Vaping: Clearing the Air

Summary of Study

Bottom Line: Bans on vaping products are likely to be harmful and ineffective. Regulations should focus on restricting advertising and sales to minors while maintaining the appeal of vaping as a less harmful alternative for people who smoke. Vaping is more effective for smoking cessation than other methods.

Two well-regarded reviews, by the Cochrane Collaboration and NASEM, conclude that there is evidence that e-cigs can aid in smoking cessation. A 2019 randomized control trial conducted in the U.K. found e-cigs to be more helpful than other nicotine replacement therapies for abstaining from cigarette use.

Coincident with the decline of cigarette smoking in the U.S. has been the rise in vaping. Vaping has some established advantages over conventional smoking. Primarily, it reduces or eliminates the tars and smoke that contribute to various cancers. A review by the National Academies of Science, Engineering, and Medicine (NASEM) found lower toxin exposure associated with e-cigs compared to traditional cigarettes.

Smoking has been steadily declining among middle and high school students for over two decades, and just 5.8% of high school students and 2.3% of middle school students reported past-month cigarette use in 2019. Rates of adult vaping remain low and are primarily driven by young adults. Current e-cig use among 18- to 24-year olds increased from 5.1% in 2014 to 7.8% in 2018. In contrast, only 4.2% of adults 25 to 44 reported current e-cig use in 2018, and rates are even lower among older Americans.

Cigarette use among 18 to 24-year-olds fell from 16.7% in 2014 to 7.8% in 2018. Rates among older Americans have also declined but remain much higher; over 16% of 25- to 64-year-olds smoke cigarettes.

One study found the most frequently cited reason for initiating e-cig use among smokers was “to reduce my smoking or smoking urges” (63%); another 53% said they initiated “to quit smoking” and 39% said it was “for my health.”

Full or partial prohibition of vaping products, even when implemented, is unlikely to significantly reduce use and is quite likely to have unintended and undesirable consequences. Vape bans will expand the black market for these products, a market that already exists.

Another problem with banning vapes or vape flavors is that doing so will reduce access for smokers who use them as quit aids.

A recent study examining e-cig flavor preferences among adults found that fruit, dessert, candy, and chocolate flavors are increasingly popular for users who switched from traditional cigarettes to e-cigs. Restricting access to non-tobacco e-cigarette flavors may discourage smokers from attempting to switch to e-cigarettes.

Read the full study here.