For the past few years, the United States public health community has been amplifying irrational fears among certain sections of the public toward youth vaping. At times, it has reached such fevered levels that one could be forgiven for forgetting that respected public health bodies in the United Kingdom have estimated vapes to be at least 95 percent less harmful than the combustible cigarettes they typically replace.
So it was interesting to see the UK response last month to a recent uptick in youth use of e-cigarettes. This had led the press—just as excitable in the UK as in the States—to produce several sensationalist articles ramping up a moral panic around vaping that is, of course, unrepresentative of the situation.
But—in a contrast that should be embarrassing to the Food and Drug Administration (FDA), the Centers for Disease Control and Prevention (CDC), and American public health nonprofits—the British public health establishment didn’t jump on the media bandwagon and stoke up further panic.
The briefing first emphasized that smoking is still the major threat to health.
In March, Action on Smoking and Health (ASH), a UK-based anti-smoking organization, released its annual survey of e-cigarette use among British youth. It showed that there had been a rise in young people vaping, a surge likely attributable to the increased market share of disposable products. Cue the press reaction.
But then, in August, ASH released an evidence-based briefing to address growing concerns. This was also endorsed by the Association of Directors of Public Health, the Faculty of Public Health, the Chartered Trading Standards Institute, the Royal Society of Public Health, and two regional tobacco control organizations.
Produced in collaboration with regulatory and educational experts and academics from three preeminent universities, the briefing is designed for public health officials, trading standards officers, local councilors, schools, retailers and parents. Additional objective and truthful resources were prepared by ASH and disseminated to schools after the summer break.
The briefing first emphasized that smoking is still the major threat to health in the UK, reminding readers that vaping is “much less harmful than smoking and is an effective quitting aid for adult smokers.”
The ASH briefing went on to firmly refute myths that had been promoted by garish headlines. It stated categorically that, “Disposable vapes DO NOT contain as much or more nicotine as a packet of 20 cigarettes.” It added that, “There is NOT strong evidence that vaping is a gateway into smoking,” with no evidence for the “gateway hypothesis.” And it asserted, correctly, that “An outbreak of serious respiratory disease (known as ‘EVALI’) in the US in 2019 WAS NOT caused by vaping nicotine.”
US public health organizations and regulatory bodies have promoted every one of these myths to the American public.
We should recall that US public health organizations and regulatory bodies have promoted every one of these myths to the American public—and some continue to do so. In a direct swipe at the FDA’s “Real Cost” campaign, ASH highlighted how it “led one group of young people to conclude that they would rather be seen smoking than vaping after viewing the campaign.”
Clearly, the UK’s treatment of vaping products is vastly different to the US. In the UK, the government subsidizes e-cigarettes, and the National Health Service (NHS), the publicly funded health care system, recommends them to smokers who cannot quit using other means. There’s also cross-party political support for vaping, and public health charities like Cancer Research UK and the British Heart Foundation endorse it. Vape shops can even be found in some hospitals.
The UK approach is delivering positive results. As ASH recently reported, there are an estimated 4.3 million adult vapers in Britain. Of these, about 57 percent are former smokers. Of the remainder, many (35 percent) are current smokers using both cigarettes and vapes. Commonly cited reasons for vaping including cutting down on smoking (17 percent), saving money (16 percent), quitting cigarettes (15 percent) and staying off tobacco (13 percent). Only 8 percent of vapers have never smoked. Unsurprisingly in light of these numbers, UK rates of smoking—the real threat to public health—have continued to decline.
If US public health fails to develop similar maturity on this issue, more American lives will needlessly be lost.
But what the ASH briefing on youth vaping shows, perhaps more than anything, is how a mainstream tobacco control organization can respond to an increase in youth vaping with a balanced and proportionate argument, without resorting to a moral panic. In the US, where youth vaping has declined by nearly 60 percent since 2019, authorities are still shroud-waving and insisting that there is a “youth vaping epidemic.”
Kids are often scared by monsters in the wardrobe or under the bed. It is only once we grow up that we (hopefully) develop the capability to assess situations realistically and react with calm and reason. UK public health officials are behaving like adults when it comes to youth vaping. If the US public health community fails to develop similar maturity on this issue, more American lives will needlessly be lost.