THE VAPE TRAP
New research affirms that as for opioids, medical model "treatments" and harm reduction for a non-medical problem become epidemic, trapping new nicotine users in dependence and worse
by Clark Miller
Published August 30, 2024
A turning point in America’s vaping epidemic came in late 2017 when after decades of steady, significant decline in youth and adult use of traditional combustible tobacco cigarettes, “smoking”, an FDA plan for harm reduction and cessation was lauded as “innovative” in America’s top medical journal – support and encouragement of use by smokers of electronic cigarettes to replace smoking of cigarettes. That endorsement would have been taken as authoritative and as another “gold standard” treatment by impressionable American medical professionals, as were assurances from pill salesmen and medical experts a few decades earlier – despite disconfirming research and evidence available for decades prior – that opioid medications could be used safety and effectively to treat pain long term. From pill salesmen.
As would have been predicted by many who have some understanding of what actually drives problem compulsive substance use including in youth, those benighted models and their outcomes have come full circle, with increasing and strong evidence that after decades of decline in addictive, problem use of nicotine, millions of new young Americans – a new generation – are now dependent on use of nicotine by new means of administration and with increasing risk of return to use of combustible cigarettes.
That likelihood of return to traditional smoking increases with misguided, reactive responses to the epidemic including bans, fear-based campaigns, prohibitions, disciplinary actions, and other punitive, controlling or coercive measures by authority that contributed in the first place to young people reclaiming dignity and autonomy by demonstrably engaging in the very adult, very assertive behaviors of use of dangerous substances. That is to say, young people driven by healthy underlying drives to reclaim autonomy and sense of control, to be accepted and validated by a group of others rather than controlled by them in response to a world of punitive, distant, controlling parents and others whose modeling behaviors are distinctly at odds with their rules and demands. Reclaim unfortunately by self-defeating methods and choices.
Now, 7 years on and with a new generation of young people dependent on nicotine by initiating vaping of it – in much higher concentrations than in the combustible cigarettes that vapes were predicted to replace – there are expressed reactive threats to “crack down” on youth who are vaping, daily warnings about catastrophic health effects and of severe consequences for youth detected and apprehended for vaping at school.
So, that JAMA-endorsed innovative plan seems to have not worked out.
And, if only “not worked out” could represent simply the failure of vaping to replace use of traditional cigarettes, acting as promised by America’s expert class as a cessation aid, we would not be facing an escalating epidemic of nicotine dependence-driven illness and gateway substance use as research increasingly establishes – just as in the predictable failure of runaway medical dispensing of addictive opioids for the nonmedical condition of chronic pain.
Uncontrolled lethal epidemics are much larger problems than another failure of a medical intervention for a nonmedical problem. Prevalence of smoking of traditional tobacco cigarettes, it may be remembered, had been dropping steadily, year by year over decades . . . until the “innovative” medical harm reduction intervention of vaping was endorsed, protected from regulation, and exploded. Smoking rates have not decreased since then.
