a ban reduces the appeal of e-cigarettes to those who are seeking to quit; ecigarettes have proven useful as a cessation device for these individuals (Hartmann-Boyce et al., 2016; Zhu et al., 2017), and we find that quitters have a preference for flavored e-cigarettes.

It seems like bad policy to impose regulations to make vaping less attractive, in no small part because in doing so, you don’t just stop people from picking up vaping, you also stop people from quitting the (far more harmful) smoking.

Thoughts?

2

People in charge of setting policies are often dimwits. That’s my thoughts

3

The problem is that like you said, vaping is just as addictive. We have made very good progress working to eliminate smoking in the US. Within a generation or two, we might have it successfully eradicated. That’s good for society – lower Healthcare costs, leas lung cancer, etc. If vaping makes it so easy and culturally “safe” to smoke, you are effectively lowering the “barriers of entry” for new people to start smoking. Like you yourself said, vaping is still addictive and dangerous – just less so. Obviously we want current smokers to vape instead if there is no will or way for them to quit otherwise, but we don’t want new people (especially young ones) to take up either smoking or vaping. I think regulation should take that into account, too.

4

I have zero tolerance for bad regulation!

5

All the money spent on regulating vaping could instead be spent on developing a more virulent tobacco mosaic virus, which could potentially save even more lives!

6

In and of itself, I don’t see how vaping is any worse than drinking coffee other than some of the unknowns of the risk might still be undecided.

7

Where shall I send my money instead of E-Bay?

8

Cite? That seems super optimistic.

9

Strangely, the OP seems to completely ignore the elephant in the room. E-cigarettes are being used to entice non-smoking children to vape. Here’s a cite- note that nicotine use among middle and high schoolers had been declining for years, but that trend reversed and the percentage has started to increase- and many of our youngest addicts are e-cigarette only.

10

Second-hand smoke chokes me. I even react to the residue in a room full of used ashtrays even if no one is smoking in it. I once brushed up against a tobacco plant, and had a red rash on my arm (that looked like prickly heat) for about an hour. I have not been tested by a doctor, but I am pretty sure I am allergic to tobacco. I am allergic to flowers and grasses, so tobacco wouldn’t surprise me.

I know lots of other people who have trouble being around cigarette smoke; asthmatics, for one. I have no problem with e-vape. No asthmatic I know does either. So, even if vape were just as bad for you as cigarette smoke, the fact that second-hand vape seems to be a lot less harmful that second-hand smoke is still a big deal.

11

Weirdly, this is not the case in the UK - studies show that the movement from “non-smoking” to “vaping” is negligible (in children and adults alike), while the movement from “smoking” to “vaping” is significant (in adults, at least).

Vaping remains banned in the same places smoking is banned (and rightly so IMO) but the general view is that there is a net societal benefit.

12

Well, a quick web search revealed this study of UK youth. “Ever use of e-cigarettes was robustly associated with initiation but more modestly related to escalation of cigarette use.” The science does not appear to align with the general view.

13

Are there significant health effects associated simply with nicotine ingestion, absent the various by-products in tobacco smoke?

14

I believe that California law says so. BTW, My physician is delighted that I use ecigs instead of smoking.

15

Yeah. You can die from nicotine poisoning. Toddlers have gotten very sick from eating cigarettes. Like, to the point that, had they not gotten medical attention, they would have died, and I’m sure some have died.

16

We want to allow companies to make money off creating and exploiting addicts because… why?

17

Bad regulations should be against the law.

18

You can get e-juice with different levels of nicotine. To quit smoking, I started at a higher amount, and ended up with 0 nicotine. And then I just got bored with that and stopped vaping.

19

(bolding mine above)

I can add some anecdotal evidence to this; I tried switching to e-cigarettes, and failed, the first time. I ended up smoking *more. I’ve heard many similar stories from friends and vapers online.

The problem is e-cigarettes, IE, cigarette look-alikes. The devices are simply too small to effectively deliver a dose of nicotine equivalent to what a smoker was getting while smoking. So the smoker ends up with a period where he’s getting a low dose of nicotine, isn’t satisfied, then lights up a regular cigarette, so he’s just taken some nicotine from the e-cig, plus more from his regular cigarette.

While both smoking and vaping you take in more nicotine, your body gets used to it, you realize the e-cigarettes aren’t doing the trick, then you switch back to just smoking; but now your body is accustomed to a higher level of nicotine you were getting via smoking + vaping, so you smoke more than you did before.

The solution is not bothering with cigarette lookalikes; at a minimum, the vape pens / cigar-sized vapor devices should be recommended to smokers trying to switch/quit, and preferably high battery, subOhm capable tanks using high-nicotine juice (12mg or higher) for heavy smokers.

The hard part for most people switching is finding the right device for them, and the right milligram level for the nicotine they vape. From there, it’s relatively easy to gradually decrease the dosage for those who want to minimize their usage, all the way down to 0 for those who want to quit entirely instead of just switching.

20

Okay, then let’s ban smoking. (And drinking.)

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Oh wait that’s not going to happen. This is a really simplistic and not very helpful attitude towards smoking and harm reduction. If everyone who smoked vaped, we’d be a lot better off.

This is a much better response. Perhaps a more effective strategy would be trying harder to keep e-cigarettes out of the hands of the youth?