President Donald Trump’s announcement Wednesday that he will seek to ban most flavored e-cigarettes comes from a good place — a rarity in this administration. But that doesn’t make a ban any less stupid.
It’s reasonable to be concerned about the massive surge in teen vapers over the past few years. The administration, led by former Food and Drug Administration commissioner Scott Gottlieb, was absolutely correct to crack down on e-cigarette companies marketing nicotine-rich products to teenagers.
Keeping young people away from the addictive products and regulating them carefully is vital, given that teens who use e-cigarettes are more likely to start smoking.
But, unsurprisingly, building a careful, evidence-based regulatory regime for the nascent industry is not exactly Trump’s style. He — as well as Michigan Gov. Gretchen Whitmer, a Democrat, who also announced intentions to ban flavored e-cigarettes in her state last week — apparently prefers the more elephantine approach of an all-out ban, blunting the potential good that comes from the product and potentially even hurting the anti-tobacco cause.
Let’s first acknowledge that e-cigarettes remain substantially less harmful than traditional cigarettes. They do not contain the tar and other chemicals that make smoking so dangerous. Yes, the recent spate of vaping-related lung illnesses — which has affected more than 450 people and killed six — is highly alarming. But it’s still not clear what’s causing the disease, though state and federal officials investigating the crisis might have a lead: a chemical found in marijuana products used by many — but not all — of those sickened across the country.
Health officials are right to warn the public of these risks. Still, that hardly justifies banning flavored e-cigarette juices and likely putting these products into an unregulated black market. Nor would it help the millions of adults using them as a tool to quit smoking. While the effectiveness of e-cigarettes as a tool for quitting has long been mixed, rigorous research published this year in the New England Journal of Medicine offers solid evidence that e-cigarettes are better at getting smokers to quit than traditional nicotine replacement therapies, offering an 18 percent success rate rather than 10 percent for products such as patches and gum.
Peter Hajek, a researcher at the Queen Mary University of London and lead author of the NEJM paper, noted that many of those in the study’s trials started to quit smoking by using tobacco-flavored e-cigarette flavors, but eventually branched out to fruity flavors and were successful in quitting. This follows survey data that suggests that one of the main advantages of the devices is that they let smokers who are trying to quit customize the flavors and nicotine levels that worked for their cessation strategy.
None of this should minimize the stunning rise of teen vaping — a legitimate public health concern that now extends to 1 in 5 high schoolers. We should encourage teens as much as possible to stay away from the product, as animal studies suggest nicotine could affect brain development in adolescents. But while teen e-cigarette use has skyrocketed, the rise in smoking rates that public health officials have warned about have so far failed to materialize. In fact, smoking rates among youths have continued to fall over the past decade.
Meanwhile, recent research shows that there might be unintended consequences to restricting e-cigarette flavors. The paper, published in the journal Substance Use & Misuse, reviewed survey data from young adults aged 18 to 29 who use both e-cigarettes and traditional combustible products and found that 17% would decrease e-cigarette use and maintain or increase smoking if flavors were limited.
Seventeen percent might not seem like a huge effect, but given that millions of people use e-cigarettes, even a small portion of the population moving to traditional cigarettes could mean a surge of new smokers. Plus, dual users — who constitute more than a third of all people who vape — are particularly at risk of exclusively becoming smokers and can often serve as a proxy for younger users.
A far better approach to addressing e-cigarettes than banning flavors is the path recently outlined by Gottlieb. The government should empower the FDA to fully regulate the industry. The FDA’s forthcoming application process for e-cigarette manufacturers will help separate legitimate e-cigarette products from juices with dangerous ingredients. And regulators and retailers must continue to enforce the age restrictions on vaping products, including liquids, online and at physical stores.
But most importantly, the administration must let science — not hysteria — guide our policy. E-cigarettes have the potential to help and to hurt. We cannot be blind to one effect because we’re ideologically disposed to see the other.