Banning e-cigarettes is not the way to address fears about the harms of vaping
San Francisco is banning the sale and purchase of e-cigarettes, a law that will take effect in early 2020.
City attorney Dennis Herrera said the measure was intended to “protect youth” and necessary because the “health and lives of our children are at stake.”
Yet, in California, selling e-cigarettes to young people under the age of 21 is already against the law.
So too is selling young people cigarettes or alcohol – but there is no plan to ban those drugs, which cause infinitely more harm than e-cigarettes.
Hypocrisy is the word that springs to mind. Let’s be generous and say instead that San Francisco’s political leaders are well-intentioned but badly off target.
Vaping rates among teenagers are soaring. Parents are worried and politicians are trying to mollify them.
But adopting simplistic measures like banning sales of e-cigarettes is not the way to address this complex issue.
How many times does it need to be repeated that prohibition doesn’t work?
If young people want to get their hands on a Juul or any other form of e-cigarette, they will do so, and easily.
In San Francisco, they can hop on the BART and head across the bay to Oakland. Or order online. While the new regulations outlaw delivering e-cigarettes to addresses in San Francisco, good luck enforcing that provision.
Banning sales will only make it more likely that young people will turn to the black market, and get unregulated, and likely more dangerous, devices.
Or, if they need a nicotine fix, there are always cigarettes.
San Francisco’s action will also make it more difficult for adults to purchase e-cigarettes, which can be effective smoking cessation tools.
A recent study in the New England Journal of Medicine found vaping was twice as effective as other nicotine replacement approaches such as patches, gum and lozenges in helping smokers quit.
Let’s focus for a moment on the fundamental issue: The growing popularity of e-cigarettes, and the Juul device in particular, means a lot of young people are being hooked on nicotine.
Nicotine is addictive but it is relatively harmless.
The harm from smoking comes from the by-products of combustion – tar, carbon monoxide and other carcinogens.
E-cigarettes work by heating a liquid that contains propylene glycol or vegetable glycerine, along with flavours and, of course, nicotine, to create a vapour.
We don’t know the long-term effects of exposure to those chemicals but they are, without a doubt, far lesser than the damage caused by burning tobacco and inhaling smoke.
So why do we care if young people vape?
The big fear is that they will become addicted to nicotine and, if vaping products are unavailable or too expensive, they will get their nicotine fix from cigarettes. The dreaded slippery slope.
But public-health officials are divided on a fundamental question: Will vaping reduce or increase smoking rates over time?
So far, the data are all over the map, especially for young people.
Much is made of the fact that large numbers of young people have tried vaping, but teens are prone to experimentation, so that’s hardly surprising.
What we should care about is young people who vape daily or more than once a week. Those numbers remain low, and there is some evidence they are falling, as the novelty and shock factor that teens enjoy wears off.
In the U.S., twice as many teens vape as smoke, but the good news is that smoking rates among teens have plummeted to record lows.
In Canada, the teen vaping rate has doubled since legalization of e-cigarettes in May, 2018, but there are still more teen smokers than vapers – 11.9 per cent versus 9.3 per cent who partake at least weekly.
In Britain, on the other hand, both vaping and smoking rates remain low among teenagers.
In all three of those major markets, it’s not clear what the “conversion rate” is – the number of vapers who become smokers but, again, the numbers seem quite low.
It’s noteworthy that Britain has embraced e-cigarettes as a smoking cessation tool for adults. It also regulates the products strictly, in particular limiting levels of nicotine and banning fruity flavours that are attractive to young people.
This is the way to go: Recognize that there are benefits as well as harms, and regulate smartly to reduce potential harms.
Banning sales of e-cigarettes, especially while allowing the sale of more lethal alternatives, is the last thing we should be doing.