Senator Dick Durbin (D-Ill.) may seem an unlikely member of the abstinence movement. Yet when it comes to smoking at least, he is firmly in favor of pushing the “just say no” line rather than providing information about how to limit the risk of harm.
No one who cares about public health wants any current nonsmoker to start smoking or vaping. Particularly, we don't want teenagers to make decisions that put their health at long-term risk when they are too young to understand the consequences. That's why it's illegal for anyone under age 18 to buy cigarettes or e-vaping products. The Federal Drug Administration (FDA) regulates the sale of these products and monitors companies' marketing practices. If a company engages in marketing designed to skirt these laws and encourage those under the legal age to buy their products, the FDA can take action against them.
Yet even as we seek to discourage young people from smoking, we also don't want to spread misinformation about the relative risks of different products, which could lead to them make worse decision and suffer worse health outcomes.
Unfortunately, some public figures are doing just that. Senator Dick Durbin recently called to increase the legal age for buying cigarettes and vaping products, saying:
“Originally, vaping was sold as the healthy alternative to tobacco cigarettes, the way to end tobacco addiction. And it turns out it’s insidious and harmful in it of itself and it doesn’t guarantee any end to tobacco addiction.”
No one claims that vaping can “guarantee any end to tobacco addiction.” But that doesn't mean that it isn't significantly less harmful than traditional cigarettes. That's something that the public needs to understand, and is increasingly lost in public debates that imply that cigarettes and e-cigarettes are essentially interchangeable.
In fact, they are very different products. First, unlike traditional cigarettes, e-cigarettes do not contain tobacco, and they do not burn or smoke. This is critical: Overwhelmingly, the harm from smoking occurs when the cigarette burns and toxins are released. While mimicking smoking, e-cigarettes do not burn, but rather heat a liquid solution made up of glycol and flavorings, and in some cases, nicotine.
As a result, vaping is up to 95 percent less harmful than smoking, according to independent research. E-cigarettes also don’t produce smoke, and therefore there's no risk to non-smokers from second-hand smoke. The vapor produced by e-cigarettes contains no dangerous chemicals or carcinogens.
In other words, e-cigarettes are much, much less harmful in terms of the health of the user and the public than traditional cigarettes. That message shouldn't be lost in general warnings not to smoke.
Of course, 95 percent less harmful doesn't mean that vaping is risk-free. Would I prefer that none of my children ever trying vaping? Absolutely. However, if they are to ever succumb to the temptation to try a nicotine product, I certainly hope that they try the one that is significantly less harmful than the alternatives.
Moreover, I have friends already addicted to traditional cigarettes and who have failed to quit using other cessation products. I hope they aren't swayed by Durbin's blithe dismissals of the significant benefits of switching to vaping, and recognize that — while, sure, it would be better to just say no and quit cold turkey — significantly reducing the harm of their addiction would be a giant step in the right direction.
Durbin understands this in other areas of life. Given his support of Obama-era contraception policies, presumably he would likely object to the suggestion that we shouldn't bother telling teenagers about condoms since they are only about 80 percent effective at preventing diseases.
Public health officials typically recognize that we can't make the perfect the enemy of the good. The World Health Organization trumpetscondoms as “highly effective in preventing HIV and other sexually transmitted infections (STIs),” while admitting that they have “an 80% or greater protective effect.” They understand that “just say no” doesn't always work.
Of course, we want teenagers to abstain from smoking, just as we want them to abstain from sex. Yet if they are going to engage in these behaviors, we also want them to know the facts so that they can mitigate the risks of lasting harm. By all means, let's work to deny teenagers access to cigarettes and e-cigarettes to keep them from smoking, but we shouldn't also deny them reliable information about relative risks.