When comparing vaping vs. smoking, all experts agree that e-cigarettes are far safer than tobacco cigarettes. This does not mean that e-cigs pose no health risks, but that medical research has yet to identify any. Everyone knows that smoking is a deadly habit, and is responsible for countless cancers and other health problems. So, why do public health officials in the US continue to pair vaping with cigarette smoking, despite what smoking statistics continue to support?
The Role of Nicotine in Classifying E-Cigs as Tobacco Products
The majority of e-liquids contain nicotine, which comes from the tobacco plant. Does this mean that e-cigs and e-liquids are tobacco products? It 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. These definitions play a part in how smoking statistics are calculated and reported.
Related: How the FDA Regulates Vapor Products
What are Tobacco Products?
Nicotine is just one of hundreds of compounds found in the tobacco plant. While nicotine was long believed to be the main cause of tobacco addiction, modern research has discovered that the other chemicals in cigarettes are responsible for the many health problems 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. The result? 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 kills off competition and innovation.
The FDA and Tobacco Products
The FDA’s policies have been met with 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 strict regulations on e-cigs is wrong, considering that they could potentially save lives.
If e-cigs are considered tobacco products, nicotine replacement therapies like nicotine gums, patches and lozenges are too, right? Wrong! The FDA classifies these over-the-counter alternatives as drugs, which 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 stats, has been criticized for including data about e-cig users in their reports. In April 2015 the CDC claimed “there was no decline in overall tobacco use between 2011 and 2014.” This is true if you disregarded people who gave up smoking for vaping, and counted everyone who tried an e-cig 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 smoking 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 bold claim, considering that e-cigs are only “tobacco products” because the FDA deems them as such. 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?
Countries deal with technological advancements in different ways, so it’s no surprise to see differing vaping policies across the globe. The UK has by far been the most accepting of e-cigs. Public Health England’s 2015 report concluded that vaping is at least 95 percent less dangerous than smoking. 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 public health benefits of e-cigs, the New Zealand Ministry of Health decided to regulate e-cigs as consumer goods. More countries will hopefully follow suit and embrace e-cigs as a safer tobacco alternative.
The United States is a leader in technology and science, but current policies prevent e-cigs from reaching their potential as smoking cessation tools. The final part of this series about nicotine will look at how other countries are responding to the e-cig boom.