Posted on May 1, 2022 By Colin
NSW Health and Australian health authorities are engaged in a well-meaning but misguided attempt to eliminate youth vaping which will do more harm than good. Clive Bates and David Sweanor explain why this campaign is flawed in a submission to Health Canada. The very same reasons apply to Australia (modified and reproduced with permission).
First, vaping is an alternative and much safer way of delivering nicotine and is a substitute for smoking.  Measures that are “tough” on vaping may have the effect of increasing smoking and creating a net increase in harm. NSW Health and a range of influential Australian health organisations that oppose vaping may be doing more harm than good in tobacco policy.
Nearly everything they do in opposition to vaping has the effect of protecting the cigarette trade from competition, inhibiting switching from smoking to vaping, and therefore prolonging the epidemic of smoking-related disease
Second, an excessive focus on young people ignores adult welfare and interactions between adult and adolescent welfare. For example, measures taken to prevent trivial risks to young people may create lethal consequences for millions of adults. Also, there are young people for whom vaping functions as a protection from smoking by providing a diversion pathway away from initiating smoking.
Finally, the link between adult and youth behaviours must be recognised. Young people do not live in isolation from adults. The primary driver of youth smoking initiation is the smoking behaviour of parents or other significant adults. [2, 3]
Young people are harmed by the economic and health impacts of parental smoking and through second-hand smoke exposure
Taking measures to prevent youth vaping does not make vaping disappear as far as young people are concerned. Like all prohibitive policies, restrictions change how products are supplied, who supplies them and at what price. It is wrong to assume that a young person who would otherwise have vaped will switch to behaviours deemed virtuous by authorities.
For example, young people could access the unregulated black market, participate in the black market as low-level suppliers, mix ands sell their own vape liquids, switch to smoking, or switch to the use of other drugs
For some youth, for some of the time, some sort of substance use is inevitable, whatever adult authorities say or do. Vaping nicotine should be of much less concern than alcohol or cannabis or the use of nicotine through smoking tobacco.
While Australian health activists, health charities, medical associations and an uncritical media have created a moral panic about vaping, we need to approach the issue with a sense of proportion. No one is arguing that youth vaping should be of no concern,
But youth vaping is a relatively innocuous behaviour compared to binge drinking, driving under the influence or regular use of cannabis.
Youth vaping presents a far lower and probably transient public health risk compared to the risks facing adults who have already smoked for years or decades.
Fourth, Australian authorities should adopt a rigorous public health perspective and focus on minimising the severe health and economic results of smoking as quickly as possible.
Vaping is a significant harm reduction opportunity not to be squandered through poorly designed regulation.
The danger of focusing on “youth vaping” is that it distracts from the primary public health mission and leads to more cancer, cardiovascular and respiratory disease.
These trade-offs need to be considered in developing policy as they have real-world consequences in terms of adult mortality and morbidity and risks to youth.
1 Bates C, Sweanor D. A summary of the evidence for substitution in a recent submission on tax policy to the National Treasury of South Africa. See: Abrams DB, Bates CD, Niaura RS, Sweanor DT, Yach D. Comments on Discussion paper: Taxation of Electronic Nicotine Non-Nicotine Delivery Systems (Vaping), December 2021. 4 February 2022. [link]
2 Mays, D., Gilman, S. E., Rende, R., Luta, G., Tercyak, K. P., & Niaura, R. S. (2014). Parental Smoking Exposure and Adolescent Smoking Trajectories. Pediatrics, 133(6), 983–991. [link]
3 Vuolo, M., & Staff, J. (2013). Parent and Child Cigarette Use: A Longitudinal, Multigenerational Study. Pediatrics, 132(3), e568–e577. [link]