Pubdate: Sat, 26 Oct 2019
Source: Wall Street Journal (US)
Copyright: 2019 Dow Jones & Company, Inc.
Author: Matt Ridley


The Volstead Act prohibiting intoxicating beverages became law on
October 28, 1919-a century ago this week-and came into force a few
months later. Most people now agree that Prohibition was a failure,
driving the alcohol industry underground, where its products became
unsafe, its profits lucrative and tax-free, and its methods violent.
Most countries have since taken the view that it is better to
legalize, regulate and tax drink than to ban it.

Today, there is a similar debate over vaping, a popular new practice
prohibited or heavily restricted in many countries. Electronic
cigarettes, which use heating elements to vaporize liquids usually
containing nicotine, were invented in China in the early 2000s by Hon Lik, 
a chemist looking for a way to satisfy his nicotine addiction without 
dying of lung cancer as his father had. Nicotine itself is far less 
harmful to smokers than the other chemicals created during combustion. 
Heavyweight studies confirm that there are much lower levels of dangerous 
chemicals in e-cigarette vapor than in smoke and fewer biomarkers of harm 
in the bodies of vapers than smokers.

Some countries argue that vaping is an effective means of reducing
smoking, while others want to see it stamped out altogether, fearing
that it could give a new lease on life to the tobacco industry. As
with drugs and prostitution, this debate pits prohibition against
"harm reduction": the idea that it is better to regulate harmful
habits to make them safer than to ban them in the hope of enforcing
abstinence, which results in criminals making them more dangerous.

In both the U.K. and the U.S. the rapid growth in vaping has coincided 
with rapid reductions in smoking rates, especially among young people. Yet 
there is a stark contrast between the two countries in how vaping has been 
treated by public health authorities and, as a result, in its safety for 

In Britain, vaping is all about nicotine, not drugs. It is socially
acceptable and is confined almost entirely to people who have smoked, even 
among the young. Less than 1% of vapers are people who have never smoked, 
and there is little sign of young people taking it up faster than they 
would have taken up smoking.

There are now 3.6 million vapers in the U.K. and 5.9 million smokers
(some people are in both categories). Many British smokers have
switched entirely to vaping, encouraged by the government, whose
official position is that vaping is 95% safer than smoking, an
assertion now backed by early studies of disease incidence. The
organizations that have signed a statement saying that vaping is
significantly less harmful than smoking include Public Health England, the 
Association of Directors of Public Health, the Royal College of Physicians 
and the Royal Society for Public Health.

There have been no deaths and few if any cases of lung illness
directly attributed to vaping in the U.K. A recent study has concluded 
that vaping is now helping up to 70,000 people stop smoking every year by 
reaching those who failed to quit smoking by other means. "The British 
public have voted with their feet and are choosing to use e-cigarettes. 
This is a positive choice, and we should promote it," says Prof. Linda 
Bauld of Cancer Research U.K.

In the U.S., by contrast, vaping has killed at least 33 people,
injured about 1,500 and earned the wrath of both the Centers for
Disease Control and Prevention (CDC) and President Trump. "Big Vape is 
intentionally addicting our kids to nicotine, merging with Big Tobacco 
while disguised as antismoking crusaders, peddling known and unknown 
chemical harms to the adolescent brain ... providing a dangerous new 
delivery platform for potheads and spreading a deadly lung disease," 
writes Katy French Talento, until recently President Trump's health policy 

Why the different experience? The CDC says that most cases of illness are 
linked to vaping products laced with THC oil, an ingredient of cannabis, 
"particularly those obtained off the street or from other informal sources 
(e.g., friends, family members, illicit dealers)." In addition, many 
American nicotine e-cigs are much stronger than those allowed in Britain, 
where there is a 2% limit on nicotine concentrations under the EU's 
Tobacco Products Directive. A typical Juul is nearly three times as strong.

In Britain, a manufacturer or importer of e-cigarettes must submit a
notification to the authorities six months in advance of a product
launch and is subject to strict product-safety regulations, including 
toxicological testing of the ingredients and emissions, as well as rules 
ensuring tamper-proof and leakproof packaging. Stimulants, colorings and 
vitamin additives are tightly regulated.

Few such regulations exist in the U.S. For many observers, this
explains the higher injury rate: "What's happening in the U.S. is not 
happening here [in Britain], nor is it happening in any other
countries where vaping is common," says John Britton, director of the U.K. 
Centre for Tobacco & Alcohol Studies at Nottingham University.

The U.S. Food and Drug Administration has recently proposed rules for 
regulating e-cigarettes that would echo the British approach by
"reviewing a tobacco product's components, ingredients, additives,
constituents, toxicological profile and health impact, as well as how the 
product is manufactured, packaged and labeled."

Some fear that this is too late and that politicians will react to the 
moral panic over vaping by preferring prohibition instead. Michelle Minton 
of the Competitive Enterprise Institute says: "A ban on flavors, devices 
or nicotine levels will have the same effect as every other prohibition. 
People will turn to illicit dealers or try to do it themselves. And, as we 
saw with the outbreak of tainted THC, this will result in overdoses, 
injury and death."

Of course, neither country has gotten everything right. In Britain,
the vaping industry argues that some restrictions prevent lifesaving
interventions. Philip Morris International -which has developed
heat-not-burn products to compete with the rise of vaping and now
promises a "smoke-free future"-would like to insert slips into
cigarette packs urging smokers to switch, but the ban on advertising
e-cigarettes prevents this. And in both countries independent vaping
firms argue that strict regulations act as barriers to entry that
favor big firms. Mike Hogan, of the U.S. Smoke-Free Alternatives Trade 
Association, told Politico, "We may be putting the entire 'harm reduction 
henhouse' in the hands of the fox industry"-by which he means Big Tobacco.

The argument for harm reduction is not one that comes easily to some
public-health advocates, because it means promoting behaviors that may 
still be harmful, just less so than the alternative. Vaping doesn't have 
to prove entirely safe for it to save lives, given that it mostly replaces 

In the 1980s the British government took the unpopular decision to
encourage the distribution of free needles to heroin addicts so that
they would not contract H.I.V. by reusing dirty needles. This condoned a 
dangerous and illegal activity, but it worked: The incidence of H.I.V. 
among people who inject drugs is much lower in the U.K. than in other 
countries that initially rejected this approach, including much of the U.S.

By contrast, the U.S. is gradually accepting the harm reduction
argument for cannabis, while Britain remains wedded officially to
prohibition and has high death rates from drug use. The argument for
legal cannabis holds that prohibition makes cannabis on the market
stronger and more dangerous, rewards illegal gangs with bumper profits and 
spawns violence. As with alcohol, decriminalization allows quality control 
and crime reduction as well as tax revenue.

A century after the American experiment with Prohibition, neither the U.S. 
nor the U.K. has fully absorbed the lesson of its failure: that public 
health and safety are best served when governments treat our harmful 
habits as problems to regulate, not evils to ban.

- -Mr. Ridley is a member of the House of Lords and the author of many 
books, including most recently "The Evolution of Everything: How New Ideas 
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MAP posted-by: Matt