From a public health perspective, the benefit of vaping comes from cigarette smokers who use vaping as a way of quitting cigarettes. How many people does this include? It turns out that about 1.8% of adults are vapers who used to smoke.
So not a lot but not nothing. A new study tries to quantify this in terms of mortality. It's extraordinarily complicated since, to begin with, "smoking-attributable mortality" is no easy thing to measure. The authors end up using a definition that includes 21 separate underlying diseases. But that's not all:
While all 21 of these established causes are causally linked to smoking, many of these deaths would still occur even in the absence of smoking at the population–level. To refine our measure of the mortality burden of smoking, we weight each cause by the cause’s sex–specific SAF. Our measure of SAM is therefore the weighted sum of all 21 established causes of death, weighted by each cause’s SAF. SAM comprises half of all deaths in our sample, and roughly one third of these deaths (32%) are attributable to smoking.
Then of course there's a whole boatload of demographic controls:
We construct our mortality panel from 1979–2019 for each unique combination of sex, 5 or 3 race/ethnicity groupings, 5–year age bins, census region, and 2013 urban status. Our estimation sample consists of decedents between the ages of 30 and 79. Population counts for the same unique combinations come from the 1969–2020 and 1990–2020 single–year county–level population files from the Surveillance, Epidemiology, and End Results Program (SEER).
There's much more, but let's cut straight to the meat. Here's what they found:
In 2011 the FDA lost its power to regulate e-cigarettes, and the authors contend that this ushered in a golden age of innovation that led to high take-up rates and therefore an immediate drop in mortality.
I can't make any sense of this. For starters, here is cigarette smoking in America:
It's been declining for decades, and if there's a change in 2011 you have to squint mighty hard to see it.
But that's hardly the main thing. Smoking largely kills you via chronic diseases that take decades to build up. There's simply no way that a small drop in smoking in 2011 could have anything more than a minuscule effect on mortality rates in 2013, as the chart shows, let alone the 10% mortality decline shown in the chart for 2016. That's crazy. It takes years for this stuff to show up.
For example: smoking peaked in the '50s and has been declining ever since. But it wasn't until 1991 that lung cancer deaths started to fall:
I'm frequently skeptical of studies showing how terrible FDA regulation is, so I try to be more careful than usual when I see a new one. But this study just makes no sense, and the authors don't even try to show any causality. I don't doubt that there was a lot of vaping innovation in the teens, but there's little evidence that this had a big impact on adult vaping or that it reduced death rates within a matter of months.
Bottom line: Perhaps the FDA is too hidebound. The evidence remains pretty thin, though.
Maybe fewer deaths from house fires when smokers fall asleep with a cigarette in their hands? (/s)
Spot on Kevin, putting aside other concerns, how soon do they expect lung cancer to manifest?
I don't know how much reliable data we have on this, but there's a lot of anecdotal stuff out there indicated a lot of smokers who "switch" to vaping are spending more time vaping than they did smoking cigs, thereby inhaling more vape than ciggie smoke because they're convinced vaping is significantly "safer."
Cardiovascular deaths and strokes would see a drop in the <5-year margin. I don't know the magnitude of that drop, however. Studies have looked at MI deaths after smoking cessation, and they happen quickly--but that is not the same as nicotine cessation, a la vapes, and e-cigs.
My first thought was that it was funded by the e-cigarette companies though that does not appear to be the case. Pesko in particular is a member of a group that says they don't take money from tobacco companies. He does seem to be a big fan of vaping for whatever reason.
Are most vape companies tobacco companies? What about state money from tobacco and vape groups?
Vapes pretty clearly seem to be the better option than cigarettes, if you're going to smoke tobacco, for a number of reasons (including carbon footprint).
With any relatively new technology we don't necessarily know about all the risks relative to it, that are novel in the sense of what came before (ex: microplastics).
Lots of innovation!!! How else can we get strawberry shortcake flavored vapes--essential to get adults to quit smoking.
I find it curious how hostile some people are to vaping. In everything that I have read, I have not found any real solid links between vaping and poor health outcomes. There are some "if you use this additive to vapes" issues (so just quit using the additives). From everything I read, nicotine addiction (without the inhaling tobacco smoke part) is not any worse than caffeine addiction. The worst I see is the "well, we do not know, there could be long-term issues...." but you can really say that about a lot of things
But by and large this seems to be a safe product that a lot of people still want to curb I think as much out of instinct or something? I think we need to just take the W here, stop worrying about vaping all that much, and worry about other issues like drunk driving that are really killing and harming people...
I find it curious how hostile some people are to legit concerns about vaping. It's too soon to have evidence on vaping safety though there's been some really scary stuff evident in kids that vape and in vapers who got original covid.
I want it stopped in it's tracks because it does give off second hand vapors and given my sensitivity to cleaning products and vapors from paint etc. I don't want to be forced into being a hermit as public places again become unsafe after about 30 years or so of smoke free spaces.
Two key points:
First, that 1.8% of adults who are vapers that used to smoke? You dismiss that as "only" 1.8% (still about 5 million people), but if you go to your own chart showing that smoking is now under (about) 15% of adults, that's now about 1/8 of former smokers now have switched to vaping, which is definitely non-trivial.
Secondly, for the drop in cancer rates, as a former smoker (quit in the 90s), I've been very aware of the rate of recovery of the lungs. By most actuarial guidelines, the medical risk of "former smoker" drops off after 10 years, and is considered the same as a never-smoker. This matches up well with the body replacing cells on about a 7 year cycle (differs per cell type, but a good average). After 10 years, almost all the cells that were actually exposed to the carcinogen have been replaced, though some damage may have been passed along in replication. There is a limit to the long tail of the damage.