To this lifelong non-smoker, using electronic cigarettes (“vaping”) seems like a desirable and effective tool for weaning nicotine addicts off the toxic clouds of smoke with which they fumigate their lungs. I do understand why an educated observer might disagree — less so why the issue has become intensely partisan.
Smoking has been controversial for centuries. While Sir Walter Raleigh popularized tobacco in England, King James I described smoking as, “A custome lothsome to the eye, hatefull to the Nose, harmefull to the braine, dangerous to the Lungs, and in the blacke stinking fume thereof, neerest resembling the horrible Stigian smoke of the pit that is bottomelesse.”
E-cigarettes, a high-tech creation, were created as a tool for smoking abatement. Evidence suggests they are the single most successful means of weaning smokers off the carcinogen-laced smoke they crave. For vapers, the nicotine arrives via droplets of vapor, often scented with very un-tobacco-like fragrances, such as mango, peppermint, coffee or lemonade. (The well-known carcinogenic effects of smoking come largely from chemicals other than nicotine.)
In particular, e-cigarettes use digital technology to deliver the smoker’s desired nicotine hit far more effectively than delivery mechanisms like nicotine gum and patches. Thus, vaping seems to make it easier to quit smoking than other approaches.
Still, there is controversy. Let’s explore some relevant facts:
First, smoking tobacco poses terrible health hazards for smokers and is likely the largest single cause of preventable deaths. Vaping poses health hazards, too, but far less than those associated with smoking tobacco.
Second, we can categorize several groups whose behavior changes with the introduction of e-cigarettes — in order of desirability. (A) Smokers who shift from smoking to vaping and then quit vaping. (B) Smokers who shift from smoking to vaping. (C) Non-smokers who shift from abstinence to vaping. (D) Non-smokers who shift from abstinence to vaping and then proceed on to smoking.
Third, people have subjective tradeoffs among the four (A), (B), (C), and (D) categories based in part on their perceptions of the relative health hazards of smoking and vaping.
If you think e-cigarettes move lots of people into categories (A) and (B) and very few into (C) and (D), then you probably think vaping is a good thing. If you think very few will use e-cigarettes as an exit ramp — (A) and (B) — and lots will use them as an entry ramp — (C) and (D) — then you probably oppose e-cigarettes.
Then there are the subjective aspects. Smith and Jones might agree that vaping induces 10 smokers to shift to vaping for every one nonsmoker induced to vape. Smith, though, might argue that one nonsmoker-to-vaper is too high a price to pay for those 10 who go from smoking to vaping (particularly if the one is a minor). Jones, in contrast, might see that 10-to-1 ratio as an acceptable tradeoff.
One of the most contentious public policy issues is the range of fragrances. E-cigarette vendors argue that they help smokers lose their taste for tobacco. (Vapers in my office confirm to me that after using the aromatic blends for a while, the smell of tobacco becomes repugnant.) Others, though, argue that the sweet flavors attract nonsmokers — especially those too young legally to smoke or vape.
To repeat, I tend to favor broad use of vaping for smoking cessation. My logic is as follows: The cost of smoking in terms of human misery is enormous. Vaping seems to be the most effective route to smoking cessation. Vaping doesn’t appear to attract a terribly large number of nonsmokers — including the young, and the same goes for the aromas.
I find the data to be compelling, but I understand how one might conclude otherwise.
What is more mysterious is how this particular issue has degenerated into one more hyperpartisan conflagration. With some exceptions, conservatives/Republicans champion vaping and liberals/Democrats hate it. For me, the left’s opposition is all the more peculiar, given their widespread support for dispersing condoms, methadone and clean needles for harm reduction. The same A-B-C-D logic applies to these programs as well as to vaping.
The best explanation for this sharp ideological/partisan divide is one I use with increasing familiarity, “It’s 2018.”
