Thursday, January 05, 2017

Physician Says that Youth Vaping Leads to Crack Cocaine Addiction

In an article published on New Year's Eve in the Philadelphia Inquirer, a physician from the Philadelphia College of Osteopathic Medicine tackles what should have been a very simple question: "Are e-cigarettes any safer for my child than tobacco?"

The actual answer, based on the scientific evidence, is unequivocally "Yes." However, that's not her answer.

The Rest of the Story

Instead of simply acknowledging that e-cigarettes are indeed safer than smoking tobacco, the physician gives a five-paragraph answer in which she never actually answers the question. If anything, her dire warnings about the unknown risks of e-cigarettes seems to suggest that her answer is "No."

Certainly, a reader who is unfamiliar with the scientific literature might well come away from this article believing that vaping is just as harmful for their child than smoking.

Sadly, this is not only inaccurate, but it is a tremendous disservice to parents because if they give the same information to their children, it could have devastating public health consequences. If youth are widely led to believe that smoking is no more hazardous than vaping, then the public's appreciation of the severe hazards of smoking will be undermined. This will in turn undermine what has been a remarkably dramatic decline in youth smoking driven by the de-normalization of smoking in our society.

Equally disturbing is how ridiculous this physician's answer is. She argues that: "e-cigarettes are a potential “gateway drug” to other substances, including traditional cigarettes, marijuana, alcohol, and crack cocaine." I defy this physician to identify a single case in which experimentation with electronic cigarettes has led a kid to try crack cocaine. I've read the literature on this topic, and there is absolutely no evidence that vaping is a gateway to crack cocaine use.

Moreover, this claim is ridiculous on its face. Despite the skyrocketing prevalence of e-cigarette experimentation among youth in the past five years, the prevalence of all cocaine use among youth has remained extremely low, at about 0.2%. Moreover, in some sections of the country, like the Northeast, the prevalence of cocaine use among youth is virtually zero, despite extremely high levels of e-cigarette use.

It seems irresponsible of a physician to put out this blatantly false, hysterical information. She essentially blames youth use of cigarettes, marijuana, alcohol, and crack cocaine on e-cigarettes. I've boasted a good deal about the significant contributions that e-cigarettes have made, but stimulating addiction to crack cocaine is not one of them. It would be quite unfortunate if we were to look to the solution to the problem of youth smoking, marijuana, alcohol, and cocaine use by focusing on the scourge of youth blowing a few vape rings from time to time.

The article also gets its facts wrong on the basic elements of the difference between vaping and smoking. The author states that: "the current recommendation is to discourage young people from smoking anything — including e-cigarettes." But you don't smoke e-cigarettes. Vaping does not involve any combustion. In fact, that's one of the most important distinguishing characteristics between vaping and smoking (the other being that e-cigarettes do not contain tobacco).

In defense of her implication that vaping is as hazardous as smoking, the only scientific evidence that the author is able to provide is that there is: "a lack of extensive and solid research on those devices, so many questions remain about their risks."

So you mean to tell me that a product which kills more than 400,000 people each year in the U.S. is no more hazardous than one about which the worst we can say is that its long-term risks have not been quantified? The same thing could be said about many dietary supplements, whose adverse effects have not been studied in clinical trials and are therefore unknown. However, you don't hear reputable scientists going around and telling people that taking dietary supplements is as dangerous as smoking.

A physician who went around telling his patients that dietary supplements may not be any safer than smoking should probably not be treating patients.

The rest of the story is that public health advocates should not be going around telling the public that e-cigarettes may not be any safer than smoking. And they certainly shouldn't be telling parents that if their child tries a vape pen, the next thing you know they will wind up as a crack cocaine addict.

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