The American Journal of Public Health (AJPH) published an article last month titled “Balancing Consideration of the Risks and Benefits of E-Cigarettes.” With 40 or 50 articles/research papers published every week on tobacco harm reduction, it is not surprising to see another commentary on e-cigarettes.
However, this particular piece was co-authored by 15 past presidents of the Society for Research on Nicotine and Tobacco (SRNT), a prime academic global organization involved with nicotine and tobacco evidence-based research. With the credibility of the SRNT, this article could be a game-changer, especially in the United States.
The article is an extraordinary contribution to the debate about vaping. The extensively referenced and well-argued report states, “This article’s authors believe that vaping can benefit public health, given substantial evidence supporting the potential of vaping to reduce smoking’s toll.” In a YouTube video released at the same time as the article was published, lead contributor Kenneth E. Warner of the School of Public Health, University of Michigan, says the public health community is guilty of “downplay[ing] the potential of vaping to help adults who are smokers, to quit smoking” and seems exasperated that the “U.S. public’s understanding of the risks of vaping has deteriorated” due to poor messaging and misinformation.
The article itself carries a damning indictment of the anti-vaping public health community in its conclusions, by stating that: “While evidence suggests that vaping is currently increasing smoking cessation, the impact could be much larger if the public health community paid serious attention to vaping’s potential to help adult smokers, smokers received accurate information about the relative risks of vaping and smoking, and policies were designed with the potential effects on smokers in mind. That is not happening.”
The authors also have little time for the hyperbole over youth vaping, pointing out, “Three recent studies have concluded that vaping likely diverts more young people from smoking than encourages them to smoke” and that “as public health groups, the media, policymakers, and the general public focus on youth vaping, vaping’s potential to help adults quit smoking too often gets lost.”
It is interesting to note two of the 15 authors are from the U.K., with the other 13 being based in the U.S. As public health academics who recognize the benefits of vaping for the public’s health, it must be frustrating for the American contingent to witness the chaotic mix of ignorance and misinformation which is prevalent in their own country, while their colleagues Professors David Balfour and Robert West look on from the U.K. The U.K. is currently advocating the use of reduced-risk products in place of combustible cigarettes and is seeing impressive results from a positive regulatory environment towards harm reduction.
It has been clear that in all jurisdictions which favor liberal regulation of e-cigarettes, vaping increases while smoking declines. And where flavors are banned, a rise in smoking rates usually follows. Yet bans and restrictions on vaping and flavors are the main conversations being had in the U.S. – even prior to this impassioned plea by the authors of the AJPH article, and whose standing in tobacco control circles is unimpeachable.
There have been a plethora of documents over the years on vaping and harm reduction. In the UK, Public Health England’s evidence review in 2015 concluding that vaping is 95 percent less harmful than smoking, followed by the Royal College of Physicians’ own research finding the same a year later, pretty much put the issue to bed in the U.K.
In Warner’s YouTube video, he references the ground-breaking report from the 2018 U.S. National Academy of Sciences, Engineering, and Medicine, which announced that vaping is “substantially less dangerous than smoking.” The August 19 article adds further considerable weight to the benefits of vaping and will likely also become a historical document in the tobacco harm reduction debate.
There will undoubtedly be some pushback against the AJPH article from highly funded anti-vaping merchants of doubt but the evidence of vaping’s benefit to public health is overwhelming and cannot be resisted by ideology and innuendo forever. The 15 former SRNT Presidents are a powerful voice, and it will be extremely difficult to dismiss their call for change.
The hope is this latest development can shift the dial further toward acceptance of vaping in the U.S., albeit a few years later than has already largely happened in the U.K. The outcome would not only be a more progressive and healthier America, but also a beacon to the rest of the world that safer alternatives to smoking are to be welcomed, not feared.
