As policymakers nationwide struggle to control a skyrocketing youth vaping epidemic and rising cases of severe vaping-related lung illnesses, some doctors say reactionary bans on nicotine e-cigarettes are a mistake.
In an editorial published Thursday in the journal Science, the group writes that such "prohibitionist measures" may thwart earnest efforts of adult smokers trying to quit regular cigarettes by turning to electronic cigarettes. The group includes public health experts from major institutions, including Columbia University, Emory University, New York University and Ohio State University.
The article goes against what most public health officials and addiction experts in the United States have been saying for months, which is that there is no safe form of vaping, and that the only substance that people should inhale is clean air.
Major medical organizations, including the American Academy of Pediatrics, the American Heart Association, the American Lung Association and the American Medical Association, have stressed that anyone who vapes should stop.
The long-term health effects of e-cigarettes are unknown, and the group is careful to point out that vaping does not come without risk.
But for adult smokers hooked on nicotine, vaping "is a harm-reduction initiative, not a harm-elimination initiative," Amy Fairchild, dean of the Ohio State University College of Public Health and one of the editorial's authors, told NBC News.
"Restricting access and appeal among less harmful vaping products out of an abundance of caution while leaving deadly combustible products on the market does not protect public health," the authors wrote. "It threatens to derail a trend that could hasten the demise of cigarettes, poised to take a billion lives this century."
Indeed, cigarette smoking is responsible for nearly a half million deaths each year in the U.S. alone. And 16 million Americans are living with tobacco-related illnesses, such as lung and other cancers, heart disease, type 2 diabetes and chronic obstructive pulmonary disease.
Fairchild and her co-authors say there should be a distinction between e-cigarettes used as smoking cessation tools and the two ongoing public health crises: nonsmoking teenagers taking up vaping, and the spate of serious lung illnesses linked to vaping called EVALI.
As of Thursday, the Centers for Disease Control and Prevention reported 2,409 EVALI cases nationwide. Fifty-two people have died, and more deaths are under investigation. A majority of patients reported using products containing THC, the psychoactive ingredient in marijuana, though some say they only vaped flavored e-liquids or nicotine products before falling ill.
Recent case reports have linked vapes to a variety of health problems, including hard-metal lung disease and chemical burns in lung tissue.
Investigators have been unable to pinpoint any single cause of the illnesses, though vitamin E acetate has been implicated. Until more is known, some states have enacted or proposed at least temporary bans on flavored vape products. The Trump administration is also reportedly considering a form of a federal ban.
"Alarm about youth experimentation with vaping nicotine is appropriate. Alarm about EVALI and EVALI-related deaths is appropriate, and we need to treat that like we would any outbreak and pour a lot of resources into it," Fairchild said. But, she added, regulation and safety standards for e-cigarettes are critical to maintain cessation tools for adult smokers.
Jeremiah Johnson, 43, of Glasgow, Missouri, credits e-cigarettes with helping him overcome an 18-year addiction to tobacco. He tried Chantix, a medication used to help people stop smoking, but the effect was temporary.
He was attracted to e-cigarettes "thinking it was more healthy" and because he didn't like smelling like smoke. He's been off combustible tobacco products for three years.
Johnson admitted he's developed some breathing difficulties since switching to vaping.
"I get short of breath quicker. Just stupid stuff like bending over tying your shoes," he said. "I shouldn't be breathing hard from doing just that."
But Johnson said he's unable to blame his shortness of breath on vaping; pointing out he's also gained a few pounds in recent years.
Still, Johnson said vaping is not a long-term solution. Now that he's quit regular cigarettes, he's motivated to quit e-cigarettes.
"I want to see my grandchildren at some point in the future and just be smart about it," he told NBC News.
Meanwhile, the CDC recommends anyone using vaping products as an alternative to regular cigarettes to carefully monitor themselves for vaping-related illness symptoms, including fatigue, shortness of breath, fever, coughing, vomiting and diarrhea.
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