When comparing vaping vs. smoking, all experts agree that e-cigarettes are far safer than traditional tobacco cigarettes. This doesn’t mean that e-cigs pose no health risks, but medical research has yet to identify any such risks. On the contrary, everyone knows that smoking is a deadly habit responsible for countless cancers and other health problems. Why do public health officials in the US continue to conflate vaping with smoking?
The Role of Nicotine in Classifying E-Cigs as Tobacco Products
The majority of e-liquids contain nicotine, which in its natural form derives from the tobacco plant. Does this mean that e-cigs and e-liquids are tobacco products? It technically depends on what part of the world you’re in.
In the US, the FDA has the final say about what legally constitutes a tobacco product. According to the FDA’s Deeming Regulations and the Tobacco Control Act of 2009, a tobacco product is “any product made or derived from tobacco that is intended for human consumption.” Although nicotine can be synthesized without tobacco, the FDA uses the fact that tobacco contains nicotine to justify the classification of e-liquids as tobacco products. The FDA’s definition also includes “any component, part, or accessory of a tobacco product,” which is how e-cig hardware also gets lumped into this category. While this may all sound arbitrary, it has important consequences for how statistics about smoking are calculated and reported, which in turn has a huge impact on public policy.
Related: How the FDA Regulates Vapor Products
What are Tobacco Products?
Nicotine is just one of hundreds of compounds present in the tobacco plant. While nicotine was long believed to be the chief driver of tobacco addiction, modern research has discovered that the other chemicals in cigarettes are responsible for the many health maladies associated with smoking. Nonetheless, the FDA currently makes no distinction between vapor products and tobacco products; even e-liquids without nicotine are classified as tobacco. What is the rationale behind such a bizarre policy?
Related: Where Does Nicotine Come From?
By subjecting the vape industry to the same regulations as the tobacco industry, the FDA can require pre-market approval, which is an expensive process that big tobacco companies can afford yet many e-cig manufacturers cannot. Therefore, the only e-cigs that easily make it to market are those made by the tobacco corporations. Meanwhile, smaller operations struggle to meet financial and administrative hurdles, which stifles competition and innovation.
The FDA and Tobacco Products
The FDA’s policies have been met with harsh criticism from tobacco harm reduction advocates around the world. Tobacco harm reduction is the practice of steering tobacco users toward less risky behaviors. It’s easier for smokers to switch to vaping than to give up nicotine cold turkey, and since an overwhelming amount of scientific research has found vaping to be safer than smoking, e-cigs can play a role in ending the smoking pandemic. Critics argue that imposing strict regulations on e-cigs is irresponsible considering that they could potentially save lives.
If e-cigs are considered tobacco products, then you would assume that nicotine replacement therapies like nicotine gums, patches and lozenges would fall under the same category as well. However, the FDA classifies these over-the-counter alternatives as drugs, so they are neither subject to tobacco regulations nor included in smoking statistics. Consequently, several double standards exist; for example, flavored e-liquids are accused of appealing to children while nicotine gums are readily sold over the counter in a variety of flavors, often on bottom shelves within reach of children
The CDC and Smoking Statistics
The CDC, which is responsible for tracking national smoking statistics, has been criticized for including data about e-cig users in their reports. For example, in April 2015 the CDC claimed “there was no decline in overall tobacco use between 2011 and 2014,” which is only true if you disregarded people who gave up smoking for vaping and you counted everyone who tried an e-cig even once as a regular tobacco user. The 2013 National Youth Tobacco Survey notoriously failed to distinguish between youth who tried vaping once and regular e-cig users, which led to highly inflated claims about the number of teens who vape. When relying upon statistics from an academic study or a government agency, always pay close attention to the methodology.
The Surgeon General’s View on E-Cigarettes
The U.S. Surgeon General isn’t immune to e-cig hysteria. In December 2016, the Surgeon General’s office published a reported titled “E-Cigarette Use Among Youth and Young Adults,” which relies upon faulty data from the CDC to argue that e-cigs, “are now the most commonly used form of tobacco among youth in the United States.” That’s a pretty bold statement considering that e-cigs are technically only tobacco products because the FDA deems them as such; however, when it comes to actual health outcomes, there is no comparison between vaping vs smoking.
How is Vaping Viewed in Other Parts of the World?
Different countries have traditionally dealt with technological advancements in different ways, so it’s unsurprising to see contradictory vaping policies popping up across the globe. The UK has by far been the most accepting of e-cigs. Public Health England’s 2015 evidence-based report on the subject concluded that vaping is at least 95 percent less dangerous than smoking tobacco cigarettes. Consequently, the Royal College of Physicians now urges doctors to recommend e-cigs to patients who smoke as a strategy for harm reduction. After acknowledging the potential public health benefits of e-cigs, the New Zealand Ministry of Health recently decided to regulate vapor products as consumer goods. More countries will hopefully follow suit and embrace e-cigs as a safer tobacco alternative.
Sadly, while the United States remains a global leader in technological and scientific innovation, conservative policies are preventing e-cigs from reaching their full potential as smoking cessation tools. The next and final installment of this series about nicotine will look at how other parts of the world are responding to the evolution of e-cigs.