NEW YORK. Sixty years ago, the U.S. surgeon general released a groundbreaking report that quelled a long-standing public debate on the perils of cigarettes, triggering substantial changes in smoking habits across America. Today, as vaping continues to be a topic of concern, some public health experts suggest that a similar report is needed to provide clarity.
Many U.S. adults hold the belief that nicotine vaping is as harmful as, or even more dangerous than, cigarette smoking. Contrary to this belief, the U.S. Food and Drug Administration (FDA) and the majority of scientists concur that electronic cigarettes are significantly less dangerous than traditional cigarettes.
However, this does not imply that e-cigarettes are entirely harmless. Public health experts are divided on the precise extent of harm or benefit these devices bring. Lawrence Gostin, a public health law expert at Georgetown University, emphasizes the urgent need for clarifying information: “There have been so many confusing messages about vaping; a surgeon general’s report could clear that all up.”
A major obstacle to understanding the long-term effects of vaping is the limited time e-cigarettes have been in existence. Scientists have not had enough time to observe if vapers develop health issues like lung cancer and heart disease. Dr. Kelly Henning, leading the public health program at Bloomberg Philanthropies, notes, “There’s a remarkable lack of evidence.”
SMOKING AND VAPING
Cigarette smoking, historically described as the leading cause of preventable death in the United States, claims an annual toll of 480,000 lives, according to the Centers for Disease Control and Prevention. A decline in smoking rates since the 1960s is anticipated to reduce this toll by 2030.
In 1964, U.S. Surgeon General Luther Terry released a landmark report declaring smoking as a cause of illness and death, leading to transformative measures such as warning labels on cigarette packs, a ban on cigarette commercials, increased tobacco taxes, and restrictions on smoking locations.
Some experts credit e-cigarettes with contributing to the decline in smoking rates. Billed as a means to help smokers quit, the FDA has authorized specific e-cigarettes as less-harmful alternatives for adult smokers.
Vaping gained popularity in the 2010s among both adults and teens. In 2014, e-cigarettes surpassed combustible cigarettes as the most-used tobacco product among youth. However, U.S. health officials’ concerns about youth nicotine addiction leading to a resurgence in smoking have not materialized. Last year, the high school smoking rate dropped to less than 2%, a substantial decline from the 35% rate seen 25 years ago.
Kenneth Warner, a researcher at the University of Michigan, credits e-cigarettes for this achievement: “If it weren’t for e-cigarettes, I think we would be hearing the public health community shouting at the top of their lungs about the success of getting kids not to smoke.”
VAPING’S BENEFITS AND HARMS
Cigarettes, labeled the deadliest consumer product, contain thousands of chemicals, with at least 69 known carcinogens. The vapor from e-cigarettes is estimated to contain fewer chemicals and carcinogens, with studies indicating improved lung function in smokers who completely switch to vaping.
Donald Shopland, a committee clerk for the 1964 report, emphasizes the relative safety of vaping: “I would much rather see someone vaping than smoking a Marlboro. There is no question in my mind that vaping is safer.”
However, concerns arise regarding the impact on non-smokers. Studies on vaping are varied, with conflicting results on its effects. Bronchitis symptoms and aggravation of asthma in young vapers have been documented, along with potential impacts on blood vessels and the heart. Nicotine, the addictive stimulant in cigarettes and vapes, remains a significant concern.
Studies suggest nicotine exposure in adolescents may affect brain development, leading to concerns about links to ADHD, depression, and stress. However, experts stress that research is limited, and more investigation is required.
Despite the conflicting evidence, there is no consensus on whether vaping effectively aids smoking cessation, with studies yielding different conclusions.
CLEARING THE AIR
Recently, the World Health Organization raised concerns about the burgeoning global markets for electronic cigarettes, especially their appeal to young people. In 2016, U.S. Surgeon General Dr. Vivek Murthy advocated efforts to prevent and reduce e-cigarette use by children and young adults.
The FDA, recognizing the potential benefits for smokers, initiated steps to regulate e-cigarettes four months before the report’s release. While several e-cigarettes have gained FDA authorization, criticism persists regarding perceived inconsistencies in product regulation.
Despite concerns, the variety of e-cigarette devices in the U.S. has surged, primarily due to disposable imports from China offering diverse flavors. Youth vaping, however, has seen a recent decline, with 10% of high school students reporting e-cigarette use in the previous month, down from 14% the previous year.
The decline is attributed to various factors, with Steven Kelder, a University of Texas researcher, mentioning the 2019 outbreak linked to black-market vape cartridges containing THC, a thickening agent unrelated to commercial nicotine e-cigarettes.
Sherri Mayfield, a postal worker, recalls the 2019 outbreak, emphasizing the need for further study on vaping. While acknowledging cigarettes as unsafe, she notes the prolonged timeframe for health deterioration: “Cigarettes aren’t safe, but at least it can take them decades to destroy your health.”
The surgeon general’s office recognizes the impact of the 1964 report and suggests similar action is required to address youth vaping. However, Dr. Vivek Murthy’s current website does not list vaping or smoking as priority issues, raising questions about the current stance on this pressing public health matter.
