Feb 7, 2020, 2:38 PM ETOther

Vaping: what people are getting wrong | The Economist

Over 60 deaths and more than 2,500 hospitalizations were reported in the US linked to EVALI (E-cigarette or Vaping Product Use-Associated Lung Injury) since April 2019.
The EVALI outbreak was uniquely caused by Vitamin E acetate, a thickening agent added to illicit THC products, rather than nicotine-based e-liquids.
In response to the outbreak, the CDC advised the US's 11 million vapers to quit, while seven states proposed partial or total bans.
Despite the health scare, the World Health Organization notes that over 8 million people globally die annually from smoking tobacco and second-hand smoke.

The FDA declared e-cigarette use among youth an epidemic in the US after reporting a 78% increase in high school vaping in 2018.
Counter-data suggests that while experimentation among teenagers has risen, the number using products daily remains small, with most users being former tobacco smokers.
Critics argue that the narrative of nicotine uniquely harming the adolescent brain is based on animal studies lacking backing from current epidemiological data.
Industry testimony highlights that among never-smokers, regular e-cigarette use and addiction reports are extremely rare.

Combustible cigarettes are significantly more addictive than vaping products due to the presence of monoamine oxidase inhibitors, which amplify the effects of nicotine and dopamine.
Scientific analysis indicates that nicotine doses obtained via e-cigarettes or snus (chewing tobacco) in Scandinavia do not produce the health consequences associated with smoking.
E-cigarette liquids primarily contain glycerol or propylene glycol to create vapor, which causes local membrane dryness but not inflammatory reactions.
Trace amounts of heavy metals may be inhaled from heating elements, though the long-term effects of these specific components remain unknown.

The global e-cigarette market was valued at $15.7 billion in 2018 and was projected to nearly triple by 2023.
Flavoring agents are critical for cessation; a Michigan shop owner reported that 99% of his customers use flavors to maintain their switch from smoking.
Michigan became the first US state to ban flavored e-cigarettes, followed by a nationwide ban on most flavor cartridges announced by President Trump in early 2020.
Currently, 30 countries have implemented outright bans on e-cigarettes, despite some nations like Lebanon having high rates of tobacco-related male mortality (26% in 2017).

Public health experts, including those in the UK, advocate for tight regulation of device quality and marketing rather than total prohibition.
The proposed regulatory model follows the European Union's framework, aiming to capture the benefits of smoking cessation while preventing youth uptake.
British public health estimates suggest e-cigarettes are approximately 95% less harmful than traditional tobacco.
There is a prevailing concern among industry advocates that banning e-cigarettes in countries with high smoking prevalence will deter smokers from switching to safer alternatives, potentially resulting in further loss of life.