A new study from researchers at Boston University has indicated that misinformation stemming from outbreaks of vaping-related illnesses in the fall of 2019 has led to an increase in cigarette consumption across the country. Cases of EVALI, which misleadingly stands for e-cigarette or vaping-use associated lung injury, sharply increased in August 2019 before peaking a month later in September. During this time, public health officials offered little explanation for the outbreak, simply attributing it to “vaping”. 

Cases had subsided by November, when the Center for Disease Control finally put out a statement acknowledging what by then was common knowledge and identified in Vitamin E Acetate, a compound found exclusively in some illicit, black-market tetrahydrocannabinol (THC) vapes, as responsible for the outbreak. Vapes that contain THC, a psychoactive compound found in marijuana, are completely unrelated from e-cigarettes and other nicotine-containing vapes, and the chemical composition of e-cigarettes is such that it is physically impossible for them to be laced with products such as Vitamin E Acetate in the manner that THC products can be. Unfortunately, by the time the CDC put out a statement, public perception had been considerably altered beyond repair.  

The media, public health officials, and lawmakers aggregated legal reduced risk smoking alternatives like nicotine e-cigarettes with black market illegal THC-containing products under the umbrella of “vaping”, despite the overwhelming difference between the two. This decision did extraordinary damage to the reputation of e-cigarettes, which have been proven 95% safer than traditional combustible tobacco, and the most effective quit-smoking tool on the market, and this misinformation has now been proven to have caused serious harm to public health. Published in the Harm Reduction Journal, this recent study from researchers at BU examined the impacts of the EVALI outbreak on e-cigarette and combustible cigarette sales.  

In addition, the study looked at Massachusetts’ ban on all vaping products that implemented in September 2019 until December 2019. The prohibition completely lacked any scientific or evidence-based reasoning and forced the closure of numerous small vape shops, costing hundreds of jobs. While a majority of shops returned to businesses after the prohibition was lifted, many shops never reopened. The crucial takeaways from the study are discussed below and the full study can be read here

Key Findings:  

  • Many governments and health organizations used the EVALI outbreak as a reason to restrict e-cigarette use.  

  • Messaging that questioned the safety of nicotine-containing e-cigarettes, “led to an increase in combustible cigarette use”. 

  • Before the EVALI outbreak and resulting e-cigarette bans, cigarette sales in the US were decreasing significantly. In Massachusetts, cigarette sales were decreasing significantly greater than in the rest of the country.  

  • After the EVALI outbreak and resulting e-cigarette bans, “e-cigarette purchases decreased significantly while cigarette purchases increased” in the US and Massachusetts. 

  • There is a “need for health authorities to reconsider how they communicate the relative risks of smoking and vaping”. 

  • Even after the CDC identified THC-containing vapes as the cause of EVALI and Massachusetts’ vape ban was lifted cigarette sales stayed steady, illustrating the damage done to public opinion. 

Massachusetts’ response to the EVALI outbreak should serve as a warning to reactionary lawmakers who seek to implement policies without any basis in scientific evidence. Governor Charlie Baker and the Massachusetts Legislature ought to have taken the time to understand the science behind e-cigarettes and harm reduction. If they had done so, they very likely would have come to a different solution, one that would have avoided doing irreversible harm to public health. 

E-cigarettes are proven to be 95% less harmful than traditional cigarettes and have been endorsed by dozens of the world’s leading public health organizations as safer than smoking an effective way to help smokers quit. There is a plethora of evidence available that policy makers can access demonstrating the importance of maintaining access to e-cigarettes for adults. According to a study from the Georgetown University Medical Centre, 6.6 million premature deaths would be avoided over the next ten years if a majority of cigarette smokers made the switch to vaping.  

E-cigarette bans and fear-driven hysteria confuse consumers about the safety of these products, preventing them from making evidence-based decisions about their health. Encouraging smokers to make the switch to vaping will save lives and transform futures. Poor messaging and misinformed legislation will only keep people smoking, and dying from, combustible cigarettes.  

The EVALI outbreak resulted in the deaths of 68 people across the United States. The anti-science response to the outbreak, and the resulting increase in cigarette consumption across the country, will undoubtedly kill many, many more.