New data on vaping

In my video about vaping (link to video, link to blog post), I explained why the e-cigarette industry’s claim that vaping saves lives is a half-truth. Their argument assumes people who vape would have died from smoking traditional cigarettes if they hadn't chosen to vape instead.

That’s true only when all of the following conditions apply:

1. The person would have smoked cigarettes if e-cigarettes were not available
2. The person switched completely to e-cigarettes
3. The person would have died from smoking-related illnesses had s/he smoked cigarettes
4. The person would not have died from vaping-related or other illnesses had s/he vaped
5. The person would not have undertaken any other measure, available now or in the future, to mitigate the risk of death

(1) fails for every vaper who would never have smoked cigarettes.

We expect this category to be sizeable – precisely because powerful marketing asserts that vaping is safe. The potential harm of a new product is hard to quantify at the start but we now know that people have died from it.

What’s easier to establish is how big this problem is. A recent Wall Street Journal article gives us the data: according to a federal survey, 20% of all middle- and high-school students in the U.S. “recently used e-cigarettes”, compared to 4% who used cigarettes. If the prevalence of cigarettes is stable, then four out of five vapers in school would never have shouldered the risk of smoking-related death but are newly exposed to possible harm through e-cigarettes.

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In thinking about point (3), keep in mind that not all smokers die from smoking-related illnesses. You should only count the preventable deaths, that is to say, the person would have lived longer had s/he not smoked. What proportion of smokers actually die from smoking-related illnesses?

This question is harder to answer than one thinks. The basic analysis would be identifying who's the smoker, and whether the person died from a disease associated with smoking such as lung cancer. However, there are few diseases with a single cause so even if a smoker died from lung cancer, it's not assured that smoking is the cause of death. The counterfactual question we're interested in is whether this same person would have died from that disease had s/he not smoked. To complicate this further, research showed that if someone quit smoking early enough, the risk factor goes down by 90 percent. CDC has this page that shows some relevant numbers.

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My video takes a deeper look into the different groups of people that may be impacted by vaping.