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Surgeon General's Report On Vaping

Last week, the United States Surgeon General's office released a new report entitled "E-Cigarette Use Among Youth and Young Adults." As has become the case here in the US, the report comes to some rather damning conclusions and is at odds with most of the research outside the States.


Here's a link to the executive summary, which itself is a whopping 28 pages long. The main report, for your perusal, is available here.


The main takeaways of the report are as follows:

  • Vaping is growing in popularity, particularly among young people. Adults aged 18-24 are more likely to use e-cigarettes than those over 25.
  • Young people are more likely to vape than smoke.
  • Nicotine, and possibly some other ingredients in e-liquid, can be considered dangerous.
  • Flavored e-liquids are popular.
  • Vaping should be treated more like smoking, with laws changed to target vapers just as harshly as smokers.


Needless to say, criticism of the report has already begun to pour in. The American Vaping Association has compiled a list of some pro-vaping reactions, some more takes from the medical profession can be found here.


So, what's wrong with the surgeon general's claims? Let's take them one by one…


First, the fact that vaping is growing in popularity isn't necessarily a bad thing, if it means that smoking is declining in popularity. Even the charts in the surgeon general's report show that though young adults are more likely to vape, they're actually less likely to smoke. What isn't mentioned is that tobacco use (when vapor products aren't lumped in with smoldering, burning masses of plant matter people traditionally associate with tobacco use) is at its lowest point ever among youth.


To wit:


"It is simply not true that e-cigarettes are a tobacco product or that vaping lures children to smoking or that it creates dependence in non-smokers. The prevalence of smoking among young people is at all time low and regular use of nicotine containing e-cigarettes among never-smokers is extremely rare," says Prof. Peter Hayek, Director of the Tobacco Dependence Research Unit at Queen Mary University of London. "On-going vigilance is needed, but so far, e-cigarettes have acted as a gateway away from smoking, for adults and adolescents alike. The report also ignores the huge benefits of vaping for adult smokers who are switching from deadly smoking to much less risky vaping in large numbers."


Speaking to the harm of nicotine, we'll turn to Prof Linda Bauld, Professor of Health Policy at the University of Stirling and Co-Chair of the Smoking in Pregnancy Challenge Group, a multi-agency group set up to support action to reduce smoking in pregnancy:


"We know Nicotine Replacement Therapy is safe – a recent study from the University of Nottingham found no adverse impact on the children of mothers who used it in pregnancy and followed up these infants until they were two years old. The evidence on sudden infant deaths primarily relates to the tobacco smoking in pregnancy which is hugely harmful and is one of the main causes of SIDS. To conflate this with e-cigarettes is inaccurate."


While we're not attempting to be an authoritative voice when it comes to the composition and effects of nicotine or any other drug, we've noted in past blogs that, stripped of the chemicals present in cigarettes specifically designed to enhance its effects and support addiction, nicotine is considered by many scientists to be fairly benign on its own. Some have even suggested positive cognitive reaction when nicotine is stripped away from the other chemicals present in tobacco smoke.


Finally, we turn to the oft-repeated argument about flavoring. Yes, young people enjoy flavor. This isn't however, a trait exclusive to those under 18, or 21, or even 24 – people young and old enjoy flavor. While we welcome tight controls to keep vaping products out of the hands of those underage, and strive to follow not just the letter but the spirit of any laws to this end, we don't believe adults should be denied a choice simply because it's one a youth might also make.


Considering the numerous fallacies in this report, we find it difficult to follow through to the ultimate conclusion that the use of vapor products should be demonized or controlled in any way aside from restricting access to underage individuals and common-sense courtesy regulations. Rather than continuing to ignore the mounting evidence that vaping is making tobacco use less popular rather than more so, we wish American policymakers would consider the facts on the ground and take steps to truly enhance public health. That starts with putting a vape in the hands of any smoker who's willing to try to switch.