Four scientists have co-authored a study debunking some of the most pervasive myths about the dangers e-cigarettes pose to youth.
The study is a wide-ranging critique of former Surgeon General Vivek Murthy's 2016 report on e-cigarettes and young people.
At the time, Murthy's report added fresh momentum to a moral panic over youth vaping that has gathered pace in recent years. Fears of young people experimenting with e-cigarettes have since been used as a justification for higher taxes, tighter regulations, and de facto bans on vapor products.
This is in spite of research that shows e-cigarettes pose just a fraction of the risks of cigarettes and the growing body of evidence that they help adults quit smoking.
By labeling youth vaping a "major public health concern," Murthy's report gave an air of credibility to the more extreme parts of the anti-vaping crowd.
But a study published Sept. 6 in the journal Harm Reduction serves as a much needed corrective to the hysteria that has pervaded the public debate on e-cigarettes in the wake of Murthy's report.
First off, the study concedes Murthy was correct to observe there were several hundred percent increases in youths who have tried e-cigarettes from 2011 to 2015. But the authors point out this observation obscures the more important measure in terms of public health, which is how frequently youths are actually using e-cigarettes.
The data show youth vaping is "either infrequent or experimental." Only a tiny proportion of young people who report using e-cigarettes are actually doing so on a regular basis.
According to the 2015 National Youth Tobacco Survey, only 0.6 percent of middle school students have used an e-cigarette on at least 20 of the past 30 days. Among high school students, the figure is 2.5 percent. Furthermore, vaping among youth who have never smoked is "negligible," according to the study's authors.Another major plank in Murthy's report was the potential hazards to young people from vaping because of the presence of nicotine. "Most e-cigarettes contain nicotine, which can cause addiction and can harm the developing adolescent brain," said Murthy.
While it is true that most e-cigarettes contain nicotine, the study's authors argue Murthy is wrong to categorize this as a major public health concern for young people. The majority of the tiny number of young people who vape regularly use e-cigarettes that don't even contain nicotine.
Data from the 2015 Monitoring the Future Study survey shows that 65–66 percent of students in 8th, 10th, and 12th grade who had ever used e-cigarettes used one that didn't contain nicotine. For current vapers, 59–63 percent reported using e-cigarettes that just contained flavorings.
Ever present in debates about youth vaping is the so-called "gateway" hypothesis. Anti-vaping campaigners often claim teens who experiment with e-cigarettes will likely transition to smoking and increased youth vaping rates may lead to a new generation of smokers. Murthy's report gave a wink to this view, citing several studies claiming e-cigarette use among young people is predictive of future smoking.
But as Polosa et al make clear in their critique, these studies suffer severe limitations and none can show causation of young people starting vaping and going on to smoking.
In the real-world, we can see the gateway hypothesis has failed to materialize. The study's authors point out, "the sharpest declines in US youth smoking rates have occurred as e-cigarettes have become increasingly available" and that "available data appear reassuring that e-cigarettes are not decelerating let alone reversing declining rates of youth smoking."
Even Murthy's claims about the dangers of nicotine are on shaky ground. Polosa et al highlight the fact that the bulk of the evidence presented in Murthy's report for the potential dangers of nicotine is not even applicable to e-cigarettes because it relies "almost exclusively on exposure to nicotine in the cigarette smoke and not to nicotine present in e-cigarette aerosol emissions."
Moreover, the references cited in Murthy's report to make his case describes effects of nicotine in adults and in animals, not young e-cigarette users. No one wants to see e-cigarettes in the hands of young people. That's exactly why we have age restrictions to ensure young people don't have easy access to these products. Indeed, these restrictions appear to be working, with the latest data showing that after years of rising e-cigarette use, youth vaping fell sharply last year.
What this new study serves to highlight is the bad use of science to pursue an even worse set of public policy goals. Restricting e-cigarette access to minors is a goal everyone shares, but it should not come at the expense of denying or impeding adult smokers the option to switch easily and affordably to a product that may save their lives.
Guy Bentley (@gbentley1) is a contributor to the Washington Examiner's Beltway Confidential blog. He is a consumer freedom research associate at the Reason Foundation and was previously a reporter for the Daily Caller.
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