“A study found a “high rate of substitution” between vapes and cigarettes, suggesting that policies aimed at preventing underage use are undermining public health.”
““It’s really a product that’s good for some people and bad for other people, which doesn’t feel like too complex of a statement, but actually feels like something that is difficult for many to grapple with,” said Hartmann-Boyce, who is an associate professor of evidence-based policy and practice at the University of Oxford.
She led a 2022 Cochrane review — considered the best type of analysis of the available evidence — which looked at studies of e-cigarettes for smoking cessation. It found the strongest evidence yet that vaping works better than traditional nicotine replacement tools such as patches or gum to help people stop smoking. For those advocating that vaping is an effective harm-reduction mechanism, it was a significant win.
But it’s also more complicated than that.
Hartmann-Boyce said that since Cochrane first started looking at the evidence nearly 10 years ago, things have changed dramatically. The devices themselves are different now and are much better at delivering nicotine. That’s good for people trying to give up smoking but creates a problem with non-smokers like kids who are trying these for the first time.
But not everyone is even convinced it’s good for most smokers in the long term.
Jørgen Vestbo, a clinician and emeritus professor of respiratory medicine at the University Hospital of South Manchester, who recently returned to his native Denmark, agrees that the randomized controlled trials show e-cigarettes can help people quit.
But he also points to data from clinical trials that show people given e-cigarettes were more likely to use them for longer than those using aids such as nicotine gum. Vestbo said population-level evidence shows that as long as you are addicted to nicotine you are more likely to start smoking again.”
“the administration revealed plans to require cigarette makers to severely cut the amount of nicotine in their products. A proposed rule change “would establish a maximum nicotine level in cigarettes and certain finished tobacco products.” The idea, it says, is to make cigarettes less addictive.
Nicotine is the substance in cigarettes that makes them physically addictive. But nicotine itself isn’t what makes cigarettes so dangerous. (Some scientists “wonder if a daily dose could be as benign as the caffeine many of us get from a morning coffee,” notes Scientific American.) It’s the other ingredients in cigarettes, and the byproducts of combustion, that make smoking cigarettes so bad for you.
This is one reason why the war on vaping is so stupid, and also speaks to the half-baked premises of the Biden administration’s latest anti-smoking plan.
In a world with lower-nicotine cigarettes, people already addicted to nicotine will still be addicted—they’ll just have to smoke more cigarettes to get their nicotine fix. That means that mandating all U.S. cigarettes be low-nicotine cigarettes could actually make smoking riskier by requiring smokers to smoke more and consume more of the other substances in cigarettes in order to get the same level of nicotine they’re used to.”
“If the U.S. goes all low-nicotine smokes, other countries will still be producing full-nicotine cigarettes. And this opens up a great opportunity for smuggling and black market sales of higher nicotine cigarettes.
A bigger black market in cigarettes means three things, none of them good. First, it creates more room for organized crime to operate. Second, it creates more room for counterfeit cigarettes that could be even more dangerous for consumers. And third, it invites more policing of cigarette sales, which means more police time wasted on victimless crimes, more monitoring and harassment of business owners, and more potentially dangerous interactions between individuals and police.”
“lowering nicotine could also backfire by convincing some smokers that their habit is harmless.”
“Electronic cigarettes, which deliver nicotine without tobacco or combustion, are the most important harm-reducing alternative to smoking ever developed, one that could prevent millions of premature deaths in the U.S. alone. Yet bureaucrats and politicians seem determined to negate that historic opportunity through regulations and taxes that threaten to cripple the industry.”
“Survey data indicate that the vast majority of teenagers who vape regularly are current or former smokers. That means the FDA’s fear that ENDS are causing an “epidemic” of adolescent nicotine addiction is overblown—especially since vaping by teenagers dropped substantially in 2019 and 2020, a development the agency prefers to ignore.”
” In an August American Journal of Public Health article, 15 prominent tobacco researchers warned that “policies intended to reduce adolescent vaping,” including flavor bans, “may also reduce adult smokers’ use of e-cigarettes in quit attempts.” They emphasized that “the potential lifesaving benefits of e-cigarettes for adult smokers deserve attention equal to the risks to youths.”
That article summarized “a growing body of evidence” that “vaping can foster smoking cessation.” Yet Rep. Raja Krishnamoorthi (D–Ill.), who wrote a bill he called the END ENDS Act, insists “there’s simply no evidence that vapes help [smokers] quit.” He also claims to believe “adults can do what they want,” which is likewise demonstrably false given the severe restrictions he favors.”
“While there is still some debate around the potential increase in drunk driving, there is a vast, peer-reviewed, scientific literature around the harms of secondhand smoke inhalation, and around the massive health benefits associated with the sharp decline in smoking in part due to smoke-free policies.
We know that smoking bans have been effective at reducing secondhand smoke exposure. Bans in restaurants, bars, and other hospitality establishments have the added benefit of ensuring that workers are not forced to carry the health costs against their will simply due to their place of employment. Bans have also been effective at reducing smoking and “reducing opportunities to smoke, changing smoking norms, and reducing smoking rates.”
Smoking and exposure to secondhand smoke increases the risk of cardiovascular disease, pulmonary disease, cancer, and death. Research has shown that heart attack admissions “rapidly declined” after the implementation of 100 percent smoke-free laws.
All of this to say that if there was in fact a small increase in fatal drunk driving accidents as a result of these bans, the bans were still worth it.”
“While America may have taken smoking more seriously, it continues to kill nearly half a million people every year. Alcohol-related deaths number almost 100,000 annually.”
““The number one substance that is involved in arrests and incarceration is alcohol in the United States,” Keith Humphreys, a drug policy expert and professor of psychiatry at Stanford University, told me. “In terms of the damage — people think of illegal drugs as the drivers of the criminal justice system, [but] none of them come close to alcohol.””
“the documented health benefits to smoking bans like reductions in secondhand smoke exposure largely outweigh any of the costs, like a small increase in drunk driving in some places. Additionally, there are simple ways to eliminate potential increases in drunk driving.”
“While there is still some debate around the potential increase in drunk driving, there is a vast, peer-reviewed, scientific literature around the harms of secondhand smoke inhalation, and around the massive health benefits associated with the sharp decline in smoking in part due to smoke-free policies.”