Anti-vaping opportunists are trying to use today’s public health crisis to capitalize on last fall’s public health hysteria. Citing concerns about vapers’ potential susceptibility to COVID-19, several states are looking into including vaping regulation as part of their coronavirus response. In a similar vein, the House Oversight Committee urged the Food & Drug Administration to “clear the market” of e-cigarette products.
Such regulation was misguided long before the pandemic developed. In fact, if anything, vaping’s record as a tremendously effective smoking cessation aid makes it as important now as ever. Good coronavirus policy — and good public health policy in general — will leave the vaping market be.
To understand how public health policy is going awry, consider the newly-approved New York state budget. It bans flavored vaping products and prohibits the sale of both conventional tobacco products and vaping products in pharmacies. It also restricts the distribution of e-liquid products only to state-licensed retailers, making online sales of e-cigarettes and other nicotine products to New York residents a Class A misdemeanor. Moreover, vapor manufacturers must post detailed ingredient lists and byproduct notices more exhaustive than any other tobacco product.
With this legislation, New York ropes vaping with conventional smoking as a public health crisis, and in some aspects, it regulates vaping more harshly. Considering how many smokers use vaping as a harm-reduction substitute, and given the evidence that vaping is substantially less harmful than smoking — comparable to other forms of nicotine replacement therapy — these regulations will only shorten life spans.
Too many Americans have already lost loved ones in recent weeks. As of April 28, the United States was just short of 1 million COVID-19 cases and 60,000 related deaths. That makes its anti-vaping laws especially regrettable, namely because they inflate the number of people especially at risk of serious illness.
Let me explain.
As a severe acute respiratory syndrome (SARS) virus, COVID-19 is particularly dangerous for people with weak respiratory systems or who are otherwise susceptible to respiratory problems. Because smoking is known to damage lungs and weaken the immune system, smokers are especially likely to contract coronavirus, suffer worse symptoms and undergo respiratory failure. A February study of about 1,100 Chinese COVID-19 patients, published in the New England Journal of Medicine, found smokers were 140 percent more likely to need ventilation, receive intensive care or die.
But contrary to rumor, there’s little evidence that vaping exacerbates coronavirus. While not wholly harmless, vaping doesn’t involve inhalation of tars and other toxic chemicals like smoking, and vaping is far less damaging to a person’s respiratory system than smoking. In fact, there is evidence that switching to vaping improves smokers’ lung health. Perhaps now, more than ever, respiratory health is crucial. That’s why many doctors are encouraging smokers to switch to vaping during the pandemic.
Vaping already has helped many people successfully quit smoking. Smokers who switch to vaping have been twice as likely to quit smoking than those who try other forms of nicotine replacement therapy.
Also, limiting access to vaping products will foster the growth of the vaping black market, which also isn’t good for public health. Almost all of the E-Cigarette and Vaping-Associated Lung Illness (EVALI) cases that dominated headlines last fall were attributable to Vitamin E acetate, a component found in THC-laced black market vaping products. Take away accessible options, especially from visible retailers with reputations to keep, and you force vapers to choose to revert to smoking or pursue potentially dangerous black market products.
Expanding the black market and increasing EVALI cases in the coming months couldn’t come at a worse time. Health care resources are stretched incredibly thin in the fight against COVID-19 as it is, and shortages of ICU beds, healthy nurses or other resources mean some patients will not get adequate care. Facilitating exposure to Vitamin E acetate will only further strain health care capacity, risking more deaths — of coronavirus patients and vapers alike.
These regulations intend to improve public health in the long run by reducing nicotine addiction. But that argument assumes e-cigarettes are a kind of “gateway” to conventional smoking, a claim in dire shortage of evidence. Studies associating teen vaping with cigarette use acknowledge the common risk factors that drive young people toward varieties of substances — but there is a severe lack of causal evidence that choosing to vape makes someone more likely to pick up a cigarette. Considering 85 percent of vapers have a smoking history, it’s difficult to conclude that vaping is a cigarette-use time bomb.
Sound policy would proportion regulation and enforcement to the degree of harm something causes. Because smoking does more damage than vaping, the law should discourage it more. Instead, in some key respects, America is building heavier barriers to vaping than smoking. At a time when respiratory health is so crucial, that is a misstep we cannot afford.
• John Kristof is an economic analyst and a consumer freedom fellow for Young Voices. Follow him on Twitter @jmkristof.