Policymakers, and federal health agencies, have long insisted that teenage vaping serves as a gateway to future smoking. The theory goes that allowing a variety of vape products on the market entices young Americans to try e-cigarettes and eventually transition to combustible tobacco products where they establish lifelong addictions.
Consequently, policymakers have sought to impose harsh new restrictions on adult vaping products including blanket flavor bans, heavy taxes and limits on nicotine levels.
Some posit that these restrictions are critical to reversing the alleged “epidemic” of teenage vaping and improving long-term health outcomes. The problem with these restrictions is their justification is based on faulty or non-nonexistent data that wrongly assumes that smoking rates are worsening. In addition, they usually treat vaping products as one and the same as traditional tobacco products, despite research suggesting these products are less harmful.
A new report by the American Consumer Institute sheds light on this subject. The report, Tobacco Harm Reduction and Teen Epidemic: Health Impacts from Vaping, examines teenage smoking data and proposes that while additional action may be needed to “prevent youth access to all tobacco products,” policymakers and regulators should be careful not to push adults and youth back to combustible smoking products. Instead, they should prioritize tobacco harm reduction (THR) to reduce smoking rates.
The report correctly notes that while health experts have long known that smoking has been linked to a variety of health problems like heart disease, lung cancer and stroke, federal agencies like the Centers for Disease Control and Prevention (CDC) have, at times, promoted inaccurate information about vaping. This includes the frequently repeated claim that young people who use e-cigarettes “may be more likely to smoke,” despite evidence that teenage smoking is declining.
Indeed, the CDC’s own National Youth Tobacco Survey (NYTS) reveals that between 2011 and 2022, the percentage of high school seniors who reported vaping in the past 30 days declined by over 16 percent. Meanwhile, the number of high school seniors who reported vaping in the past 30 days has also increased by over 16 percent. In addition, those who reported the dual use of cigarettes and e-cigarettes also declined. These findings suggest that students who vape are not migrating to cigarettes. In fact, the opposite is occurring. There is significant evidence that American youth are transitioning from smoking to vaping.
The NYTS is good news because research has consistently found that vaping is significantly less harmful than smoking and more effective at helping smokers quit than other cessation products. In 2015, the UK Royal College of Physicians concluded that vaping may be as much as 95 percent safer than smoking. This is because vaper products, while not totally harmless, expose users to fewer dangerous chemicals and carcinogens than combustible cigarettes and appear in lower quantities. The CDC has openly acknowledged this fact.
The reality is that the magnitude of risk posed by vaping is far less than smoking. As the report points out, when data on high school seniors’ cigarette and e-cigarette use is combined with the fact that vaping is only five percent as dangerous as smoking, and that the average life expectancy of a smoker is 10 years shorter than for a non-smoker, it can be determined that switching from smoking to vaping saves lives. Among high school seniors alone, this switch has saved approximately 153 years of life per 100 high school students, assuming patterns of use and non-use remain constant.
These findings have profound implications for American THR policy. For years, policymakers have justified outlandish vape restrictions on the notion that they are needed to reduce smoking rates. Yet, in practice, all these restrictions do, is limit consumer access to safer tobacco alternatives and possibly even drive users back to traditional tobacco products.
Research suggests that e-cigarettes serve as popular alternatives to cigarettes. Therefore, when new restrictions, like taxes, are placed on these products, consumers are discouraged from making future purchases. A 2020 National Bureau of Economic Research study found that even a one percent increase in e-cigarette prices was associated with a one-half percent increase in cigarette sales, strongly indicating that restrictions on vape products may increase smoking rates. There is no reason to think this would not apply to American youth.
While it is obviously preferable that teenagers neither vape nor smoke, vaping is the lesser of the two evils. Children can and do find ways to smoke, despite a national requirement that Americans must be at least 21 years of age to purchase tobacco products. Therefore, it’s critical that policymakers come to terms with this reality and adopt policies that seek to minimize this risk rather than pretending that they can eliminate it entirely.
As this report suggests, policymakers can move the conversation forward by acknowledging that tobacco products exist along a risk continuum adjusting tobacco policy accordingly. Removing targeted flavor bans and prohibitive taxes on vape products that do nothing to help American teens is a good first step. Federal regulatory agencies like the CDC can, in addition to informing the public about the dangers of smoking, also walk back claims that using e-cigarettes makes teenagers more likely to smoke. While it is true that teenage vaping rates have recently increased, the total number of smokers has continued to decline. Other agencies like the Food and Drug Administration (FDA) can also make a difference by streamlining the approval process for vaping products, which has frequently proven slow and cumbersome.
Most importantly, policy makers and federal agencies should adopt a comprehensive approach to tobacco policy that embraces THR and evaluates products individually according to their benefits and risks.
Nate Scherer is a policy analyst with the American Consumer Institute, a nonprofit education and research organization. For more information about the Institute, visit us on www.TheAmericanConsumer.Org or follow us on Twitter @ConsumerPal.