Fight against vaping likely more complex than anti-tobacco efforts
WHILE FEDERAL AND STATE AUTHORITIES are looking for ways to curb the growth in use of e-cigarettes, healthcare providers are concerned about their own role in addressing the dangers of vaping.
Among their biggest concerns is a perception that vaping is a less harmful alternative to regular cigarettes, although there isn’t conclusive evidence about the long-term health risks of the devices.
The push to ban certain vaping products comes in light of an outbreak of lung illnesses and deaths associated with e-cigarettes that had risen to more than 530 cases by Sept. 16, according to the Centers for Disease Control and Prevention. Seven deaths have been confirmed in California, Illinois, Indiana, Kansas, Minnesota and Oregon.
Public health leaders have recently called for people to temporarily avoid using e-cigarettes until more is known about the cause of the illnesses.
“At this point we need to have a stop until we figure out what’s going on,” said Dr. Georges Benjamin, executive director of the American Public Health Association.
Benjamin said healthcare providers have a vital role to play in raising public awareness about the potential dangers of vaping. Medical organizations could lobby lawmakers to pass regulations that would make it tougher for children to gain access to vaping products, he said.
In August, the CDC suggested healthcare providers ask patients who report having used e-cigarettes within the last 90 days whether they have had pulmonary illness symptoms. Providers should also get a detailed history of e-cigarette products used by the patient if they may be connected to a pulmonary illness and conduct follow-up evaluations of those treated for a suspected vaping-related illness.
“We are urging physicians to talk with their patients about nicotine and tobacco use as a part of their medical history and in talking about vaping, just give them the facts,” said Dr. Patrice Harris, president of the American Medical Association. “It’s our responsibility as physicians to go where the evidence leads us.”
Some health experts see similarities between the awareness effort related to e-cigarettes and the anti-tobacco campaign that many credit with decreasing both adult and youth smoking rates.
Warnings on cigarettes and tobacco products have been backed by years of evidence, but it may be more difficult to convey similar messages about the relatively new vaping trend.
A June study published in the Journal of the American Heart Association found results of previous trials comparing e-cigarettes with nicotine replacement therapies were inconclusive because of their small sample size.
The belief that vaping devices could be less dangerous than regular cigarettes has prevented public health experts from speaking out against e-cigarettes in the
“If the result of stopping vaping is that people smoke Marlboros again, then that’s a disaster— they’re not equivalent.”
Cliff Douglas Vice president of tobacco control at the American Cancer Society
same way they combated tobacco. And a study published in February in the New England Journal of Medicine found vaping was more effective for helping tobacco users quit than nicotine replacement therapy when both products were accompanied by behavioral support.
“It underscores the extreme complexity of what we’re dealing with today,” said Cliff Douglas, vice president of tobacco control at the American Cancer Society. He stressed that the organization does not endorse e-cigarettes for smoking cessation, but recognized they could be an alternative for adult smokers who have exhausted or refused to try other cessation methods.
“If that’s what they choose, and they’re not going to try any other way, then they should receive support and also be encouraged to stop using those products as soon as they’re able, but never to resort to conventional cigarette smoking,” Douglas said. “If the result of stopping vaping is that people smoke Marlboros again, then that’s a disaster—they’re not equivalent.”
Cigarette smoking is the leading cause of preventable death in the U.S., responsible for 480,000 deaths annually, according to the CDC.
Nearly 11 million adults in the U.S. use e-cigarettes, according to a 2018 study in the Annals of Internal Medicine. Only 15% of e-cigarette users are not former cigarette smokers. ●