Tobacco. Heroin. Opiates. We didn’t know. Initially we didn’t know that those elixirs would turn into addictions. The beauty turned into a beast. In the beginning, physicians touted the benefits of tobacco: it relaxed you. Heroin was considered a non-addictive cure for morphine addiction, as well as a treatment for pneumonia, tuberculosis and coughs. (British mothers shipped heroin to their sons at the front during World War I.) As for opiates, they dulled excruciating pain. We blame Big Tobacco, Big Pharma, Big Mobsters for hooking us; but at least at the very start, a lot of “experts” didn’t know.
Today nifty e-cigarettes are morphing into a product not so nifty. At first they seemed a marvel: You could inhale away, without sending noxious smoke into the lungs of everybody near you. You could wean yourself off cigarettes. You could look chic, since the gizmos looked like flash drives.
The beauty is morphing. We have recorded more than 800 injuries and twelve deaths linked to vaping. In 2016 the Surgeon General outlined the dangers from inhaling nicotine, often mixed with THC (tetrahydrocannabinol).
The uptake is startling: 20% of high schoool seniors now vape, a 78% increase from last year. Five percent of middle school students vape. Vaping has outstripped tobacco as the teenagers’ drug. You can buy flavored e-cigarettes; you can buy Vaprwear (hoodies designed expressly for vaping), watches, phone cases, backpacks.
The question looms: what will Uncle Sam, or his minions, the state Mini-Sams, do?
States are stepping to the front. This summer Michigan was the first state to issue a total ban on the sale of e-cigarettes, followed by New York, which banned only fruit and candy-flavored e-cigarettes (not the mint and menthol ones, which presumably draw adults rather than teenagers). Massachusetts followed Michigan, banning all the vapes; Rhode Island included only the flavored ones. Legislatures in Illinois, New Jersey, and Delaware are proposing bans; and a few cities, notably San Francisco, the home of Juul, manufacturer of e-cigarettes (owned, in turn, by Altria, maker of “real” cigarettes) has banned the vapes. And at last Uncle Sam is stepping into the fray: the FDA expects to launch restrictions soon, subject to public hearings.
Physicians are increasingly apt to ask patients: do you Juul? Juul, like Google, is now a verb.
Some retailers, moreover, are taking the e-cigarettes off their shelves in the United States. Walmart has stopped selling-them. Ditto for Rite Aid. CVS, which barred cigarettes in 2014, never sold the e-version. (For gas stations, convenience stores, and Walgreens, e-cigarettes remain lucrative.)
Even Juul has stopped advertising-flavored e-cigarettes in the United States, has announced it won’t fight whatever ban Uncle Sam issues.
Smooth sailing as we tamp down this growing addiction?
Maybe not.
Expect kickback. The bans will hurt smokers trying to stop. The bans will drive small vaping stores into bankruptcy. The bans will force teenagers to embrace the real thing, cigarettes, which are more toxic. The bans are not scientifically justified: we don’t know for certain what components are the toxic ones, or whether inhalers were inhaling black-market products; in fact, banning retail sales will encourage a black market. Bans will drive users onto the internet (where most teenagers are most comfortable shopping anyway). We don’t ban cigarettes’ sales to adults: why ban e-cigarettes to adults? The arguments roll forth. The people who loathe Big and Little Government will join their voices, protesting against the nanny-state.
As for Big Tobacco, which owns Juul, it can wait this battle out, knowing that it will find a market overseas, and knowing that bans on marketing will not necessarily end the use of this elixir.
For public health advocates, the alarms have been a walke-up call for action. We’ll see whether enough other forces wake up to the dangers of this technologically-driven 21st-century addiction.
Joan Retsinas is a sociologist who writes about health care in Providence, R.I. Email retsinas@verizon.net.
From The Progressive Populist, November 1, 2019
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