Vaping: Why Restrictions Will Do More Harm Than Good

Those who propose banning or restricting access to flavoured vaping oils fail to understand the harm government prohibitions can cause argues political writer Oliver Dunn.

It is clear even to observers with no medical expertise – like myself – that the evidence shows that vaping is far better for your health than smoking traditional cigarettes. A randomised clinical trial found that smokers who switched to vaping saw levels of chemicals indicative of cigarette smoking drop to the same level as the control group of smokers who neither smoked nor vaped. Similarly, two research papers found that vaping instead of smoking cigarettes helped participants to quit smoking and significantly benefited the smoker's cardiovascular health.

However, as 2019 ended, both India and the Philippines announced a ban on E-cigarettes. In a further blow, in the USA and Canada restrictions on vaping have either been passed or proposed at the state and provincial level, particularly aimed at restricting the availability of flavoured vaping oils and increasing the legal age for vaping. Calls have also begun across the Atlantic for the UK and other European countries to roll out similar restrictions. 

Why are governments across the world seeking to restrict access to E-cigarettes despite the overwhelming evidence that it is less harmful than smoking? In a word: 'EVALI' or E-cigarette or Vaping Associated Lung Injury, which describes the range of serious respiratory conditions experienced by a few thousand vapers in the US. The outbreak of EVALI started in June 2019, peaked in September, and as of December 2019, 2506 people had been hospitalised with 54 tragic deaths.

It is these events in the US that caused such a swift response. In the US alone Texan schools are using 'vape-detecting technology' to arrest vaping students, legislation is being considered which would raise the legal vaping age to 21, and President Trump has announced his intention to ban flavoured vaping oils. 

While some such as Professor Charlotte Pisinger of the European Respiratory Society have been arguing that flavoured vaping liquids should be banned for some time, the recent urge to do so is mostly a response to the current outbreak and the idea that sweet flavoured oils are encouraging young people to vape. As Professor Pisinger puts it "cigarettes should taste like cigarettes, not like candy". 

Many politicians the world over have been persuaded by this kind of argument to seek more significant restrictions on vaping, but they have dangerously ignored the actual cause of the outbreak; government prohibitions. Nicotine-based products did not cause the explosion but hot THC-releasing liquids (THC is the compound in cannabis that makes users 'high') cut with vitamin E acetate. 

The New England Journal of Medicine found that 94% of the lung samples of a representative group of people who had breathing problems after vaping contained vitamin E acetate. No one who vaped a nicotine liquid had vitamin E acetate in their lungs. The blame should be attributed to the prohibition of cannabis, which has created a black market where it pays for producers to dilute their products unscrupulously.

Black market producers of THC vaping oil mixed in the vitamin E acetate to make their stock of the active ingredient go further, ultimately putting more money in their pockets. Diluting or bulking out illicit substances is very common: it's why you will often find rat poison in cocaine. 

The geographical distribution of EVALI cases throughout the United States clearly illustrates the harms that prohibitions can cause: states that permit recreational marijuana sales are experiencing far fewer cases of lung injury. This should serve as a warning to those who propose restrictions on vaping: that although their concern is likely genuine, their proposed actions may do more harm than good. It is very reasonable that a ban on flavoured vaping oils will either cause vapers to return to smoking traditional cigarettes or seek out potentially dangerous black market flavoured oils produced to meet the demand that banning them is unlikely to diminish completely. If the continued popularity of cannabis despite its illegality (10 million British adults admit to having used it) tells us anything, it is that if people want something, they will find a way to get it. 

What this shows is that when considering public health outcomes governments should prove far more reticence before introducing bans or restrictions on vaping. There are tens of millions of cigarette smokers in the Philippines and India whose health could have been improved significantly if they switched to vaping, but now their governments have deprived them of that option; mainly because they have misunderstood the cause of the EVALI crisis as being a result of a lack of government action as opposed to being caused by it. 

If politicians across the world want to improve their citizen's health, they should throttle the black markets by bringing the production of THC vaping oils out into the light, not forcing the thriving and vital vaping industry into the dark. To do so may have tragic consequences.