Supporters of harm-reduction strategy say campaign against e-cigarettes has unintended consequences, many of them not good

By Al Cross Published March 24, 2021 FEATURED, HEALTH POLICY, TOBACCO

Photo of e-cigarette pods by Scott Olson, Getty Images
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Billionaire Michael Bloomberg’s $160 million, three-year campaign to fight youth use of electronic cigarettes by young people may have had its intended effect, but some experts think it has had unintended effects, including scaring young people away from e-cigarettes and toward traditional tobacco cigarettes.

“Others who have worked for decades to reduce deaths from smoking say the ongoing campaign against e-cigarettes is misguided, built on unsound science and likely to do more harm than good,” Marc Gunther writes in Philathropy Today. “Scientists are deeply divided. Each side accuses the other of distorting evidence.”

He cites Kenneth Warner and David Mendez of the University of Michigan, who “built a computer model that tracks the U.S. adult population’s smoking status and smoking-related deaths. When they ran data about vaping through the model, they found that under all but the very worst-case assumptions, the benefits of e-cigarettes, which can help smokers quit, exceed their costs in terms of lives saved.”

Warner is a founding board member of a campaign to end tobacco use, and has been president of the Society for Research on Nicotine and Tobacco, senior scientific editor of the surgeon general’s 25th-anniversary report on smoking and health, and dean of public health at Michigan. He and others argue thusly:

“E-cigarettes are much less dangerous than smoking. Vaping appeals to smokers who want to quit but need a nicotine fix. Like kids, adult vapers prefer flavors. So while no one wants teenagers to vape, removing flavored e-cigarettes from the market deprives adult smokers of a popular safer alternative,” Gunther writes. “Worse, the critics say, by exaggerating the dangers of e-cigarettes, Bloomberg [has] inadvertently given people a reason to smoke. Public opinion polls show that Americans overestimate the risks of vaping.”

The critics include Steven Schroeder, former president of the Robert Wood Johnson Foundation, who favors the strategy of harm reduction, which Gunther says “aims to limit the dangers of risky behavior by offering safer, though not entirely safe, alternatives.”

Schroeder told Gunther, “The ideal solution for vaping would be to keep it out of the hands of kids and preserve it as a gateway for smokers who want to quit.” Gunther writes, “Laws barring the sale of tobacco products to anyone under 21 should accomplish that. But the age limits are poorly enforced so the anti-tobacco nonprofits are determined to go beyond harm reduction to abolition — for better or worse.”

Bloomberg’s allies cite studies that show youth who use e-cigarettes are much more likely to become smokers of traditional cigarettes. The other side says the studies show correlation, not causation, and that young e-cig users are “more prone to experimentation or rebellion than their peers,” Gunther writes.

Matt Myers, president of the Campaign for Tobacco-Free Kids and Bloomberg’s main funding partner, told Gunther, “You can’t understate the significance of the youth-use problem. The level of harm that we have seen to kids far outweighs any benefit to adult smokers that has been actually studied and documented.”