This Anti-Vaping Congressman Insists There Is Simply No Evidence E-Cigarettes Help Smokers Quit –


In my union column last week, I noted that politicians who favor new taxes and restrictions on nicotine vaping products tend to ignore the lifesaving potential of this harm-reducing alternative to conventional cigarettes. One of these politicians, Rep. Raja Krishnamoorthi (D-Ill.), Proves my point in a letter to the Chicago Sun-Times who exaggerates the threat posed by underage vaping, confuses vaping with tobacco use, and insists that “there is simply no evidence” that e-cigarettes help smokers quit.

Krishnamoorthi, who falsely urged the Food and Drug Administration (FDA) last year to ban e-cigarettes as a COVID-19 hazard, believes “vapers are a huge health threat to millions of young Americans “. To support this claim, he cites data from the National Youth Smoking Survey (NYTS), which show high school vaping fell 29% in 2020 after increasing significantly in the previous two years. Ignoring this drop, Krishnamoorthi instead points out that “20% of high school students [are] are currently using this highly addictive product, ”meaning they reported vaping in the previous month. This figure is down from around 28% in 2019.

Krishnamoorthi also does not mention that teenage smoking is a much more dangerous habit, has been declining since the late 1990s, reaching record levels in recent years. In the NYTS 2020, 4.6% of high school students reported having smoked cigarettes in the previous month, up from 5.8% in 2019 and 15.1% in 2011, a drop of 70%. In the Youth risk behavior survey, this rate fell from 27.5% in 1991 to 6% in 2019, a decrease of 78%. According to Follow-up of the future study, which covers a longer period, the prevalence of smoking in the last month among high school students fell from 36.5% in 1997 to 7.1% in 2020, a drop of over 80%.

This downward trend has accelerated as vaping has become more popular among teens, suggesting that e-cigarettes are replacing combustible tobacco products in this age group. This is unambiguous good news from a “public health” perspective, since e-cigarettes are a much safer source of nicotine – another point Krishnamoorthi conspicuously ignores in his vaping claims.

Most high school students who vape (61% in 2020) are occasional users. a analysis NYTS data from 2017 to 2019 found frequent consumption (over 20 or more of the previous 30 days) was concentrated among current or former smokers, which is consistent with the hypothesis that teens are increasingly vaping rather than smoking. “Frequent use and signs of e-cigarette addiction remained rare among students who had never used only e-cigarettes and never any other tobacco product,” the researchers reported.

“Vaping probably makes some young people addicted to nicotine,” David JK Balfour and 14 other leading tobacco researchers say in a report. American Journal of Public Health item published last month. “However, the evidence does not suggest that it is addictive in very large numbers.”

And contrary to fears frequently expressed by vaping product critics, there is little evidence that vaping products encourage smoking in teens who otherwise would never have tried nicotine. “As high school students’ smoking has declined at an increasing rate since young people started using electronic cigarettes, some may vape to reduce or quit smoking,” Balfour et al. Remark. “If vaping prompts some young people to try cigarettes, the overall impact must be low. A recent study estimated that if vaping increased the odds of trying cigarettes among young non-smokers by 3.5… smoking initiation among young adults would increase by less than 1 percentage point. , data from a U.S. survey shows that smoking among young people has declined to its fastest rate ever during the vaping boom. While vaping increases initiation into smoking, other unknown factors more than make up for it. “

Krishnamoorthi ignores these considerations by deceptively equating vaping with “tobacco use”. As of September 15 Press release, he said, federal excise taxes on vaping products “can reduce tobacco use in America and prevent a generation of children from becoming addicted to smoking and vaping.” Yet e-cigarettes do not contain tobacco or burn anything – crucial differences that explain why Public Health England has estimated that switching from smoking to vaping reduces health risks by at least 95%.

“Laboratory tests on the ingredients of electronic cigarettes, in vitro toxicology tests and short-term human studies suggest that electronic cigarettes are likely to be much less harmful than combustible tobacco cigarettes,” according to the National Academies of Sciences, Engineering and Medicine. reported in 2018. The British Royal College of Physicians also concluded that “vaping is not completely without risk but is much less harmful than smoking tobacco”. A 2017 study in the journal Tobacco control valued that depending on how many smokers make the switch, the availability of vaping products could prevent up to 6.6 million premature deaths in the United States alone.

Krishnamoorthi affirms that “there is simply no evidence that vapers help [smokers] to quit smoking. Yet, as Balfour et al. Note, “A growing body of evidence indicates that vaping can promote smoking cessation, although the evidence is not definitive. “

A 2020 meta-analysis of 26 randomized controlled trials concluded “that there is moderate-certainty evidence that [e-cigarettes] with nicotine increases quit rates compared to [e-cigarettes] nicotine free and compared to nicotine replacement therapy. The results of population studies, according to Balfour et al., “Are consistent with a nearly doubling of the success of quit attempts, found in randomized controlled trials, and the fact that e-cigarettes are smokers” l most used aid in shutdown attempts. They also note that the decline in cigarette sales in the United States has accelerated sharply as sales of vaping products have taken off, reinforcing the impression that more vaping means less smoking.

While denying the existence of this evidence, Krishnamoorthi says he thinks “adults can do whatever they want”. But that is not true either.

Krishnamoorthi supports federal excise taxes that would double or triple the cost of nicotine liquids, discouraging smokers from quitting and making vapers a much more deadly habit. He wants to ban the flavors of e-liquids that ex-smokers overwhelmingly prefer, which would also make these products less attractive as an alternative to conventional cigarettes. And he wants mandate reductions in the nicotine content of e-liquids, which would have a similar effect, while allowing the FDA to order further reductions.

Krishnamoorthi says the FDA should have the power to make nicotine levels so low that they are “minimally addictive or non-addictive,” which would make vaping products an unsatisfactory substitute for cigarettes, thereby negating this potentially life-saving option. Even the FDA, despite dragging its feet on approving products it calls “electronic nicotine delivery systems” (ENDS), recognizes that they promise to reduce drug-related illness and death. smoking. Krishnamoorthi’s attitude, on the other hand, is crystallized in the name he chose for his nicotine reduction bill: the END FINS law.

Krishnamoorthi said FDA regulations aim to ensure vaping products “have a net positive public health benefit” because “the unregulated and untaxed market now requires no such proof.” Krishnamoorthi’s admission that electronic cigarettes could “have a positive net benefit to public health” is rather puzzling given his position that there is no reason to believe that they help smokers to quit smoking. . And it’s a mystery what taxes have to do with whether e-cigarettes are less dangerous than tobacco cigarettes, which remain on the market despite their well-established dangers anyway.

Krishnamoorthi, who wants to “END THE END”, seems to have concluded that it is better for public health to eliminate competing nicotine products which greatly reduce the dangers smokers face. He arrives at this implausible conclusion by claiming that the millions of Americans who have chosen vaping as an alternative to cigarettes to reduce the risks do not exist.


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