As the health effects of vaping are further researched, vapers and non-vapers alike have wondered about bans and what they would mean for public health. Despite the harm of using e-cigarettes and other devices, vaping bans do not work to improve the public health situation.
To date, the majority of U.S. restrictions regarding vapes have to do with bans on flavored e-cigarettes. Most notably, San Francisco was the first municipality to ban flavored e-cigarettes in June 2018, with 68% of San Franciscans voting for the bill. This ban, which is still in effect, does not prohibit vaping in San Francisco.
Much of the rhetoric behind San Francisco’s ban was flavored tobacco products were the gateway for 80% of teen smokers. But did the ban actually prevent teen tobacco use?
Being the first ban of its kind in the United States, research was promptly conducted to answer this question. In May of 2021, a peer-reviewed article published in the Journal of the American Medical Association concluded after the ban’s implementation, underage San Franciscans had a higher chance of smoking cigarettes. This left the San Franciscan smoking rate 4% higher than the national median.
However, it is important to note the study has a sense of recency bias to it — measuring data only in 2019 shows a rise immediately following the ban, but does not display enough data to definitively show a rise in cigarette usage.
Yet bans of this nature would not make sense until the usage of e-cigarettes is understood; research is still emerging related to their harmful effects.
Kurt Ribisl, the Department of Health and Behavior chair at UNC-Chapel Hill, said the focus of bans and regulations on combustible nicotine products, such as cigarillos and cigarettes, should be prioritized.
“The regulations should punish the most toxic products the most — the combusted products,” Ribisl said. “You want to keep some products that are less toxic than a combusted product.”
There have been instances where more stringent regulations have been put in place regarding the regulation and sale of e-cigarettes.
For example, Australia banned vaping on a national level based on a government-ordered research project regarding the recommendations of individual health professionals, government agencies and professional organizations.
The Australian study stated none of the organizations listed in the survey expressly said vaping was more harmful than smoking and instead argued vaping is unhealthier than not vaping. Regardless of the hypothetical abstinence of people from vaping, understanding the reasoning behind banning certain nicotine products over others is still extremely important when relating to harm.
“The clean nicotine products are nicotine patches that are FDA approved,” Ribisl said. “Cigarillos are dirty, and e-cigs are somewhere in the middle.”
Ribisl also emphasized the difference between Food and Drug Administration authorization, which means a product is OK to sell, and approval, which is a recommended product for nicotine treatment.
Why not just ban tobacco products altogether?
That would be simply too fast and too far. To effectively eradicate a $105 billion industry would be reckless, and considering the addictive nature of nicotine, it would force 61 million people to quit cold turkey or look to illegal alternatives.
Instead of banning e-cigarettes outright, the United States should focus on lowering the nicotine content in products and better regulating the market. However, the FDA’s lackluster approach to regulating e-cigarettes has been an opportunity for foreign products to finesse their way through oversight.
One of the ways this has happened is through name changes. For example, Chinese vape brand Elf Bar was blocked from entering the U.S. earlier this year but continued to be sold as EBCreate. This leaves a lot to be desired from the FDA, which has attempted to process millions of applications for review.
“They really have not been able to combat the disposable products,” Ribisl said, regarding the FDA.
If regulators are having this kind of issue with unauthorized sales while on-market alternatives exist, it is questionable whether the FDA could manage an outright ban.
The FDA needs to ensure options are still available for people who vape, or at least consume nicotine. This would relieve the pressure on the FDA to keep a ban on such a large industry, while also not forcing people to quit cold turkey.
While the effects of vaping are indeed unhealthy, the prohibition of vaping would not lead to healthier outcomes for current vapers, who would likely look to alternatives. By targeting only vaping, it is possible those users would turn to possibly worse options, such as cigarettes.
Let’s not make matters worse by enabling a thriving black market and instead implement regulation in place of degradation while we wait to understand the full effects of vaping and where it fits on the spectrum of nicotine products.
