The piece was co-authored by some of the leading scholars in tobacco control: Amy Fairchild of Ohio State; Ronald Bayer of Columbia; Cheryl Healton and David Abrams of New York University; and James Curran of Emory. Three of them are deans of some of the most prestigious public-health schools in the country.
Bayer and his colleagues wrote that allowing combustible cigarettes to stay on the market, but "restricting access and appeal among less harmful vaping products out of an abundance of caution," would be a massive setback for public health globally. They supported a harm-reduction approach, analogous to the United Kingdom, which assumes that nicotine itself will not be eradicated from the world anytime soon and advocates for careful policy and regulation.
"In public health, there are always trade-offs," Bayer said. "You have to weigh both the risks and benefits."
The authors call for some sort of "product monitoring system" while adding, "if the [US is] going to take policy action on flavors, menthol in combustible products must be the first target." But, as Bayer emphasized, the crucial conclusions and recommendations they make are for taxing vaping products—enough to keep them out of the hands of teenagers, but lower than those on combustible cigarettes so as not to discourage current smokers to switch. They also suggest federally raising the legal age to purchase nicotine products to 21.
Minors’ attraction to vaping became the focus of several surveys related to the spike of illness. Just last week, the Centers for Disease Control and Prevention (CDC) released some data from its annual National Youth Tobacco Survey (NYTS), which noted that a majority of kids who tried e-cigs cited mere "curiosity" as their motivation. (Flavors themselves came in a distant third.) However, many critics slammed the NYTS for being both imprecise and incomplete: The student respondents didn't have an option to choose "wanting nicotine" as a primary reason for experimenting with e-cigarettes, and, as some harm-reduction opponents have already pointed out, e-cigarettes are not even tobacco products, since there is no tobacco in them.
The vaping crisis has divided public opinion on the matter into two distinct camps: those who recognize that the rapid increase in teenage vaping is a serious problem that must be dealt with but also see cigarettes as a harm-reduction tool to help smokers ditch cigarettes; and those who believe that this problem can be eradicated through prohibition tactics, like adopting flavor bans that many states and large cities have already done. Last week, President Donald Trump proposed raising the minimum age for the sale of e-cigarette products to 21 due to the rise in vaping-related deaths and illnesses. Trump defended his decision to propose an age limit on vaping products rather than an outright ban by saying e-cigarettes would become illegally available if he outlawed them.
As of October, the US Centres for Disease Control and Prevention (CDC) had reported 34 deaths and more than 1,600 cases of lung injuries related to vaping.