A more balanced public health approach is needed

Rutgers researchers call for a balanced approach to examining recent trends in e-cigarette use among adults.

Julia Chen-Sankey, assistant professor in the Department of Behavior, Society, and Health Policy at Rutgers School of Public Health, and Michelle T. Bover-Manderski, professor in the Department of Biostatistics and Epidemiology at Rutgers, said while there are obvious health issues associated with e-cigarette use, particularly adoption by those who have never used tobacco products before, there are also potential benefits that do not can be ignored.

Rutgers researchers posted a guest comment in the Opening of the Journal of the American Medical Association (JAMA) network, examining new data on the trend of e-cigarette use among American adults. Chen-Sankey and Bover-Manderski, who are also researchers at the Rutgers Center for Tobacco Studies, discussed the need for a public health approach that balances the risks with the potential of e-cigarettes to facilitate smoking cessation by people. adults.

You saw a study which has raised important questions about e-cigarette use among American adults. What is does this study find, and what questions has it raised about public health policy?

Chen Sankey: The article focused on recent trends in e-cigarette use among adults in the United States in 2017, 2018, and 2020. Among the findings was the observation that while current e-cigarette use – defined as vaping in the previous 30 days – by young adults 18 to 20 years old decreased between 2018 and 2020, it increased in the other age groups. Daily use of e-cigarettes among current users has also increased.

But perhaps most alarmingly, e-cigarette use has increased significantly for people who have never smoked combustible cigarettes. It has also declined among combustible cigarette smokers trying to quit, despite the potential of e-cigarettes to help people quit smoking.

Bover Mandersky: In terms of how these conflicting findings should be applied to health policy, there is a need to balance concerns about the dangers of e-cigarette use among young people new to tobacco products and the potential benefits e-cigarettes may have for people who want to quit smoking combustible cigarettes.

How do we find this balance?

Chen Sankey: There are several policy advances and strategies that can be helpful in ensuring that the net public health benefits of e-cigarette use are not overshadowed by its harmful effects. For example, the recent approval of e-cigarette products by the United States Food and Drug Administration (FDA) through its Premarket Tobacco Product Application process may help establish public confidence in products. electronic cigarettes allowed.

The FDA is also likely to authorize certain e-cigarettes as modified risk tobacco products, which may help encourage smokers to consider e-cigarettes as a tool to quit smoking combustible cigarettes.

Bover Mandersky: Additionally, to stimulate combustible cigarette smokers’ acceptance of the use of e-cigarettes for smoking cessation, public health education and mass media communication strategies should focus on evidence-based on evidence regarding the reduction of harm associated with switching to e-cigarettes.

Why do you think some adults who smoke combustible cigarettes have turned away from vaping as a way to quit smoking?

Chen Sankey: Over the past five years or so, e-cigarette products have become less appealing to combustible smokers interested in quitting, but more appealing to people who have never smoked. A few factors may help explain this discouraging trend.

On the one hand, local and national policies aimed at reducing e-cigarette use among youth can simultaneously reduce adult smokers’ interest in and use of e-cigarettes when attempting to quit smoking. Additionally, the media may have altered smokers’ understanding of vaping due to the significantly higher volume of media coverage of the risks of youth vaping compared to the potential benefits of vaping for adult smokers of combustible cigarettes.

Bover Mandersky: It is also likely that public health groups and medical professionals have focused on the risks of vaping for young people rather than the potential benefits for adults who use combustible tobacco.

One bright spot in the research is a substantial drop in e-cigarette use by young adults aged 18-20. What explains this drop?

Chen Sankey: The gap may be associated with the 21 Tobacco Act which limited the sale of tobacco and nicotine delivery products, including e-cigarettes, to this age group nationwide from January 2020. Another potential explanation for the disproportionate reduction is national restrictions on certain flavored products. cartridge e-cigarettes introduced in February 2020, a policy that may have significantly reduced the appeal of e-cigarettes among young people.

Bover Mandersky: And of course, we cannot ignore the COVID-19 pandemic-related lockdowns and social distancing requirements, which may have limited this group’s opportunities to use e-cigarettes in social or group settings.

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