Need for more nuanced messaging on vaping, smoking

The latest Global Youth Tobacco Survey (GYTS) shows that 14.1 percent of youth aged 13 to 15 are current vape users. This is a jump from 11 percent in 2015. This modest increase is enough to worry some health advocates, intensifying calls for greater regulation of vaping products.

It is certainly the case that these kids should not be touching any sort of smoking or vaping paraphernalia. In that regard, more stringent vaping regulations might be warranted. However, things must be put in perspective when reporting about these trends.

For instance, analysis of these vaping trends is usually disconnected from smoking trends. This becomes a problem if vaping is a substitute for traditional smoking. If the jump in vaping incidents was caused by young people switching from traditional cigarettes, that is a positive development, since vaping is significantly safer than smoking. The switch toward vaping would lead to better health outcomes for the youth.

But if the increase in youth vaping incidence is not from a switch away from traditional smoking, then the negative effects of vaping would just compound the effects of smoking. In such a case, the effect on youth health outcomes would be detrimental.

Youth smoking trends provide useful information on which of these two scenarios are happening. Based on previous GYTS surveys, cigarette smoking among Filipino youth has been steadily decreasing from 18.9 percent in 2000 to just 10 percent in 2019. This continued displacement of traditional smoking by vaping among the youth suggests a possible benefit for youth health outcomes.

Just imagine how bad the statistics on youth smoking prevalence would have been if vaping was not present as a substitute.

This brings us to the issue of messaging by various advocacy groups and policymakers. The Department of Health (DOH) has been pushing anti-vaping messaging as part of its approach to improve youth health outcomes. At a smoke-free and vape-free summit organized by the DOH, the claim that vaping is not a substitute for traditional smoking was often repeated. Their basis for this claim is that vaping is just as bad for the health as smoking and that vaping does not help smokers wean themselves off traditional cigarettes. But these are unfounded assertions disproven by the data.

One assessment by Cochrane collaboration of 78 scientific papers finds “high certainty evidence that people are more likely to stop smoking for at least six months using nicotine e-cigarettes, or ‘vapes,’ than using nicotine replacement therapies, such as patches and gums.” In terms of safety relative to traditional cigarettes, the Royal College of Physicians notes that long-term health risks of e-cigarettes “are unlikely to exceed five percent of those associated with smoked tobacco products.” A study published in the journal Tobacco Control concluded that the level of toxicants in electronic cigarettes was 9-450 times lower than in traditional cigarettes and are in nontoxic amounts.

When faced with the data, the speakers at the event said these were inconclusive. Health authorities usually function under the precautionary principle. They err on the side of caution when faced with an innovation to lessen the risk of unwanted consequences. However, the precautionary principle does not come without risk itself. Prolonging the implementation of a useful innovation leads to unnecessary casualties. The precautionary principle must be reasonable, not excessive. A mere switch to a more nuanced messaging would result in health benefits for the youth population.

The ball is in the DOH’s court now.

Julan Aldover,