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During the rise of e-cigarettes, the smoking rate of young people is declining rapidly


According to foreign reports, another e-cigarette expert Jacob Salem said that flavored e-cigarettes should be banned, which was mentioned in a letter from Illinois congressman Raja krishnamoorthi to the Chicago Sun Times last week, Politicians who support new taxes and restrictions on nicotine e-cigarettes often ignore the life-saving potential of this harm reducing alternative to traditional cigarettes.

Nicotine Salt Mini Electronic Cigarette

Nicotine Salt Mini Electronic Cigarette

The following is the full text of the refutation:

This letter proves my point. It exaggerates the threat of e-cigarette smoking by minors, confuse e-cigarette with tobacco use, and insists that there is no evidence that e-cigarette can help smokers quit smoking.

Krishnamoorthi falsely urged the U.S. Food and Drug Administration (FDA) to ban e-cigarettes last year. He believes that e-cigarettes pose a great health threat to millions of young Americans. To support this statement, he cited data from the National Youth Tobacco Survey (NYTS), which showed that after a sharp rise in the first two years, e-cigarettes for high school students fell by 29% in 2020.

Ignoring this decline, krishnamoorthi instead stressed that high school students are currently using this highly addictive product, which means that they reported e-cigarettes last month. This figure is lower than about 28% in 2019.

Krishnamoorthi also failed to mention that the much more dangerous habit of smoking among teenagers has been declining since the late 1990s, reaching a record low in recent years. In 2020 NYTS, 4.6% of high school students reported smoking last month, down from 5.8% in 2019 and 15.1% in 2011, a decrease of 70%.

In the youth risk behavior survey, this rate decreased from 27.5% in 1991 to 6% in 2019 - a decrease of 78%. According to the monitoring future research covering a longer period, the smoking rate of high school students in the past month decreased from 36.5% in 1997 to 7.1% in 2020, a decrease of more than 80%.

As e-cigarettes become more and more popular among teenagers, this downward trend has accelerated, indicating that e-cigarettes are replacing combustible tobacco products in this age group. From a public health perspective, this is undoubtedly good news because e-cigarettes are a less harmful source of nicotine - a point krishnamoorthi clearly ignored in his statement on e-cigarettes.

Most high school students who smoke e-cigarettes (61% in 2020) use e-cigarettes occasionally. The analysis of NYTS data from 2017 to 2019 found that frequent use (20 or more days in the past 30 days) was concentrated among current or former smokers, which is consistent with the assumption that teenagers are increasingly smoking e-cigarettes rather than smoking.

Among students who have only used e-cigarettes and never used any other tobacco products, frequent use of e-cigarettes and signs of dependence on e-cigarettes are still rare, the researchers reported.

"E-cigarettes may make some young people addicted to nicotine," David JK Balfour and 14 other major tobacco researchers said in an article published last month in the American Journal of public health. "However, the evidence does not show that it makes a large number of people addicted."

There is little evidence that e-cigarette products encourage teenagers to smoke, otherwise they will never try nicotine. Since teenagers began to use e-cigarettes, the smoking rate of high school students has been declining. Some people may reduce or quit smoking through e-cigarettes. If e-cigarettes lead some young people to try smoking, the overall impact must be very small. A recent study estimated that if e-cigarettes increase the probability of non-smoking young people trying to smoke by 3.5... The probability of young people starting to smoke will increase by less than 1 percentage point. In addition, American survey data show that during the rise of e-cigarettes, the smoking rate of young people decreased at the fastest rate ever.

Krishnamoorthi masks these considerations by misleading equating e-cigarettes with tobacco use. In a letter dated September 15, he said that a federal excise tax on e-cigarettes could reduce tobacco use in the United States and prevent a generation of children from indulging in smoking and e-cigarettes.

However, e-cigarettes do not contain tobacco and do not burn anything - the key difference explains why the UK public health department estimates that switching from smoking to e-cigarettes can reduce health risks by at least 95%.

"Laboratory tests, in vitro toxicology tests and short-term human studies on the components of e-cigarettes show that the harm of e-cigarettes may be much less than that of combustible tobacco cigarettes," reported the National Academy of Sciences, the Academy of engineering and the school of medicine in 2018. The Royal College of physicians also concluded that "e-cigarettes are not completely risk-free, but their harm is far less than that of smoking." A 2017 study in the Journal of tobacco control estimated that according to how many smokers switch to e-cigarettes, the use of e-cigarette products can prevent as many as 6.6 million premature deaths in the United States alone.

Krishnamoorthi objected that there is no evidence that e-cigarettes can help smokers quit smoking. However, as Balfour et al. Said, please note that there is increasing evidence that e-cigarettes can promote smoking cessation, although the evidence is uncertain.

A meta-analysis of 26 randomized controlled trials in 2020 concluded that there is moderate deterministic evidence that e-cigarettes containing nicotine and nicotine replacement therapy have improved smoking cessation rates compared with e-cigarettes without nicotine.

Balfour et al's population research results say that this is consistent with the fact that the success rate of smoking cessation attempts has almost doubled in randomized controlled trials, and that e-cigarettes are the most commonly used auxiliary means in smokers' smoking cessation attempts.

They also pointed out that with the growth of e-cigarette product sales, the decline of cigarette sales in the United States has accelerated sharply, which strengthens the impression that more e-cigarettes mean less smoking.

Krishnamoorthi denies any such evidence, but says he believes adults can do whatever they want. But it's not true.

Krishnamoorthi supports the federal excise tax, which will double or triple the cost of nicotine liquid, so as to prevent smokers from quitting smoking and enable e-cigarette users to re-establish more deadly habits. He wants to ban the overwhelming taste of e-cigarette oil loved by former smokers, which will also reduce the attractiveness of these products as alternatives to traditional cigarettes. He hopes to force the reduction of e-cigarettes Nicotine content in tobacco oil, which will have a similar effect, and authorize the FDA to order further reduction.

Krishnamoorthi said that the FDA should have the right to reduce nicotine concentration to the lowest level of addiction or non addiction, which will make e-cigarette products unable to satisfactorily replace cigarettes, so as to effectively eliminate this life-saving option. Even the FDA, although it delays what it calls the electronic nicotine delivery system (ends) The approval of products, but also recognized their commitment to reduce smoking related diseases and deaths.

In contrast, krishnamoorthi's attitude is reflected in the name he chose for his nicotine reduction act: the end ends act.

Krishnamoorthi said that FDA regulation aims to ensure that e-cigarettes have positive public health benefits, because unregulated and duty-free markets do not need such evidence now.

Krishnamoorthi acknowledges that e-cigarettes can produce net positive benefits to public health, which is puzzling because his position is that there is no reason to believe that e-cigarettes can help smokers quit smoking. What is the relationship between taxes and whether e-cigarettes are less dangerous than tobacco cigarettes is a mystery. In any case, although their harm has been determined, tobacco cigarettes still exist On the market.

Krishnamoorthi, who wants to end ends, seems to have concluded that eliminating competitive nicotine products that can significantly reduce the risks faced by smokers is better for public health. He reached this incredible conclusion by pretending that millions of Americans who choose e-cigarettes as an alternative to reducing the risk of smoking do not exist.

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