Missing the mark on e-cigarettes risks imperilling the fight against smoking

A new study from the Barcelona Institute for Global Health (ISGlobal) has indicated that infants and young people who are exposed to tobacco smoke may see their metabolism and physiology permanently altered.

The analysis is the first to investigate links between early-life environmental exposures and epigenetic age in children, or the measure of biological age in an individual. The study found that persons exposed to tobacco smoke before birth or in early childhood demonstrated accelerated epigenetic ageing, something that has been linked to a higher risk of metabolic, cardiovascular or neurodegenerative diseases.

The findings are undoubtedly devastating, and further, underline the importance of urgently curbing smoking rates around the world. This is doubly true given the emergence of troubling studies from various countries indicating that the rate of smoking, especially among young people, only increased amid the stress of the Covid-19 pandemic.

In England, the number of young adult smokers rose by one quarter during the first lockdown, while the years-long decline in cigarette sales in the US levelled out in 2020. Jordan, already battling some of the world’s highest smoking rates which mean that fully half of all deaths each year in the country are linked to smoking, saw more than half of the country’s smokers increase their tobacco intake amid pandemic restrictions.

In light of these troubling rises in tobacco consumption, public health officials the world over should be taking any measures possible to help smokers minimise the damage that their habit is wreaking on their own health and that of others. Instead, however, many health authorities and governments have taken illogically aggressive stances against safer nicotine products such as e-cigarettes, threatening to derail their anti-smoking efforts at precisely the wrong time.

In its recent tobacco report, the World Health Organization (WHO) called for greater regulation of “harmful” e-cigarettes—a move which was met with alarm by public health experts who fear calls to curb vaping could delay the transition away from far riskier combustible cigarettes.  "The WHO is right that non-smokers, especially children, should be discouraged from using any nicotine product,” charged Professor John Britton, emeritus professor of epidemiology at the University of Nottingham, “But for the more than one billion tobacco smokers in the world, electronic nicotine delivery systems are part of the solution, not the problem."

The European Union’s intransigence on the issue has received similar criticism. Greek EPP deputy Maria Spyraki has called attention to the fact that e-cigarettes are less harmful than combustible tobacco and underlined that “The goal is to win the war against cancer. One in five patients in the EU suffers from lung cancer, therefore we have to help smokers by giving them the opportunity to gradually quit.” Italian MEP Pietro Fiocchi, meanwhile, has urged European policymakers to differentiate better between e-cigarettes and combustible tobacco and advised against taxing them similarly. Fiocchi, who sits on the Parliament’s Special Committee on Beating Cancer (BECA), warned that “as taxes on both traditional products and vaping items will be set at the same level […] poorer Europeans, who cannot afford to vape, will buy other, unhealthier products instead.”

Sadly, many EU countries have already taken aggressive steps against vaping which risk sending many smokers back to combustible tobacco. Despite being saddled with some of the highest smoking rates on the continent, Hungary decided to ban all e-cigarette flavours in 2017. The Netherlands has proposed a similar plan, in spite of widespread opposition from health researchers and the wider public. Denmark is slated to prohibit the sale of all e-cigarette flavours except for tobacco flavour from next April; Copenhagen has already instituted a ban on manufacturing these flavoured products.

Worse still, several studies have already shown that imposing tighter regulations on e-cigarettes may be counterproductive from a public health standpoint, steering consumers back toward the combustible tobacco products which are far more dangerous for their health.

A National Institutes of Health-funded study in the US, for instance, has raised serious concerns over the proposed Tobacco Tax Equity Act of 2021. The Act would see an increase to the federal cigarette excise tax applied across all nicotine products, including e-cigarettes. Led by nine health economists, the study found that the tax increase would actually increase youth cigarette use by 8 percent, while reducing e-cigarette use.

Another study, this time from the Yale School of Public Health (YSPH), found that flavour bans on e-cigarettes correlated with the doubling of high school student's chances of smoking cigarettes. By removing flavours from e-cigarettes, authorities were removing the primary motivation for choosing vaping over smoking, researchers said.

No matter how well-intentioned, laws designed to curb e-cigarette use clearly steer individuals toward toxic combustible tobacco products. As the endless parade of studies illustrating the devastating public health effects of tobacco smoking have shown, the implementation of these laws would be a worst-case scenario for smokers and non-smokers alike.

(Devdiscourse's journalists were not involved in the production of this article. The facts and opinions appearing in the article do not reflect the views of Devdiscourse and Devdiscourse does not claim any responsibility for the same.)