It seems that honesty has disappeared as a core principle in tobacco control. Today, I report that yet another group of tobacco control researchers is bemoaning the fact that many youth understand the relative health effects of vaping and smoking and is encouraging lying to kids instead.
In a paper published in Tobacco Prevention and Cessation, investigators from the University of Louisville examined YouTube videos promoting electronic cigarettes. They found that one of the major selling points for vaping in these videos was the claim that using e-cigarettes is safer than smoking and switching from cigarettes to e-cigarettes can therefore improve health. However, here is how they report this finding and how they describe its implications:
"Our findings extend similar conclusions in related work: that the
majority of YouTube videos promoting e-cigarettes demonstrate the social
benefit and acceptability of e-cigarettes in part by claiming that
using e-cigarettes is safer and healthier than consuming traditional
This comparison perpetuates a narrative that e-cigarettes are safe
because they are “healthier” or “safer” than other traditional tobacco
products. Promoting a product by claiming that it is better than a
hazardous substance, like traditional tobacco, only has merit when
targeting cigarette users who are considering quitting or cutting back.
Given that scientific information about safety is largely inconclusive,
claims using words like “safer” to describe e-cigarettes could
contribute to confusion about the overall safety of these products,
especially among youth. A recent analysis found that 34.2% of youth
believe that e-cigarettes are less harmful than traditional cigarettes,
and 45% are not sure.
Furthermore, e-cigarette use among youth who did not use traditional
cigarettes was more likely when they perceived e-cigarettes to be less
harmful than traditional cigarettes."
The paper concludes that: "There is a need for “anti” e-cigarette videos on YouTube, especially
ones targeted at youth, to more accurately convey current scientific
understanding about the safety of these products."
The Rest of the Story
To be clear, this paper is suggesting that e-cigarette promotional videos are inaccurately asserting that vaping is safer than smoking. The paper calls for anti-vaping videos that "more accurately" convey scientific understanding about the safety of these products, condemning videos that claim that e-cigarettes are safer than real, tobacco cigarettes.
In other words, the paper is clearly calling for public health practitioners to lie to our nation's youth by telling them that vaping is no safer than smoking or by hiding the fact that vaping is much safer than smoking.
Ironically, the paper argues that telling kids the truth - that vaping is safer than smoking - is creating "confusion" because a recent analysis showed that one-third of youth believe that e-cigarettes are less harmful than traditional cigarettes. How is that confusion? What the paper calls "confusion" is actually the truth.
The investigators appear to be upset that many youth have a correct understanding of the relative safety of vaping compared to smoking.
A core principle of public health is honesty. Another core principle of public health is transparency. And a key element of health communication is telling the truth. We do not mislead, deceive, or lie to the public in order to promote health behavior change. That is what we have incessantly attacked the tobacco companies for doing. Deceiving people is not a valid or appropriate strategy in public health.
But the rest of the story is that many tobacco control practitioners are encouraging precisely such a strategy. They can't stand the fact that youth may have a correct understanding of the relative health effects of vaping compared to smoking, and they want youth to be lied to in order to confuse them or even worse, deceive them into thinking that vaping is actually just as hazardous as smoking.
While the overall goal of this dishonesty may be valid - trying to discourage kids from vaping - the means being urged to reach this end are inappropriate. In public health, we do not lie to the public to promote our agenda. That's what the tobacco companies used to do. And there is no excuse for us to sink to that level.