Public Opinion on E-Cigarettes and Tobacco Use During the Pandemic

According to a report by foreign media on March 24th, 2022, a new survey conducted by Morning Consult reveals that one quarter of adults have been regularly using e-cigarettes during the pandemic, and many are also smoking traditional cigarettes. The rates of tobacco use and e-cigarette use have been high.

For years, policy makers have been playing a game of cat and mouse with e-cigarette manufacturers. In 2020, as public outcry over youth vaping reached a boiling point – and with the outbreak of a mysterious lung disease associated with THC vaping – the US Food and Drug Administration has increased enforcement efforts against e-cigarette manufacturers.

Meanwhile, this month, Congress closed a loophole in these regulations that allowed certain manufacturers to evade FDA oversight by using synthetic nicotine instead of nicotine derived from tobacco.

Sales of electronic cigarettes have exploded over the past four years, despite a recent decline in usage rates in the United States, including among teenagers. For instance, the estimated proportion of high school students who use e-cigarettes dropped from 27.5% in 2019 to 11.3% in 2021, although these figures may not be directly comparable due to the disruption caused by COVID-19 in many schools at the time. Meanwhile, in 2020, 3.7% of adults reported using e-cigarettes, a slight drop from the previous year.

The public has stated that although electronic cigarettes may be a tool for quitting smoking, they are just as harmful as traditional cigarettes.

A new discovery has shed light on this apparent paradox and also revealed public attitudes towards using e-cigarettes as a substitute for traditional cigarettes. Among adults who regularly used e-cigarettes before the pandemic and started using them during it, 37% reported using them more now than before the COVID-19 crisis, while another 48% said their usage remained the same.

The chairman of the anti-smoking advocacy group, Tobacco-Free Kids, Matthew Myers, said the survey underscored the "importance of the FDA's jurisdiction over product regulation, marketing practices, and information disclosed to consumers.

Furthermore, despite claims from the e-cigarette industry that their products are a smoking cessation tool - in fact, Juul Labs Inc. is attempting to clean up its image after facing a string of lawsuits, claiming it targeted children through the use of fruit flavors and trendy marketing - investigations show that the public is not buying it.

A survey of adults has revealed that around 70% of respondents hold negative views towards both traditional cigarettes and electronic cigarettes. Additionally, a majority of the public believe that both types of smoking products are harmful to people's health, with 52% citing this as the case. Of the remaining respondents, 16% felt that electronic cigarettes were worse than traditional cigarettes, while 14% believed the opposite to be true.

It is perhaps unsurprising that people who frequently use e-cigarettes (at least once a week) are more likely to say that e-cigarettes are not as harmful to one's health as traditional cigarettes.

According to Eric Lindblom, a former official of the FDA Tobacco Products Center and a senior scholar at Georgetown University Law Center, e-cigarettes have some potential as a smoking alternative, but they are not a panacea. O'Neill National and Global Health Law Institute.

For many people, electronic cigarettes are just as popular as traditional cigarettes.

One-third of regular e-cigarette users say they smoke traditional cigarettes more than five times a day, and 40% of them frequently use e-cigarettes. Meanwhile, only 10% of regular smokers say they use e-cigarettes at least five times a day.

Compared to regular e-cigarette users, regular smokers have a stronger preference for e-cigarettes (41%) than a preference for e-cigarettes (66%).

For smokers trying to quit, e-cigarettes are a complete substitute. However, some individuals both smoke traditional cigarettes and use e-cigarettes. Studies suggest that these individuals may ultimately struggle to break free from the nicotine contained in electronic cigarettes.

Miles expressed concern that the government has not established suitable regulations and therefore risks inadequate communication.

A larger portion of the public holds a negative view on the relationship between teenagers and e-cigarettes. Almost three-fourths of adults are concerned about the claims that e-cigarette manufacturers are targeting their products towards young people, with 72% of people stating that these companies should be responsible for young people using e-cigarettes. The proportion of people who believe that blame should be placed on the parents of schoolchildren is similar, at 74%.

However, a majority of adults blame the FDA, with 66% indicating the agency is at fault.

Blaming parents is a tragedy. The manufacturers in this industry and the retailers who sell to children should bear the greatest responsibility for this issue," said Lindbloom. At the same time, the FDA "is not to blame for the problem; they simply did not stop it quickly and firmly," he said. This problem was caused by bureaucratic and political obstacles during the Obama and Trump administrations.

The e-cigarette industry and public health advocates may engage in more disputes.

Electronic cigarette manufacturer Juul will soon learn whether a jury will agree with allegations that it intentionally marketed its products to children. After settling lawsuits worth millions of dollars in Arizona and North Carolina, Juul will face trial this summer. When similar accusations first emerged, the company launched a large-scale public relations campaign and, by the end of 2018, had removed most flavors from shelves -- except for menthol, which the FDA is now considering banning.

However, not all e-cigarette manufacturers are eager to comply with regulations, experts warn that they may find other ways to circumvent oversight. For example, in July 2020, the FDA ordered Puff Bar to cease sales of its flavored e-cigarette products - but the company resumed sales in February 2021, this time using synthetic nicotine, and quickly became the top-selling e-cigarette brand among young people.

This phenomenon has prompted Congress to recently decide to include synthetic nicotine under FDA jurisdiction. Investigations indicate that the public is accepting stricter regulations, with two-thirds of adults stating that the FDA should further limit the production of flavored e-cigarette products. Support for state-level legal actions is also gaining traction among the majority.

For more than a decade, e-cigarette manufacturers have worked tirelessly to delay and evade regulation," said Meyers. "When the FDA sees e-cigarette manufacturers finding new ways to attract children, they must remain vigilant and take swift action. This is crucial.

Juul, Puff Bar, and the FDA have not responded to requests for comment.

(Source: Morning Consult)