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Cigarette smoking back in vogue amid vaping crackdown

Cigarettes appear to be having a moment. Despite decades of public health messaging that has driven home the message that smoking is a dangerous and damaging habit, there are increasingly troubling signs that the practice is, once again, becoming “cool.”

The shift is particularly prevalent among people in their mid-twenties, apparently inspired by the aesthetic of cigarettes as presented on social media. Amid the fatalism of the COVID-19 pandemic, cigarette sales in the United States increased in 2020 for the first time in two decades. Indeed, the coronavirus era appears to have halted, and even reversed, years-long progress in the fight to reduce tobacco use across the world. With stress and anxiety levels on the rise, so are smoking rates: a Kaiser Family Foundation study found that the number of American adults reporting symptoms of anxiety and depression quadrupled from 2019 to 2021, with an additional one billion cigarettes sold during the same period.

In the UK, meanwhile, the first lockdown in 2020 saw the number of smokers aged 18-34 increase by a quarter, while an additional 4.5 million more adults were classed as high-risk drinkers. The trend was particularly evident in women, and people from lower socioeconomic groups.

Even more concerning are claims by smokers that they had made the switch from vaping to cigarettes because of some perceived health benefit. Despite being a safer way to consume nicotine compared to tar-based cigarettes, e-cigarettes have fast become a casualty of health authorities’ reluctance to issue clear guidance on these products. “Cigarettes seem like a known evil, whereas vaping you don’t know the side effects at all,” 22-year old Emile Osborne recently explained to the New York Times.

Such a comment indicates a profound misunderstanding of the relative risks of different nicotine products. It should be alarming to public health experts and politicians alike, and jolt them into creating a clearer tobacco control strategy that recognizes the contribution that reduced-risk products like e-cigarettes can make to curbing smoking rates.

Indeed, economic studies have demonstrated a link between e-cigarette and cigarette use, with one typically used as a substitute for the other based on price factors. It would make sense, then, that policymakers’ failure to make e-cigarettes more readily accessible than combustible tobacco products is pushing smokers back to cigarettes, with devastating results for public health. Given that vaping concerns are based on misinformation and a lack of clear guidance from health authorities, the future of anti-smoking efforts will require a fundamental shift in thinking about alternative nicotine products.

Some countries, such as the UK, have already made substantial progress using this sensible strategy. In 2015, Public Health England (PHE) released a landmark study that found e-cigarettes to be 95 percent safer than smoking, ultimately advocating the “use of e-cigarettes to help quit smoking” as part of its annual Stoptober campaign. Today, the country is a world leader in e-cigarette use among current and former cigarette smokers.

Other authorities, such as those in the EU, have dithered on the issue of e-cigarette use. As the ongoing “moral panic” over e-cigarettes spreads on the continent, policymakers appear to have entirely sidestepped readily available evidence regarding vape safety in lieu of pandering to the mob— all this despite stubbornly high smoking rates across the bloc.

Instead of recognising e-cigarettes’ harm reduction potential, European governments have responded with intolerance: Hungary banned e-cigarette flavours in 2016 and introduced a vape tax the following year, with Finland implementing similar controls on all nicotine products. A flavour ban proposed in the Netherlands is set to take effect from 1 July 2022. The problem exists at the EU level, as well, with some MEPs warning that a report on e-cigarettes by the European Commission’s Scientific Committee on Health, Environmental and Emerging Risks (SCHEER) missed the mark by failing to incorporate an assessment of e-cigarettes’ relative risks compared to conventional cigarettes.

The World Health Organization (WHO), meanwhile, appears to be dangerously behind the times on the issue. The leading health body has remained stubbornly opposed to e-cigarettes since they first entered the market, ultimately calling on governments to ban vaping in public places and restrict e-cigarette marketing despite the emergence of several studies arguing in the opposite direction.

The WHO’s position on e-cigarettes is so outdated that, coinciding with the ninth meeting of the Conference of the Parties of the Framework Convention on Tobacco Control (COP-9) in November last year, more than one hundred specialists signed an open letter urging the body to take a more positive stance on tobacco harm reduction. “There is no real scientific doubt that these smoke-free products are much safer than smoking and that they can help smokers quit,” the letter reads, “So we should be working hard to make that happen.”

Worrying signals about tobacco use emerging from the pandemic should serve as an impetus for authorities to ensure that the relative risk of nicotine products compared to cigarette use is reflected in public health communication and regulation. Designs for a smoke-free generation are futile without it.

This article does not necessarily reflect the opinions of the editors or management of EconoTimes

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