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New Duke study shows FDA vaping crackdown can increase teen smoking by 47%

Efforts by the U.S. Food and Drug Administration (FDA) to limit the availability of vapor products could drive almost half of existing youth vapers back into the welcoming arms of Big Tobacco, according to new research by Duke Health.  By conducting an online survey of some 240 participants ages 18-29, the researchers posed a hypothetical situation.  How many of the respondents would modify their e-cig or smoking behaviors should the FDA take dramatic regulatory actions against vaping?  The proposed scenarios included the following.

      • The limiting of e-liquid flavors to only tobacco and menthol
      • The reduction of nicotine concentration levels
      • The restriction of the variety of vaping devices available on the market  

About one-third of the survey participants self-identified as dual users of both combusted cigarettes (CC) and electronic cigarettes (EC).  According to the study’s findings, 47 percent of all youth respondents said that they would likely increase their use of conventional tobacco products should the FDA eliminate or severely reduce the nicotine concentrations of e-liquids used in vaping.

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Another 22 percent further stated that they would likely smoke more often should the FDA drastically limit the numbers of customizable vaping devices or restrict the types of available features, like temperature control and nicotine dosage management mechanisms. 

About 17 percent claimed that they would probably revert to smoking completely should the FDA limit the numbers of e-liquid flavors available on the market to only tobacco and menthol variations.  The Duke Health study entitled Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions (Substance Abuse & Misuse) makes the following conclusions.   

“Findings from our study suggest that eliminating the availability of flavored e-liquid, nicotine content, and customizable EC devices may lead to intentions to reduce EC use and simultaneous intentions to increase CC [combusted cigarettes] use among young adult dual EC/CC users. Given that 38% of tobacco users are dual or multiple tobacco product users – and that 23% of this group specifically use CC and EC – these findings serve as a useful baseline indicator of what a significant proportion of tobacco product users believe they would do in response to regulations.”

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While the Duke Health study involves a rather small control group of youth vapers, lead author Dr. Lauren Pacek believes that the related findings should serve as a wake-up call for legislators and FDA officials.  Even local and state politicians should be careful of passing anti-vaping ordinances that may result in an alarming increase in teen smoking rates almost overnight.  For example, the city of San Francisco recently passed a local legislation banning the sales of all vapor products, either through conventional brick and mortars or online.

While Dr. Pacek warns that regulatory actions like these may produce the exact opposite desired effects,  she does, however, endorse the need for specific regulatory proposals surrounding the need for child-proof packaging, increased safety standards, and restrictions on kid-appealing advertising.  In an interview with Medical Express, Pacek stated, "We wanted to take a first pass at seeing what users' anticipated responses to new regulations might be.  Our findings suggest that while some regulations, such as banning certain flavors to limit appeal to adolescents, might improve outcomes for those young users, the new regulations might have unintended consequences with other portions of the population."

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