Regulating e-cigarettes requires a scalpel, not a hammer | Editorial

The U.S. is in the middle of a vaping epidemic — an epidemic of panic. Over the past few weeks, there have been reports of a mysterious vaping-related lung disease that impaired — and at least six times killed — otherwise young healthy people. In response, on Wednesday, President Donald Trump announced that he instructed the Food and Drug Administration to draft regulations that would ban flavored e-cigarettes, which are thought to make the product more appealing to teens.

Trump wasn’t the only one looking to take swift action on vaping. On Sunday, New York Gov. Andrew Cuomo issued an executive order to emergency ban flavored e-cigarettes; Michigan announced plans for a similar ban earlier this month. New Jersey’s state Senate President Steve Sweeney proposed to ban all vaping products. Last week, N.J. Gov. Phil Murphy announced an e-cigarette task force that will make recommendations by October 3.

When young people are dying, it is tempting to demand that the government immediately do something . But e-cigarettes pose a complex problem for lawmakers: How do we maximize the public health benefits of vaping while minimizing the harms?

E-cigarette is an umbrella term to multiple products — legal, illicit, containing nicotine, and some containing THC. Because e-cigarettes are a relatively new product — around for less than two decades — there are still many unanswered questions about the long-term health effects of years of vaping nicotine. However, a review conducted by England’s public health agency concluded that e-cigarettes carry only 5% of the harm of combustible cigarettes. Following this conclusion, England started a campaign to promote vaping as a healthier, though not harmless, alternative to smoking cigarettes.

Using vaping as a way to stop using cigarettes works. According to a randomized controlled trial recently published in the New England Journal of Medicine, e-cigarette use was twice as effective as a nicotine cessation program in maintaining a year of abstinence from smoking. One major reason for the appeal of vaping for adult smokers is the flavors. Research suggests that a ban on flavors will drive some adults back to smoking cigarettes.

That’s a major risk considering that close to half a million people a year in America die because of cigarette-related illnesses every year.

The potential public health benefits of vaping are being overshadowed by reports of an explosion in teen vaping and the mysterious vaping illness.

According to the CDC, in 2018, 1 in 5 high school students vaped in the past 30 days — a significant increase from 2017. That is concerning and must be addressed. The reported vaping-related deaths and illnesses are also concerning. But, from the information currently available, it seems that the “mysterious illness” is related to illicit THC vaping — not products that are bought legally.

Instead of turning to prohibition to address vaping, regulation of e-cigarettes needs to be careful and nuanced. To do that, we need to know much more — starting with localized data on who vapes, what is vaped and why for lawmakers to draw from. Banning vaping products without more information could do more harm than good.