Vaping advocacy has put in concerted effort to make the narrative about the physical harms of tobacco smoke, and how vaping reduces those harms. But it's not the only issue in play. Public health and governments are worried about the bigger picture of substance addiction as well, and view addiction as an unhealthy state.
In 1950, roughly half of Western world adults were nicotine-dependent. They couldn't get through the day without regular intake of nicotine. Through exhaustive campaigning, Western governments managed to reduce that to around 20% by the turn of the millennium. Partly through the emergence of vaping, that has reduced even further to record lows in tobacco smoking now. However, most vapers haven't quit nicotine. So the number of nicotine-dependent people is remaining stable, even while numbers of smokers are reducing.
Government understands that both big tobacco and vaping aren't in business to save lives, they're in business to make money. So they have financial incentive to induce people (especially young people) to become nicotine addicts. More customers = more profits. So there is a tendency among governments to view harm reduction not just as a way to reduce diseases related to smoking, but also as a mechanism for big tobacco to rebuild its customer base and revert to the 1950s situation of half the populace being tobacco customers. There have been numerous references to this in the media, by regulators and in legislation. The NY Times noted:
Even if Philip Morris’s health claims turn out to be true, health officials warn, IQOS could be a Trojan horse. Smoking in America has dropped to an all-time low. Some health advocates worry Philip Morris — which spent $3 billion to develop IQOS — wants to use its new machine to halt that progress. If IQOS attracts new smokers, it could hook a new generation on nicotine.
Scott Gottlieb has also referred to this recently:
If by opening a path for e-cigs to be an alternative for adult smokers, all we end up doing is hooking a new generation of kids on nicotine, we’ll have failed in our purpose. We’ll have swapped one public health tragedy for a new one.
The new Canadian legislation also references this in the preamble to the Act:
For vaping products, the purpose of the TVPA is to:
- protect young persons and non-tobacco users from inducements to use vaping products;
- protect the health of young persons and non-users of tobacco products from exposure to and dependence on nicotine that could result from the use of vaping products;
Most Western governments seem quite happy to allow and even encourage vaping among smokers. However, they are asking big tobacco and vaping to impose a glass ceiling on their customer base by limiting it only to current smokers. No industry can build sustainable growth on a customer base that dwindles year on year. In essence, Gottlieb and Co are asking big tobacco and vaping to render themselves obsolete over time.
It's an issue that vaping advocacy can no longer skirt. The question is no longer "Is vaping safer than smoking?" but rather "How do we limit harm reduction to current smokers and make it a gateway out of combustion rather than a gateway into lifelong substance addiction?"
This applies even to things like the NHS giving out vaping gear to smokers. The vaping community views this as tacit support for vaping. And, at first glance, it is. But where is that ex-smoker-turned-vaper three years down the line? The assumption from the vaping industry is that he will still be vaping and thus still a customer. I think the NHS will have wanted him to transition off nicotine dependence entirely.
Whenever regulators engage with industry, they know that they are going to hear a sales pitch rather than a solution to the problem. This is why the NRA advocates arming teachers and guards as a solution to school shootings. More guns being sold = better. Big tobacco and vaping wanted to dazzle health officials with harm reduction science, in the hope that they wouldn't notice as nicotine dependency rose inexorably to 1950s levels again. That isn't going to work. Governments and regulators saw it coming a mile off. How is vaping advocacy going to address this? It's not that "But it's safer than smoking!" is the wrong answer. It's just that it doesn't answer the question that is being asked.