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Should a new Surgeon General Report be conducted to address the issue of vaping, similar to how a previous report clarified the effects of smoking?
Science & Health

Should a new Surgeon General Report be conducted to address the issue of vaping, similar to how a previous report clarified the effects of smoking?

Six decades ago, the U.S. surgeon general published a report that resolved a longstanding dispute within the public regarding the risks of cigarettes and resulted in significant shifts in smoking behaviors in America.

Currently, certain health professionals suggest that a comparable study may aid in clarifying the controversies surrounding vaping.

A significant number of American adults hold the belief that nicotine vaping is equally or more harmful than smoking cigarettes. This belief is incorrect. Both the U.S. Food and Drug Administration and the majority of scientists concur that electronic cigarettes, based on current evidence, are significantly less hazardous than traditional cigarettes.

However, this does not imply that e-cigarettes are completely safe. There is disagreement among public health professionals about the level of harm or benefit that these devices provide. Lawrence Gostin, an expert in public health law at Georgetown University, emphasizes the urgency for clear and accurate information on the matter.

Gostin suggested that a report from the surgeon general could help clarify the numerous confusing messages surrounding vaping.

A significant challenge is that the use of e-cigarettes has not been observed for a sufficient amount of time for researchers to determine if it leads to health issues such as lung cancer and heart disease.

Dr. Kelly Henning, head of the public health program at Bloomberg Philanthropies, stated that there is a notable absence of evidence.

Smoking and Vaping

Smoking cigarettes has been widely recognized as the number one cause of avoidable fatalities in the United States. According to the Centers for Disease Control and Prevention, approximately 480,000 lives are lost each year due to smoking. However, a recent study published by the American Journal of Preventive Medicine predicts that this number should start to decrease by 2030 due to a decrease in smoking rates that began in the 1960s.

FILE - In this April 9, 1965 file photo, Surgeon General Luther Terry testifies on Capitol Hill in Washington before the House Commerce Committee hearing on proposed labeling of cigarette packages.

On April 9, 1965, Surgeon General Luther Terry testified before the House Commerce Committee in Washington about the potential labeling of cigarette packages.

In the past, ashtrays could be found everywhere and over 42% of adults in the United States were smokers.

On January 11th, 1964, the U.S. Surgeon General, Luther Terry, published a significant report stating that smoking is linked to illness and death. The report called for government action to address this issue. This report is seen as a pivotal moment in history, as it led to the implementation of warning labels on cigarette packaging, a ban on cigarette commercials, increased tobacco taxes by governments, and stricter regulations on smoking in public places.

In 2022, the percentage of adults who smoke was 11%.

Certain specialists argue that e-cigarettes should be given some recognition. These devices were marketed as a means to aid smokers in quitting, and the FDA has approved a few e-cigarettes as safer options for adult smokers.

FILE - So far, investigators have not identified a particular device, liquid or ingredient behind the U.S. outbreak of severe vaping-related illnesses.

FILE – So far, investigators have not identified a particular device, liquid or ingredient behind the U.S. outbreak of severe vaping-related illnesses.

During the 2010s, the use of vaping significantly increased among both adults and teenagers. In 2014, e-cigarettes became the most commonly used tobacco product among youth, surpassing combustible cigarettes. By 2019, 28% of high school students reported vaping.

Health authorities in the United States expressed concerns that children addicted to nicotine would return to smoking cigarettes. However, this has not been the case. In fact, the rate of high school students who smoke has decreased significantly to less than 2%, which is a significant drop from the 35% rate observed approximately 25 years ago.

Kenneth Warner, an expert in tobacco-control policies at the University of Michigan, described the achievement as a remarkable success in the field of public health.

He stated that without e-cigarettes, the public health community would be loudly celebrating their success in preventing kids from smoking.

The Advantages and Disadvantages of Vaping

Cigarettes are considered the most lethal consumer good ever created due to their smoke containing numerous chemicals, with at least 69 of them having the potential to cause cancer.

FILE- A man vapes with an electronic cigarette, exhales in Fair Oaks, Virginia. (Photo: Diaa Bekheet).

