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Vaping's greatest harm is that it's attractive to young people

Despite the undoubted benefit of transferring millions of people off cigarettes, vapes are causing a new stream of harm by attracting so many young people, many of whom may have never smoked tobacco.

People may have been doing it since about 5000BC, but those early humans at least had the excuse that no public health messages warned against deliberately inhaling burning substances.

The emerging evidence that at least one ingredient commonly found in e-cigarettes may be deadly has understandably dismayed those addicts who have found inhaling nicotine vapour a healthier alternative to smoking cigarettes.

Now that US health authorities have documented at least seven deaths and several hundred lung ailments linked to e-cigarettes, vapers are breathing less easily. US President Donald Trump’s pledge to ban e-cigarettes with flavourings, because of their well-charted appeal to children and teens, may be the only non-controversial statement he has made since taking office.

Despite the shock of vaping’s apparent potential to cause deaths, and so quickly, the question is not purely one of relative safety. Despite the undoubted benefit of transferring millions of people to a less harmful nicotine hit, the e-cigarette is causing a new stream of harm by attracting so many young people, many of whom had not and probably would never have smoked tobacco.

The habit may be made safer by restricting additives, the prime suspect so far being tocopheryl acetate, a vitamin E-derived thinning agent present in more than half the death and disease cases. But cannabis and home-concocted substances are also in the frame, and given the sheer variety of substances people are using in e-cigarettes, regulators and researchers have a tiger by the tail. It’s hard to see this fast-growing habit ever earning more than a heavily conditional safety pass.

Common sense alone tells us our lungs are not designed to cope with inhaling large volumes of substances and particulates. Up to 12,000 Londoners are estimated to have died prematurely as a result of smog inhalation after a dense fog in 1952, and air pollution still brings premature death to an estimated 40,000 Britons a year, according to the Royal College of Physicians. Consciousness of lung health is even expected to knock up to 20% off some London suburbs’ house prices following introduction of the city’s new stringent air-monitoring systems.

But common sense, health and even money seldom triumph over cherished recreational vices or, in this case, fashion.

Children and teens may soon outpace hardened smokers as e-cigarette adopters. US health authorities found one in five high-school seniors said they had vaped last year. Other estimates are that 28% of American 16-year-olds vaped in 2017, rising last year to 37%. In the UK, teen users are estimated to have doubled in the past four years, rising to 16% last year. Where those countries’ teens go, New Zealand teens are sure to follow.

Even if those figures are inflated by teens falsely claiming to have vaped, that would merely further illustrate how cool vaping has become. Manufacturers cannily introduced alluring “flavours” early on and have marketed them with as much skill as was once used to promote tobacco smoking as glamorous.

It is salutary to recall that New Zealand’s Ministry of Health blocked the commercial importation of vaping products for several years because of regulatory and safety concerns, including the risk of children accessing them, and was widely criticised for its stance. Now it is shown to have been prescient. Vaping is indeed a nifty new gateway, not just to nicotine addiction but to substance abuse for a new generation.

Giant vape manufacturer Juul has defended the flavouring of e-cigarettes, citing research that the novelty of mint, vanilla or lime makes it 30% more likely that a tobacco smoker will swap to the less dangerous habit. Although that may be accurate, it was derived from a study funded by Juul and two tobacco companies. For the tobacco industry, vaping is a commercial lifeline, and its new genie is too long out of the bottle to squash it back in. Curtailing access now would only create black markets and even more hazardous amateur devices and substances.

Whatever dangers researchers find, society’s dial will probably remain guardedly set on “harm minimisation”. Harmful as it may be to inhale a mixture of propylene glycol, glycerin, water and pharmaceutical-grade nicotine, it’s still probably safer than inhaling tar, arsenic, ammonia, toluene, radioactive polonium-210 and other chemicals found in cigarettes.

That humans have been smoking since 5000BC does not mean smoking is not harmful. Rather, it suggests we are slow learners.

This editorial was first published in the September 28, 2019 issue of the New Zealand Listener.