Is steam safer than smoking cigarettes?

I was 15 when I started smoking, as were most of my friends. We smoked to rebel against our parents. Because young girls do it. Because cigarettes were both banned and easy to obtain: 10 quarts in a cigarette vending machine, which could still be found at most New Jersey suburban pizza and donut shops in the early 1990s.

All this – the call, the access, the illegality of the cigarettes – was a will. When my friends and I were born, cigarette manufacturers sewed their products into the fabric of our culture so that no more than a hundred years of research linking them to a set of slow, painful deaths was enough to deter many of us. .

Tobacco companies have made cigarettes a diet and a fashion tool. Most people who do not start smoking at the end of adolescence will never do so. The cigarette manufacturers knew it. They used camel cartoons, pictures of Santa and larger-than-life cowboys in their commercials. Their key ingredient was highly addictive. When concerns emerged about nicotine addiction, cancer and heart disease, they kept regulators at bay by minimizing scientific uncertainty. Then they bought scientists and propaganda disguised as companies as independent research. By the time their disappointments were unveiled, a new generation of smokers – promising billions of dollars in revenue for the industry – was hooked.

In the late 1990s, Big Tobacco was finally brought to account for its practices and a series of public health policies were put in place. They have virtually eliminated the scourge of teen smoking. But many of us who became tobacco users at 13, 14, 15 years and stay at 39, 40, 41 years. And in recent years, we have seen history repeat itself.

The tobacco industry offers a new type of smoking device, the e-cig pen or vape, which is much healthier than traditional cigarettes: no tobacco, no tar, just nicotine and flavored steam. The industry says that these devices will finally help us stop smoking or reduce our habit in adult smokers. But here's the problem: e-cigs have brought tobacco back into fashion for teens. As a result, the cost of this new treatment could be another generation exposed to the same dependence that we are still fighting.

Tobacco remains the leading cause of preventable death. Smoking kills an estimated 480,000 people a year – more than AIDS, car accidents, illicit drugs and suicide – and costs $ 170 billion ($ 624.4 billion) in annual health expenditures, according to the centers. control and prevention of diseases.

E-cigs manufacturers say, and some health experts believe, that e-cigs could help reduce these terrible numbers because they contain far fewer toxins than traditional tobacco cigarettes. It is thought that if all current smokers used these devices, the burden of illness and death could be significantly reduced.

Few were as captivated by this argument as Scott Gottlieb, outgoing commissioner of the Food and Drug Administration, the federal agency responsible for the regulation of tobacco products and nicotine.

Since taking office at the agency two years ago, Gottlieb has attempted to strike a balance between encouraging adult smokers to switch to e-cigarettes and keeping devices safe from minors . Smoking poses a disproportionate risk to children and adolescents, in part because nicotine is known to affect brain development. In 2016, the FDA banned the sale of electronic cigarettes to minors and issued a series of new regulatory requirements for vaping devices. Then, under Gottlieb's mandate, the agency extended by several years the deadline to comply with these requirements, while announcing its intention to reduce the nicotine content of regular cigarettes.

This plan turned against last year, when adolescent vaping reached epidemic proportions. Since then, Gottlieb has been trying to put the industry in check by forcing particular e-cig manufacturers to develop plans to protect their children's products and by sending thousands of warning letters to retailers caught selling nicotine products to minors.

The e-cigs manufacturers have reacted to this pressure with a bait-change that would make the pride of their Big Tobacco predecessors.

Juul, the company most responsible for the soaring teenage adolescence, has cleaned up its Facebook and Instagram accounts and has agreed to significantly limit sales of its most youth-friendly flavors, such as the mango, cream and fruits. The company also received a $ 12.8 billion minority investment in December from tobacco giant Altria, which will allow Juul products to be exposed alongside regular cigarettes in the country's outlets. For its part, Altria has volunteered to remove all its flavored pod products from the market until the resolution of the youth vaping epidemic. Gottlieb's most aggressive efforts to combat smoking, including reducing nicotine levels and banning menthol flavors in traditional cigarettes, are still in the planning stages. It is unclear whether his successor will guide them in policy making.

Meanwhile, according to Reuters, many imitators of Juul are making their way into convenience stores in defiance of an FDA rule banning the sale of new e-cigs after August 2016. Juul stands as a health conscious company, even as it develops new vaping products, potentially more addictive. And Philip Morris International has created a nonprofit organization – the Foundation for a Smoke Free World – through which he has attempted to associate with the World Health Organization. The stated goal of the foundation is to reduce the burden of smoking on global health. According to tobacco industry observers, the documents disclosed by PMI suggest that its true purpose is to promote its own vaping products.

None of this should be a surprise. The tobacco industry was built around an inherently dangerous and unhealthy product. And he has a long history of duplicity.

There are still many questions about the effectiveness and unanswered safety regarding e-cigs. It is unclear how well they work as a tool for quitting. And while they are almost certainly safer than regular cigarettes, they are not necessarily safer.

– New York Times Press Office

Jeneen Interlandi is a renowned editorial writer who writes about health, science and education.