Faculty Editor: Professor Jeffrey DaCosta

E-cigarettes were introduced commercially by a variety of different companies throughout the early 2000s as a safer alternative to traditional cigarette smoking, as well as a smoking-cessation tool. Vaping not only has been shown to help smokers quit, but was considered to be up to 95% safer than traditional smoking according to research conducted by Public Health England.1 The invention of e-cigarettes thus seemed like the answer to physician’s prayers, since smoking is the leading cause of preventable deaths in the U.S., and nearly 500,000 American deaths annually are attributed to smoking.3 However, a recent outbreak of acute lung injury caused by vaping, which has resulted in 60 deaths and almost 3,000 hospitalizations to date,2 has left the country utterly confused, and questioning how safe vaping truly is. The CDC is currently investigating the causes behind these cases of lung illness, and while a majority of them seem to be connected to the use of illicit THC cartridges that have been cut with vitamin E acetate, 10% of cases have been a result of nicotine use exclusively.3 Because current research does not yet point to a specific product or chemical, and since e-cigarette production is largely unregulated, many questions remain concerning the origins of this outbreak and its possible repercussions if not addressed.

Regardless of which products and ingredients are contributing to this outbreak, confusion has risen regarding national healthcare policy, and what measures should be taken to keep consumers safe. This issue is as much a public health issue as it is an economic issue, as smoking costs the U.S. economy $300 billion annually in medical costs and lowered productivity due to premature death.3 Several states throughout the U.S. have already imposed partial or severe restrictions on the sale of vaping products, while still allowing the sale of traditional cigarettes and tobacco products. Massachusetts passed one of the most restrictive bans to date, halting the sale of vaping products altogether for 4 months. While bans like these are aimed towards harm reduction, the lack of scientific consensus on the true harm of vaping makes it difficult to determine if these bans will do more harm than good. Eliminating access to potentially safer alternatives to smoking leaves smokers with fewer, and possibly more dangerous, options to choose from. In the absence of e-cigarettes, the percentage of cigarette smokers may begin to rise once again, which would have a detrimental effect on both public health and the U.S. economy.

Since vaping is still relatively new and not well regulated, the data produced from research hasn’t been sufficient to determine what exactly has caused the vaping outbreak, and whether or not vaping acts as a safer alternative to smoking. As more time passes and more research is done, there is hope that these questions will be answered. Until then, policymakers should tread lightly when regulating any sort of nicotine product, as to minimize the amount of harm done to the general public, as well as the U.S. economy. The CDC still encourages people to abstain from vaping and smoking altogether,2 and while for many this is much easier said than done, it is imperative that an individual who engages in smoking or vaping should acknowledge the potential risks before doing so, and make an informed decision based upon the results of current research and the regulations put in place by healthcare policymakers.


  1. E-cigarettes around 95% less harmful than tobacco estimates landmark review. (2015, August 19). Retrieved October 17, 2019, from https://www.gov.uk/government/news/e-cigarettes-around-95-less-harmful-than-tobacco-estimates-landmark-review 
  2. Outbreak of Lung Injury Associated with E-Cigarette Use, or Vaping. (2019, October 17). Retrieved October 17, 2019, from https://www.cdc.gov/tobacco/basic_information/e-cigarettes/severe-lung-disease.html.
  3. Smoking & Tobacco Use | CDC. (n.d.). Retrieved October 17, 2019, from https://www.cdc.gov/tobacco/index.htm.

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