Why the vaping issue is just so complicated
(CNN) — By proposing to effectively ban the sales of most flavored vaping products in brick-and-mortar retail settings like gas stations and convenience stores, the Food and Drug Administration is essentially reaching back to the late 20th century. That’s when the federal government continually tightened regulations on the placement and content of traditional tobacco advertisements — mainly to reduce the exposure of children to such ads.
At the white-hot core of the e-cigarette controversy: Young people who vape are significantly more likely to start smoking traditional cigarettes in the future, according to several studies.
Many teens and adults use e-cigarettes as well as cigarettes. Except most young smokers aren’t using e-cigarettes to cut down on traditional smoking.
Our recent research found more young people reported using e-cigarettes than cigarettes in late adolescence. But by young adulthood, traditional cigarette smoking ruled. Those who escalated their e-cigarette use over time also showed subsequent increases in cigarette smoking, suggesting a progression toward more frequent vaping and smoking as they got older. A recent report also found that vaping among America’s teenagers has continued to rise even as their use of other substances like alcohol and opioids has decreased.
More than 20% of high school students vape, according to the Centers for Disease Control and Prevention. That translates to some 3 million young e-cigarette users, without even counting their middle school counterparts.
One sign of the pervasiveness of vaping in teen culture: Juul, the most popular e-cigarette brand in the US, is getting the verb treatment, a la “Google that.” “Juuling” is now a thing, as in “I got caught Juuling during class today, so I’m stuck in detention.”
While e-cigarettes may be a “safer” option for adult smokers, e-cigarettes are not safe for young people. Most e-cigarettes, especially the most popular brands, still contain nicotine, and nicotine is a highly addictive drug — especially for teens, who are likely to get hooked on the drug more easily than adults.
Although it may be illegal for those in high school or younger to buy e-cigarettes, that hasn’t stopped manufacturers from marketing them in a way that makes the products appealing to teens. The slickly packaged e-cigarettes also are heavily promoted via social media, a concern since research shows these strategies effectively pique kids’ interest.
So when the FDA announced new regulations last month, it took aim at flavored e-cigarettes, which come in a wide variety of sweet, kid-friendly flavors — like blue raspberry or cotton candy — that sound more like Slurpees than a delivery system for one of the world’s most addictive drugs.
The FDA’s rules changes will chip away at the e-cigarette’s candy-wrapper coating. Most retail locations that serve children and adults will only be allowed to sell e-cigarettes in flavors that mimic the taste of traditional cigarettes — tobacco, menthol and mint.
These moves are in keeping with recent studies showing that flavors play a significant role in adolescent vaping. Our recent research for the nonpartisan RAND Corporation also suggests that even seeing e-cigarettes in convenience stores — where they are often displayed next to the cigarettes behind the cashier — may lead more teens to try vaping.
Tobacco companies have a long history of aggressively targeting children and teens, trying to transform them into lifelong customers. Many of these firms have entered the e-cigarette business in recent years. But newer companies without historic ties to tobacco, such as Juul Labs, have also been criticized for using youth-friendly marketing campaigns to help popularize their products. A CNN investigation has revealed that Juul Labs was encouraging (and in some cases paying for) social media influencers to promote its product.
The federal government also has a history of reining in cigarette marketing, starting with a 1970 ban on advertising cigarettes on television and the radio.
The FDA considers the current use of e-cigarettes among teens an “epidemic,” and the numbers back that up. Teen smoking rates have dropped by more than 50% since 2011, but vaping among high school studentsincreased by more than 600% during that same period.
Some may see aggressively cracking down on the sales of e-cigarettes — while traditional cigarettes remain omnipresent at gas stations and convenience stores — as a step in the wrong direction. It could make it harder for smokers to access vaping products and potentially incentivize smoking over vaping when smoking among adults has hit historic lows.
Vaping could be seen as the lesser of two evils. Some vaping advocates view e-cigarettes as a hero in the war against traditional smoking. Research has shown that adult smokers who switch to e-cigarettes can reduce their exposure to a wide range of carcinogens and other toxins. There is also a general consensus in the public health community that vaping is almost certainly a safer alternative to smoking cigarettes — for adults.
If smokers can switch to vaping, e-cigarettes may have the potential to significantly reduce smoking-related disease. This is an important point since smoking remains the leading preventable cause of death in the US.
But vaping products seem to be gaining more traction among teens than adult smokers. Of the estimated nearly 20% of US adults who use any tobacco product, only 3% use e-cigarettes, while the vast majority of high school students who use tobacco products engage in vaping.
If the newly announced FDA regulations fail to help reverse the teen vaping trend, e-cigarette use among the young could end up leading to more nicotine use in the long-term and cast a dark shadow on the anti-smoking movement.