Regulating e-cigarettes may have the unintended consequence of driving vapers back to smoking, a new study suggests.
Young American adults that both vape and smoke said in a Duke University survey that restrictions on nicotine content, e-liquid flavors and adjustable e-cigs might drive them to smoke more combustible cigarettes.
E-cigs like the Juul may be less harmful than combustible cigarettes, but they still contain highly addictive nicotine and pose health risks, including to the cardiovascular system.
The study authors believe that e-cigarette regulations would be beneficial on the whole, but caution that restrictions need to be made with careful consideration for how people addicted to nicotine will respond.
At long last, the FDA is drafting regulations on e-cigs, including limits to their nicotine content – but doing so may drive some 47 percent of dual users back to cigarettes, a new study finds
Vapes took an unexpected and almost immediate turn from quit-aids to cool accessories as the Juul shot to popularity, with an over 600 percent sales increase from 2016 to 2017.
The problem is that the combustible tobacco alternative’s growth spurt came at the expense of American youth.
Even as smoking rates among all ages reached an all-time low last year, a quarter of high school seniors now say they vape.
Outcry over the Food and Drug Administration’s (FDA) failure – or at least hesitancy – to regulate e-cigs wasn’t exclusively about teen use, but the rate of vaping kids was the impetus for the agency to change its tune
Former FDA Commissioner Scott Gottlieb made the ‘teen vaping epidemic’ his crusade, raiding Juul Labs and jump-starting the process of creating regulations on e-cigs.
Currently, there are no limits or guidelines on nicotine or flavoring content for e-cigs and their e-liquids.
To try to discourage children and teenagers from vaping, the FDA has demanded that Juul change its marketing and advertising strategies.
But it is only now considering what regulations to place on nicotine content for the devices and the liquids that the heat.
‘The FDA now has regulatory authority over all tobacco products, including e-cigarettes and we know that some communities have taken action to ban flavored e-cigarette products,’ said Dr Lauren Pacek, the study’s lead author and an assistant professor in psychiatry and behavioral sciences at Duke.
‘We wanted to take a first pass at seeing what users’ anticipated responses to new regulations might be.’
The 240 participants, ages 18-29, in the Duke survey were asked how three potential regulations changes would affect their e-cig use and cigarette smoking.
In the survey, they asked the study participants about regulations that would cut nicotine levels in e-cigs to zero, give users less control over the nicotine levels and temperature to which e-liquids are heated, and that would limit flavors.
Prior studies have shown that many teen vapers don’t even realize that their e-liquids contain nicotine, and even adults are often unaware how potent their devices – such as the Juul, pods for which contain as much nicotine as a pack of traditional cigarettes – are.
Last week, a Centers for Disease Control and Prevention (CDC) survey suggested that even eight out of 10 current cigarette smokers were in favor of limits on e-cig nicotine levels.
But most e-cigarettes users – particularly young adults – use their vapes alongside combustible cigarettes, and seem to feel differently about regulations.
In the first scenario, e-cigs would be available but ‘only in nicotine-free (0 nicotine) e-liquid.
To that, 47 percent of participants said that they would most likely use the devices less or give them up entirely – but they said they’d be more likely to smoke more combustible cigarettes.
A second hypothetical regulation was to make e-cigs less adjustable, keeping users from controlling how much nicotine they get and what temperature it’s burned at.
About 22 percent of the young adults said that if the devices weren’t customizable, they’d use these less and smoke cigarettes more.
The final hypothetical regulation would limit e-cig flavors to only tobacco or menthol.
This change had the smallest effect, with just 17 percent of current dual users saying they’d move away from their e-cigs and likely smoke more.
Notably, however, sweet flavored e-cigs (and indeed cigarettes) have always targeted young, minority and low-income populations, so this change might also affect a more at-risk group of people.
The overall takeaway, however, was that these broad regulations might actually have the opposite of their desired effects for many current e-cig users.
‘It’s likely some potential new regulations on e-cigarettes will result in a net good for the whole population, such as limiting flavors that might entice young users, improving safety standards, or mandating that liquids come in child-proof containers, ‘ said Dr Pacek.
‘Our findings suggest that there should also be thoughtful consideration to potential unintended consequences that could affect other subsets of users of e-cigarettes and other tobacco products.’