As children went back to school in the fall of 2019, parents, educators, public health experts and lawmakers grew more concerned by the day. A number of “e-cigarette or vaping-related lung injuries,” or EVALI, popped up in the United States, and no one – not even the Centers for Disease Control and Prevention (CDC) – had an overview of what was happening .
Finally, in November, the CDC belatedly identified a “very strong culprit”: vitamin E acetate, a compound found as an adulterant in illegally manufactured THC cartridges. That said, no nicotine vaping products. (Two months earlier, police had arrested two brothers in Wisconsin for what the local sheriff called an “empire” of the illegal, vapable THC.)
However, the damage was already done. “Vaping” had been accused by the authorities, the media and the public – and all vaping, whether nicotine or THC, was subsumed under that one verb.
This was particularly evident in Massachusetts, where Republican Governor Charlie Baker led his state to arguably the largest crackdown on e-cigarettes in the country. From September to December 2019 he was issued for a month total Ban on nicotine and cannabis vapes. Small mom and pop nicotine vape shops closedsometimes forever. Then, when Baker lifted the total ban, he did signed a law that would soon ban flavored e-cigarettes and menthol cigarettes as well as institute a 75 percent excise tax on the wholesale price of all electronic nicotine delivery systems (ENDS)).
Years later, neither Baker nor the Massachusetts Executive Office of Health and Human Services, which at the time of writing had not responded to Filter’s request for comment, appeared to not acknowledge that they had made at least one mistake. But even if their ultimate political goal was a taste ban or exorbitant ENDS taxes, they can no longer blame EVALI. They cannot claim that their interventions protected public health; in fact, they may have to admit the opposite.
“The EVALI fear was also linked to an immediate increase in cigarette consumption.”
A new study now suggests This legislation, resulting from misrepresentation about EVALI and e-cigarettes in Massachusetts, actually caused one increase in cigarette consumption all over Boston.
“One key finding we found was that EVALI was clearly linked to a sharp drop in e-cigarette sales,” said Dr. Michael Siegel, professor of community health sciences at Boston University and co-author of the study filter. “More troubling, however, was that the EVALI fear was also linked to an immediate surge in cigarette consumption in Massachusetts and the United States.”
In an article published May 5 in the Harm Reduction JournalBoston University’s two co-authors, Amanda Katchmar, Adrian Gunawan, and Siegel, performed an intermittent time series analysis of consumer data year-on-year. They gathered this information from Nielsen, a global research research company that collects the data from a scanner at the time of purchase in many large retailers, grocery stores, and large gas stations.
The authors looked at the data for a specific month and compared it to the same month of the previous year, with the months studied ranged from mid-2018 to September 2020. They focused on a handful of intervention points, including the increase in EVALI cases across the United States and Massachusetts‘ Temporary downright ban on e-cigarettes, subsequent ban on taste and 75 percent excise tax.
“They shut down the entire e-cigarette business in the state for months for no good reason,” Siegel said. It was the opposite of the COVID pandemic in many ways, where a crippling public health crisis forced businesses to shut down. With EVALI, it was the decision to shut down the companies that crippled public health.
“As a result, I think a lot of people actually thought e-cigarettes were more dangerous than cigarettes.”
Vaping products are widely accepted by public health experts to be much less harmful than cigarettes, although the US government has not yet made that statement. Many are hoping to have a pre-market tobacco use process that will require the Food and Drug Administration (FDA) to verify that they are vaping products “suitable for the protection of public health,Will affect public opinion later this year.
“We suspect there was a lot of misleading information about the disease,” Siegel said filter. “It was attributed to e-cigarettes, although it turned out they had nothing to do with it. So I think a lot of people actually thought e-cigarettes were more dangerous than cigarettes. “
Some simply drove across state lines to New Hampshire, Rhode Island, or even Connecticut to purchase vaping products. But another reaction was abundantly evident in the data: As the consumption of e-cigarettes among adults has decreased, there has been a marked increase in cigarette consumption.
“This is the first study that really empirically proves this trend,” said Siegel.
Analysts from the tobacco industry have made similar statements. In several filter-checked reports, research by Goldman Sachs has shown that the e-cigarette market continued to contract as cigarette sales increased during the 2020 pandemic. The public perception of vaping as a less harmful alternative has been marred by both EVALI and misleading news about the relationship between vaping and COVID.
“Cigarettes and vaping are interchangeable goods, and attacking one drives the other’s sales,” said David Sweanor, expert on the tobacco industry and chair of the Advisory Board for the Center for Health Law, Policy and Ethics at the University of Ottawa. told filter. “Very targeted efforts have been made to attack the low-risk alternative.”
Data from the finance department supports this claimand in January the Wall Street Journal recently reported “US cigarette sales were even stronger last year than in 2015 when gas prices fell sharply, giving consumers more discretion and many people switching back to cigarettes after trying first-generation vaping devices.”
However, it is impossible to discuss EVALI without referring to the environment in which the range of diseases emerged: at the height of what the CDC and FDA call it “Epidemic” of adolescent e-cigarette use. Concerned parents had set up anti-vaping nonprofits, and JUUL co-founded the same summer EVALI cases surfaced appeared before a congressional committee to testify about the marketing strategies of his company.
For Siegel, EVALI was a public focusIgnorance. Now, he said, public health officials “just have to tell the truth”.
The Influence Foundation, which operates filters, has received unqualified grants from JUUL Labs, Inc.
Photo by Lindsay Fox via Flickr / Creative Commons 2.0