A New Frontier: Why Vaping is the Solution to Ending Nicotine-Related Deaths for Good
It’s the largest preventable cause of death. It kills 5 times more people than road accidents do — annually. It amounts to millions of hours of lost productivity and costs our health systems billions. I am, of course, referring to smoking. We all know that smoking is bad for the health, but if we are to solve this problem, it is important to dig deeper and understand the science behind why smoking is so bad. Whilst the answer may seem simple, the majority of smokers are unaware of why smoking is so harmful (Reuters), and there are large amounts of misinformation online. It is important to clear this up and use a pragmatic approach if we are to end nicotine related deaths for good.
Smoking is harmful because of the inhalation of thousands of combusted chemicals — one of which is nicotine, the addictive chemical that smokers enjoy. It is not the nicotine itself that is harmful, but the chemical reactions associated with burning the tobacco in order for it to be inhaled. When combustion occurs (combustion of any material, not just tobacco — which contains nicotine), it releases carbon monoxide, CO2, heavy metals, and tar, all of which are toxic to humans when inhaled. It is the burning process itself that causes cancer and is harmful to the body — the tar released when anything is burnt kills the cilia cells in the lungs, and the heavy metals inhaled interfere with metabolic processes. Breathing in any kind of smoke is harmful, including the exhaust from cars (Guardian), the smoke from cannabis, and the smoke released from herbal (non-tobacco) cigarettes that actors use.
The smoke released from cigarettes is especially harmful due to the extra chemicals that tobacco manufacturers add to cigarettes — ammonia for instance, (the product used in cleaning products and fertiliser) is added to boost the effects of nicotine and leads to an increased pH level which destroys cells and causes mutations, which can lead to cancer. The combustion of tobacco releases over 6000 separate chemicals, of which around 300 are toxic, and over 70 are known to be carcinogenic.
Countless studies have been conducted looking at the health impacts of nicotine. They overwhelmingly point to one conclusion: nicotine in itself is not harmful to adults. This is reinforced by studies which look at societies which consume tobacco in other forms, such as chewing tobacco or smokeless tobacco. In Sweden for instance, researchers looked at a popular product called ‘Snus’, a form of tobacco which is ingested orally by placing it in the upper lip area. The findings were that when nicotine is consumed in this form (without being attached to carcinogenic smoke particles), there was no increased risk of heart attack or atherosclerosis. (World Health Organisation). The question then, is how can we deliver nicotine, which in itself is not harmful, to smokers without delivering the thousands of other harmful chemicals which are inhaled when tobacco is burnt? The answer: e-cigarettes.
Whilst politicians and policy-makers may reject this answer on the grounds that all forms of addiction are morally wrong, this fails to recognise that there will always be people who choose to pursue activities not deemed ‘morally acceptable’. Since there is no way of effectively judging whose version of morality is correct, and since people will continue to consume nicotine and other drugs regardless of their legal (or moral) status, the Government should push as hard as possible to get existing smokers to switch to e-cigarettes, which are 95% safer than traditional cigarettes. (Gov.uk)
The rise of JUUL and other new-generation e-cigarettes, which are stylish, slim, and inexpensive, will no doubt have an immense impact on converting remaining smokers away from traditional cigarettes. Gone are the giant clouds of vapour and the idea that vaping was an activity confined to hipsters. JUULs, are small, discreet, and can be used almost anywhere without attracting much attention.
One significant reason as to why people are moving to e-cigarettes is the ability to consume nicotine in different flavours, which makes vaping far more enjoyable than smoking, and therefore means people are more likely to stop smoking permanently. These products are not without controversy however, and critics point out that these flavours are attracting young people to vaping, people who would not otherwise have begun smoking. However, the truth behind this claim is unclear, and a recent study found that the advertising of flavoured e-cigarettes does not increase the likelihood that children and adolescents will begin to use e-cigarettes (NHS). Whilst more research should be done, and the industry should work with health officials and Psychologists, we should not pursue the bans on e-cigarette flavours implemented in some US states, bans which are leading to thousands of deaths as a result of people not switching.
Allowing vaping in some indoor areas where children are not present, such as bars and casinos, would be another significant incentive to use e-cigarettes. The risk of allowing vaping in all public areas, whilst it would no doubt encourage many more smokers to make the switch, is that it could normalise the habit. This is problematic, as one of the key reasons why smoking rates have declined is because it is not seen as normal, and is instead stigmatised. Nicotine addiction should remain this way if we are to ensure that the rates continue to decline. However, by allowing vaping in bars, adult-only sections of certain restaurants, and other building such as casinos — it would encourage many more people to make the switch and so improve health outcomes for everyone.
Exempting e-cigarettes from VAT for 5 years would also have a substantial impact. Whilst they are currently taxed at the standard 20% VAT rate, exempting vape products would make their price markedly cheaper, which would encourage people, especially people amongst lower-income groups (the groups where smoking rates are higher), to switch for financial reasons. Although this may lead to a temporary decrease in government income, it would be balanced out by the savings made to the NHS as fewer people will require treatment for smoking-related diseases. In utilitarian terms, this would also have a far greater impact on public health than most other health measures.
What is clear is that e-cigarettes and new technology promise to solve some of our greatest problems. We should not be afraid to experiment and encourage innovation in these fields, and we should approach such topics in an open-minded and pragmatic manner if we are to solve nicotine-related deaths for good.
A longer version of this story was published on 12/02/20, and is available at: https://medium.com/@adyleho/the-history-and-future-of-smoking-a7ab84351ad0