1 in 5 high school students are now vaping nicotine using e-cigarettes. According to the National Institute on Drug Abuse (NIDA), in just one year (2017 to 2018) the number of high schoolers who reported their use of e-cigarettes jumped by nearly 10 percentage points from 11% to 20.9%; this number equates to about 3 million young people according to the U.S. Centers for Disease Control and Prevention. As with the tobacco debate in the United States, such high numbers spark questions about the role of the government in public health.
Policymakers have taken note of the dramatic jump in vaping and have created stricter regulations around electronic nicotine delivery systems (ENDS) in the last several years. Most of this regulation is just beginning to roll out now. The FDA, for instance, now requires sale only to individuals over the age of 18 and includes ENDS in their definition of tobacco products under the 2009 Tobacco Control Act; this means ingredients will now be required on packaging, for instance.
In the new wave of e-cigarettes and regulation, it is worth exploring the history of the U.S. tobacco debate and how it informs our present course.
Many readers will recall a time in the mid-20th century when cigarettes were not only popular, but advertised as healthy. Such claims were made in the name of marketing rather than data, of course, but they allowed cigarette use to take a serious hold in American culture. As normative scientific studies started to reveal the deleterious effects of tobacco use, the tobacco industry responded by claiming there was scientific uncertainty and lack of proof. After nearly a half a century of unprecedented corporate success, the industry fought hard to push back against the science that threatened to undo their achievements. CEO’s within the tobacco industry came together to fund more, not less, scientific inquiry into the safety of cigarettes. The trouble was that they only funded skeptics of the causal relationship between smoking and disease, which amplified a minority opinion that was not based in large-scale data.
At the same time, the industry poured huge amounts of money into Congress and created a strong lobby with significant influence in U.S. government. They continued to advertise using paid doctors, dentists, and celebrities as a central strategy for disrupting the science that threatened their industry. It should not be understated how brilliantly effective the tobacco industry was, and is, at creating a narrative that supports their products. They are, quite simply, masters of public relations.
By the mid-1960s, advocacy groups, the U.S. Surgeon General, and the court system jointly attacked the industry in such a way that regulation and litigation ultimately led to the erosion of Big Tobacco’s power. We now see the rise of a new nicotine delivery system, but not necessarily new strategies for product success.
Fast forward 50 years, and we find similar strategies creeping up once more. When teens are asked what they think is in e-cigarettes, 66% report that they believe it is just flavoring and 13.7% don’t know (NIDA). The reason? Manufacturers have not been required to disclose ingredient information or risks on packaging until recently, and e-cigarettes have been marketed to youth through appealing flavors and packaging meant to mimic kid-friendly food items such as Reddi-wip, Nilla Wafers and Warheads candy.
Other tactics that the e-cigarette industry have been using include offering scholarships, using social media marketing, sponsoring music events, and once again pouring money into political campaigns and lobbying efforts. Just this year, as Congress considers raising the tobacco and vaping product purchase age from 18 to 21, e-cigarette leader, Juul Labs, gave nearly $100,000 to members of Congress through the company’s political action committee.
As in so many public policy issues, it’s important to follow the money – the advertising money, the political action committee money, and the public relations dollars – to ensure that history does not repeat itself. While representatives of the e-cigarette industry claim to have the interests of youth at heart, their actions seem to suggest otherwise. It will ultimately fall to government to study, track, and protect the public’s health on this one.
Dr. Heather Farley is a professor of Public Management in the School of Business and Public Management at College of Coastal Georgia. She is an associate of the College’s Reg Murphy Center for Economic and Policy Studies.
Link to the National Institute on Drug Abuse: https://www.drugabuse.gov/related-topics/trends-statistics/infographics/teens-e-cigarettes
Reg Murphy Center