Last month, the Smoke Free Alternatives Trade Association (SFATA) announced that they found evidence of an “epidemic” of misinformation when it comes to consumers’ understanding of vaping products and nicotine in general.
“SFATA believes that while the [Food and Drug Administration (FDA)] is busy giving adults and teens an epidemic of misinformation, Public Health England, the national health organization of the U.K., has truthful data showing that ‘vaping may be contributing to 20,000 U.K. smokers quitting every year,’ says Mark Anton, the trade group’s executive director, in a press release. Anton, while using talking points that industry advocates in the United States argue regularly, is honestly telling the truth.
Public Health England (PHE) is one of the only public health agencies in the world that promote vapes and e-cigarettes as legitimate aids for harm reduction and smoking cessation interventions. Even the National Health Service (NHS), the U.K.’s national healthcare delivery system, supports the PHE findings that long-term e-cigarette use is safer than combustible cigarette use and such devices are at least 95 percent safer than a combustible cigarette. From there, as I have previously argued on many occasions, regulations developed in the U.K. are promulgated based on science and not paternalism.
The United States is a different story. Barring Anton’s rhetoric, the truth behind the “misinformation” argument derives from a legitimate area of concern. Despite the political economy behind the tobacco tax and the federal government’s dependency on cigarette dollars, the health components used in justifying aggressive regulations usually derive from a single-sided and often unethical approach to fighting population-level health challenges related to tobacco use and nicotine use addiction.
Nicotine is treated differently compared to other illicit and formerly-illicit substances. Drug control advocates make themselves out to be hypocrites by supporting harm reduction strategies when dealing with marijuana, psychedelics, intravenous drug use, and opioids over risk minimization interventions that involve nicotine. That one-sided logic luckily eludes tobacco harm reductionists and causes some folk to question whether there are ethical implications when considering a broader context.
Charles Gardner, the director of Health Science and Technology for the Foundation for a Smoke-Free World, calls the climate of consumer misinformation in the United States a troubling one.
“Giving smokers accurate information on relative risks helps them make informed choices for their own health. If they make the right choices, they can reduce their health risks substantially,” Gardner told me. He added: “On a population level, this means far fewer people suffering from preventable smoking-related disease and death. The outcome will be an improved quality of life for millions of people.”
Here, I asked Gardner about the impacts of “full-picture” information access at a population-level and whether it would impact a quality-adjusted life year (QALY). His response, naturally, was a confirmation that QALY measurements, a theory used in health economics to measure resource allocation and the overall health care costs for treating someone, are positively impacted.
A recent study published in the journal Epidemiology concluded a similar case utilizing a QALY measurement.
“This modeling suggested that a fairly permissive regulatory environment around vaporized nicotine products achieves net health gain and cost savings, albeit with wide uncertainty,” Frederieke S. Petrović-van der Deen et al. concluded.
The researchers utilized a multistate life-table model for about 16 diseases linked to tobacco use and simulated a QALY scenario and health system cost analysis at a no-percentage discount rate, utilizing New Zealand as a background jurisdiction. “We incorporated transitions from never, former, and current smoker states to, and from, regularly using vaporized nicotine and literature estimates for relative risk of disease incidence for vaping compared to smoking,” the researchers stated.
Considering these arguments, we can conclude that improvements in quality in health and life for smokers can be owed to individuals who have more information about what they are ingesting into their bodies. Additionally, if you apply medical ethics to this argument, accessible information about nicotine could further support an individual’s autonomy, or the right to decide what is best for their health.
Declaration: Journalistic ethics mandate that I declare that I have received funding through the KAC Tobacco Harm Reduction Scholarship programme to travel and attend the 2019 Global Forum on Nicotine in Warsaw, Poland, this summer. The grant is made possible by the Foundation for a Smoke-Free World. This piece was written independently of such funding, the sources of financing, and complies with Vaping Post’s editorial position of independence.