Shots Fired: The War On Vaping

After reading all the stories about vaping in today’s media news, one would think we are still living in 2011. When e-cigs first came onto the mainstream scene, there were a lot of concerns about them being a gateway to tobacco use, and “re-normalize” smoking. Throughout the years this theory has been proved unfounded. Every country that has embraced e-cigarettes has seen smoking rates decline among both adults and children.

This decline can clearly be seen in Britain where anti-smoking campaigners and health groups have touted the benefits of vaping for several years. Despite draconian anti-smoking legislation, the smoking rate barely changed between 2007 and 2012, but it fell by more than 20% once vaping took off.

Considering this, it was surprising to read today that vaping is a “one-way bridge” to smoking. According to a group of doctors writing an editorial in the European Respiratory Journal, “electronic cigarette use is strongly associated with the subsequent initiation of combustible tobacco product use among adolescents”. In fact, many organizations and industries want e-cigs to be regulated like tobacco products, with a total ban on advertising, a ban on flavorings and a ban on vaping in all “indoor locations, public parks, and places where children and youths are present”.

Single issue campaigners are well aware that you can get almost anything banned by playing the “think-of-the-children” card. Nine times out of ten, it is a cynical device to restrict the choice of adults. In this instance, the policies proposed would not only restrict freedom but also damage health, since they would act as an effective deterrent to smokers who would otherwise switch to vaping.

Arguments for “gateway effects” are always misleading. They are typically supported by people that don’t agree with something but don’t have the proper justifications to ban it. Cannabis being a prime example. Since marijuana has never caused any deaths, supporters of the war on drugs resort to claims about it being a gateway to heroin. E-cigs have never killed anyone either, thus anti-nicotine extremists resort to claims about vaping leading to smoking.

The correlation between the both is fairly obvious- they are not casual. Teens who vape are more likely to smoke, but they are also more likely to ride motorcycles, watch X-rated movies, and have unsafe sex. They are also more likely to smoke cannabis, for that matter, but that doesn’t mean that vaping leads to any of these behaviors, nor would they be less likely to engage in them if vaping didn’t exist. If it were true that vaping is a gateway to smoking, where’s all the evidence showing a growing epidemic of teen smoking? The authors of the editorial say that “electronic cigarette use among students has increased dramatically” in the US. And so it has, but it has coincided with a dramatic fall in cigarette smoking, as the graph below shows.

The dotted line shows the secular trend in smoking amongst high school students. It has been steadily falling before vaping became popular, and has decreased dramatically ever since. Is this merely a coincidence? Possibly, but it certainly doesn’t represent that large numbers of non-smoking vapers are taking up smoking. It is not unlikely that high school students who would have started smoking if e-cigarettes did not exist have taken up vaping instead.

Not unlikely, but impossible to prove. The alternative theory — that e-cigarettes are a “one-way bridge to smoking” — is also impossible to prove, but that does not stop anti-vaping propagandists from stating it as fact.

Therein lies the problem. There’s much to be learned about the vaping phenomenon but while those who study the science are careful about their conclusions, prohibitionist hucksters yell from the rooftops. This, combined with the media’s love of a good scare story, has allowed junk science to flourish and cranks to prosper. Even people who know nothing about vaping think they know that it causes “popcorn lung” (it almost certainly doesn’t).

It’s a sad fact that more people in the US and Britain believe that vaping is just as dangerous, if not more so than they did five years ago. The public health movement has failed in its duty to properly educate the general public about risk. In the UK, credit must be given to organizations such as Public Health England and Cancer Research UK for attempting to give people accurate information, but they are fighting an uphill battle against a coordinated campaign of quack science, doubt and diversion that is oddly reminiscent of the tobacco industry in the 1960s.

Consumers cannot make meaningfully free choices if they lack crucial information. The plethora of misinformation about vaping has created a market failure. Why would a smoker switch to vaping if e-cigarettes are even worse for you? There are almost certainly smokers out there who would have made the switch if they were adequately informed about the relative risks. Addressing this information asymmetry should be a priority for the government. Let us not die of ignorance.