“Trust the science” has been the prevailing public health mantra since the dark days of the COVID-19 pandemic. We have been reminded that policy should be driven by facts instead of polarizing, political rhetoric.
Yet, when it comes to tobacco use, we continue to ignore the science. Vapor products are scientifically proven to be less harmful than combustible cigarettes. Still, public health officials and policymakers continue to ban and tax these products out of existence. If we want to prevent tobacco deaths, we need to trust the science.
In nearly 20 years of work on drug policy, I have seen where abstinence-based efforts have contributed to increased death. I also have learned that when we don’t offer individuals the opportunity to improve their health on their terms, they continue to put themselves at greater risk.
When I served as general counsel at the New York State Office of Addiction Services and Supports, we enacted a ban on cigarettes in treatment programs, and that led some to forgo treatment or to spend time figuring out ways to violate that policy. Both results run counter to improving their health.
Policymakers are right to be concerned about the dangers of cigarette use. According to the Centers for Disease Control and Prevention, 480,000 Americans die yearly of cigarette smoking. To reduce negative health outcomes and save lives, we must innovate and use every tool we can to achieve genuine results.
Unfortunately, many policymakers are restricting the innovations that are scientifically proven to reduce smoking deaths — namely, vaping devices. Policymakers at all levels have taken aim at vapes because, according to them, they serve as a gateway for young people to start smoking. We have to acknowledge that some folks will continue to use tobacco regardless of policy restrictions. Maybe we need to consider less harmful alternatives.
Nancy Rigotti, a professor of medicine at Harvard Medical School and the director of the Tobacco Research and Treatment Center at Massachusetts General Hospital, recently wrote a paper pushing the medical community to adopt vapes as a cessation tool. The paper, published in the New England Journal of Medicine, states, “The available evidence indicates that switching completely from smoking combustible cigarettes to vaping nicotine e-cigarettes substantially reduces a person’s exposure to tobacco toxins, reduces respiratory symptoms, and reverses smoking-related physiological changes.”
Another study found that the presence of vapor products not only had little effect on encouraging smoking among young people, but they encouraged more adults who use cigarettes to quit. Therein lies the biggest problem with vape bans: they are taking away a popular item that people use as an exit ramp to quit smoking altogether. Study after study proves that nicotine alternatives, including vaping products, are significantly safer than cigarettes because it’s the tar in traditional cigarettes — not nicotine — that causes health problems.
If we encourage smokers to switch to vapes, as the British National Health Service does, while taking steps to keep them away from young people, we will reduce the effects of tar and other chemicals on society dramatically. Researchers from Georgetown and Yale universities found that the continued use of nicotine vapor products would save 1.8 million lives by 2060. They conclude that the continued presence of these products is a net positive on public health outcomes because they are helping transition people away from harmful traditional cigarettes.
If we ban nicotine alternatives, people who want nicotine will stick to traditional products and the risks they incur. Unlike more progressive public health programs in Europe, the Food and Drug Administration’s careless move to ban menthols, for instance, comes without a comprehensive education program around nicotine delivery devices, leaving millions of smokers without an effective cessation pathway. This would ultimately lead to greater negative health outcomes — from illnesses to death.
We can’t allow political rhetoric and emotion to cloud empirical reason when it comes to public health policy. We need to trust the science. Efforts to reduce the harm of tobacco use and cigarette smoking have been distracted by fear and misinformation from motivated special interests. Encouraging the use of safer alternatives like vapes to help people transition away from combustible cigarettes will save millions of American lives.
