Vaping Critics Ignore The Bigger Picture

16 years after the first e-cigarette was invented, media outlets across the world have been quick to link the devices to what is apparently their first potential ‘death’. The case has fueled concerns about the potential harms of vaping, a proven harm reduction tool for smokers who struggle to quit their habit, despite no identified cause and much of its surrounding circumstances remaining unknown.

The unidentified American man from Illinois was hospitalised with lung troubles and died this year. He is the only fatality out of 193 cases of respiratory illness cited by the US Centre for Disease Control between June 28th and August 23rd this year among the millions of Americans who ‘vape.’

Anti-vaping lobbyists and members of Australia’s public health orthodoxy have been quick to cite the death to defend Australia’s current ban on smokers legally accessing nicotine vapes, the only such ban in the Western developed world. However, an understanding of the surrounding circumstances and what we do know about vaping is essential before any lessons can be drawn.

No reliable scientific authority has ever claimed that vaping is completely safe. It’s impossible to understand every possible risk of any innovative product without decades of experience and after all, any device that delivers heated vapours to the lungs can cause irritation or inflammation. Nicotine, widely used by former smokers who transition to vaping, is also an addictive stimulant.

This is why public health experts and bodies like the UK Royal College of Physicians and the US Food and Drug Administration recognise that those who are susceptible to particular lung conditions, minors, and adults who did not previously smoke or vape, should be deterred from vaping.

These bodies have instead recognised that vaping’s value lies in its potential to reduce tobacco-related harm. Tobacco smoking kills millions of people around the world every year and is considered to be at least 20 times more harmful than vaping nicotine according to agencies like Public Health England who have comprehensively reviewed years of evidence. This is why doctors in the UK are actively encouraged by their government to recommend vaping as an alternative to patients who smoke.

The primary harms of smoking arise from burning the tobacco leaf, a process which exposes tobacco smokers to tar and carcinogens. Vapourising nicotine solutions allows smokers to satiate their cravings without burning tobacco.

A single potential death in the United States then cannot provide any meaningful justification to prohibit an alternative to a legal practice that is proven to cause the premature deaths of 19,000 Australians each year.

Australia has long been considered a leader in smoking cessation and is home to some of the world’s highest tobacco taxes. Yet in the years since 2013, our quit rates have stagnated. Over the same period, vaping experienced a rapid uptake worldwide and this has coincided with a significant fall in quit rates amongst countries including the United Kingdom and United States- neither of which outlaw vaping nicotine. This despite these nations levying lower tobacco excise than Australia.

Vaping is even considered a more effective quit aid than nicotine patches and gums.

As for the cases of respiratory illness, the US CDC notes that “no specific product has been identified in all cases nor has any product been conclusively linked to the illnesses.” The prior history of illness, lifestyle factors and even the vaping device used by the one man who died, and whether it was even a legal device, remain unknown. Many of the respiratory illness cases in the US involve individuals abusing unregulated or illegal products loaded with THC: the psychoactive ingredient of cannabis.

A vast majority of vapers who use nicotine are former smokers who use it to quit or limit smoking, not to get stoned.

If anything, these cases support the legalisation and regulation of vapes and nicotine solutions to uphold safety, quality and the monitoring of future consumer practices and their impact.

Australians vape with nicotine, contravening laws which are rarely enforced and simply prevent smokers from obtaining nicotine solutions at their local store as easily as they can obtain cigarettes.

Vapers instead order solutions from countries like New Zealand, depriving the government of tax revenue and stunting a burgeoning and innovative local vape industry. While products from New Zealand must meet general safety requirements, not all countries enforce the same standards.

Potentially deadly solutions containing 99% pure nicotine can be ordered from China, and illegal products free from child-resistant packaging requirements have been linked to accidental poisonings. The lure of these products disappears when regulated products are legally and conveniently available.

We may not know every possible risk of vaping for at least a few decades. But this is no excuse for an anti-innovation, overly prohibitionist approach that puts smokers’ lives at risk and is fuelled more by moral panic than by proven public health concerns.

Satya Marar is the Director of Policy at the Australian Taxpayers’ Alliance and Legalise Vaping Australia.

This article was originally published in the Herald Sun on 2 September 2019.

Satyajeet Marar