The Great Vape Debate
Why I’m writing about e-cigarettes
Marc Gunther
7 hours ago·5 min read
Welcome to The Great Vape Debate. This publication on Medium will be a home for my writing about tobacco control issues, particularly those affecting electronic cigarettes. I’ve never smoked cigarettes or vaped with a Juul or a Puff Bar. During my years as a reporter covering business, I never wrote about the tobacco industry. So I’m mildly surprised to be engaged by the questions surrounding smoking and e-cigarettes. But engaged I am.
I came upon the debate about vaping while reporting on philanthropy, which I’ve been doing since 2015, regularly for The Chronicle of Philanthropy and occasionally for others, including The New York Times, Washington Post and Vox.
My thinking about philanthropy has been influenced by, among others, Stanford professor Rob Reich, who in his book, Just Giving, writes that the philanthropy of the rich is an exercise of power. Billionaire philanthropy, he argues, deserves to be met with scrutiny and not (as used to be the case and often still is) merely with gratitude.
With that in mind, after getting a tip at the end of last year, I began a deep dive into a campaign against electronic cigarettes funded by a $160-million, three-year grant from Bloomberg Philanthropies. I was surprised and troubled by what I learned.
Much of the Bloomberg money went to the Campaign for Tobacco-Free Kids, the US’s most powerful anti-tobacco nonprofit. Grants to oppose e-cigarettes also flowed to the American Cancer Society, American Heart Association and the American Lung Association. Meanwhile, Michael Bloomberg, who is the patron of Bloomberg Philanthropies, the founder of the Bloomberg media empire and the former New York City mayor, spent millions of dollars of his own money to support political anti-vaping efforts, notably two ballot measures in San Francisco that ultimately led to a ban on e-cigarettes in the city. As a result, San Francisco is now a city where you can buy combustible cigarettes — which are far more dangerous than e-cigs — and marijuana, but you cannot buy e-cigarettes.
That makes no sense if what you care about is public health. Banning what appears to be a safer alternative to a lethal product is nutty.
My research and reporting, which included 30 interviews, led to a 4,500-word story published in April by The Chronicle of Philanthropy. The tobacco control movement is “neck-deep in intractable, internecine warfare” over vaping, Cliff Douglas, formerly of the American Cancer Society, told me. This came as news to me. Like most Americans, I suspect, I had the impression that vaping was very dangerous. I’d heard about an epidemic of vaping by young people. I was vaguely aware of EVALI, a potentially fatal lung condition that authorities said was caused by vaping. That turned out not to be true. I had absorbed the bad news about vaping because the Bloomberg-funded nonprofits, aided by a credulous media, has dominated the public conversation. I had no idea that e-cigarettes could, at least in theory, contribute to public health — if vaping was taken up primarily by smokers who want to choose e-cigarettes instead of Marlboros, Newports and Camels.
Perhaps the biggest surprise came when I learned that respected elders in the world of tobacco control — people like Steven Schroeder, the former president of the Robert Wood Johnson Foundation and Ken Warner, a distinguished professor emeritus at the University of Michigan, as well as the deans of the schools of public health at NYU, Emory and Ohio State — all worried that the campaigns against vaping by Tobacco-Free Kids and Bloomberg were doing more harm than good. They raised their objections in an excellent essay in Science headlined Evidence, alarm and the debate over e-cigarettes.
As I’ve learned more about the history of tobacco control and the rise of vaping, I’ve become convinced that these issues need more attention. They are important because it seems likely that vaping could help save lives and alleviate suffering. (Tobacco use is estimated to cause the deaths of 480,000 Americans a year.) They are also interesting, at least to me, because the e-cigarette debate may be able to help us think more carefully about bigger issues, particularly in the nonprofit world. For example:
Public interest groups and their impact: Nonprofit organizations are well intentioned, for the most part, but good intentions don’t always translate into good outcomes. It’s easy to assume that groups fighting for the environment or human rights deserve our support, but some are clearly better at it than others. Still others pursue misguided strategies. Because the tobacco industry has been so morally corrupt for so long, it’s natural to trust that the anti-smoking forces are on the side of the angels. But nonprofits get things wrong sometimes, and they need to be held to account.
The trustworthiness of peer-reviewed science: How dangerous are e-cigarettes? Are they a gateway to smoking? Can they help adult smokers quit? What are their longterm effects? There’s no consensus among scientists. To the contrary, published studies reach conflicting conclusions. If we’ve learned anything from our experience with Covid-19, it is that science is imperfect and evolving. We’ve also learned that the CDC and FDA are not infallible, to put it mildly. Elected officials, regulators and reporters need to keep an open mind about the science of vaping and to try to read the studies, not just the abstracts.
The importance of tradeoffs: No young person should use e-cigarettes, but they clearly help some adult smokers to quit. (In the UK, where the government encourages smokers to switch to vaping, e-cigarettes are sold in some hospital gift shops.) So many policy questions involve tradeoffs — setting a minimum wage, closing schools during Covid, wiping out student debt — which are too often poorly understood. When it comes to vaping, much of the outcry against e-cigs has been driven by well-educated, well-to-do parents who understandably want to protect their kids. Smokers who might benefit from switching to e-cigarettes tend to be poor, less educated and under stress; they lack political clout. E-cigarette policy should take the needs of all into account.
The terrible irony of the vaping story is that evidence is emerging — it’s preliminary evidence, to be sure — that the moral panic over vaping might be leading more people to chose combustible tobacco over e-cigarettes. High taxes on e-cigarettes on Minnesota appear to have “increased adult smoking and reduced smoking cessation,” according to a working paper published by the National Bureau of Economic Research. Michael Pesko, an economist at Georgia State University, and his colleagues have written that tax data indicates that traditional cigarettes and e-cigarettes are “economic substitutes.” That suggests that if governments tax e-cigarettes to make them more expensive or regulate them so they become harder to find or less appealing by, for instance, banning flavors, the unintended consequence could be to encourage more people to smoke. Surely no one, except for the tobacco companies, will be pleased about that.