In Fair Oaks, Virginia, a man is seen using an e-cigarette and releasing vapor. The photo was taken by Diaa Bekheet.

The mist produced by e-cigarettes has been approximated to have significantly fewer chemicals and carcinogens. While some harmful substances are found in both, they appear in significantly lower levels in e-cigarette vapor compared to traditional cigarette smoke.

Research has demonstrated that individuals who transition entirely to using vaping instead of smoking experience enhanced lung function and other positive health outcomes.

Donald Shopland, a former clerk for the committee responsible for the 1964 report and co-author of an upcoming book on the subject, stated that he would prefer to witness someone vaping rather than smoking a Marlboro. He confidently believes that vaping is a safer option.

What about the risks for individuals who have never smoked?

Dr. Neal Benowitz, a prominent academic expert on nicotine and tobacco addiction from the University of California, San Francisco, stated that there have been approximately 100 to 200 investigations conducted on vaping. However, these studies have yielded conflicting results due to their use of different methods. Additionally, many of these studies were constrained in their ability to distinguish the effects of vaping from those of previous smoking habits.

FILE - A health warning is seen on the packaging of a disposable vaping pod device in Washington , June 26, 2023.

A cautionary message is visible on the wrapping of a single-use vaping pod tool in Washington, dated June 26, 2023.

According to Warner, the research is varied and conflicting.

Research has found that young individuals who engage in vaping may experience bronchitis symptoms and worsened asthma. Additionally, studies suggest that vaping can have an impact on the cells that line the heart and blood vessels, potentially contributing to the development of heart disease. Many experts attribute this to the presence of nicotine, a stimulant known for its addictive properties in both cigarettes and vapes.

Research conducted on animals indicates that exposure to nicotine during adolescence can impact the development of the brain region responsible for attention, learning, and impulse control. Additionally, studies on humans have shown a potential correlation between vaping and symptoms of ADHD, depression, and stress. However, experts note that there is limited research in this area and further investigation is necessary.

At present, there is no unanimous agreement among scientists that using e-cigarettes is a successful method for quitting smoking, as various research studies have yielded conflicting results.

Clearing the Air

In recent weeks, the World Health Organization expressed concerns over the rapid expansion of the international electronic cigarette industry, citing a wide variety of appealing flavors that are particularly attractive to youth.

In 2016, Dr. Vivek Murthy, the U.S. Surgeon General, stated that action was necessary to prevent and decrease the usage of e-cigarettes among minors and young individuals. He emphasized that all forms of nicotine are hazardous for children.

Approximately four months prior to the publication of the report, the FDA initiated measures to govern e-cigarettes, with the belief that they would be advantageous for smokers.

The FDA has approved multiple e-cigarettes, but has rejected over 1 million applications for product marketing. Critics argue that the agency’s regulation of products has been biased and erratic.

In recent years, there has been a significant increase in the variety of e-cigarette products available in the United States, primarily due to the importation of disposable devices from China that offer fruity and sweet flavors. However, the use of e-cigarettes among young people has decreased, with 10% of high school students reporting using them in the past month, compared to 14% in the previous year.

What caused the decrease? According to Steven Kelder, a researcher at the University of Texas, it is difficult to determine what strategies are effective.

He brought up a recent incident in 2019 where individuals who were using vape products containing THC, the psychoactive component of marijuana, experienced hospitalizations and fatalities.

Kelder stated that the recent outbreak of illnesses linked to vaping can be attributed to a thickening agent found in illegal vape cartridges, which is not found in regular nicotine e-cigarettes. This may be a contributing factor to the perception of e-cigarettes being unsafe among Americans.

Sherri Mayfield, a 47-year-old postal employee, recalls the 2019 epidemic and the cases of sudden illnesses and fatalities among young people. Mayfield stated that further research on vaping is crucial while on a smoking break in New York with colleagues.

She stated that cigarettes may not be safe, but at least it can take decades for them to harm your health.

According to a statement from the surgeon general’s office, the 1964 report sparked a 60-year effort to address the negative impact of smoking. They also recommended taking similar steps to address the issue of youth vaping.

Currently, vaping and smoking are not listed as priority issues on Murthy’s website.