In the 1970s, a company called Swedish Match began to advertise snus to Swedish men. Snus was not a new product; tobacco pouches that users tuck into their cheeks or lips, where they slowly release nicotine, have been around since the 17th century. But snus was out of fashion and had been replaced by combustible cigarettes.
At the time, Sweden, like many other countries, had a smoking problem. Forty percent of the men smoked. But with the resumption of snus sales, smoking rates have plummeted. In 2000, Sweden was the only industrialized country to meet the World Health Organization’s goal of reducing adult smoking to less than 20 percent.
Snus is a prime example of a theory called harm reduction which argues that, rather than promoting public health policies that eliminate tobacco altogether, addicted consumers should have access to products that give them the nicotine they have. need, but which greatly reduce the health risks posed by cigarettes. Snus delivers a dose of nicotine, but releases chemicals without the dangers of combustion and tar, some of the major contributors to lung cancer.
Seems familiar? When e-cigarettes (also known as vapes) first appeared in the mid-2000s, some researchers in the tobacco control community believed that young smokers in the United States could make a similar choice, leading to a drop in the rate. of overall smoking. Electronic cigarettes create an aerosol by heating a liquid containing nicotine. This aerosol can be inhaled and exhaled like regular cigarette smoke, but it does not contain the tar and most of the toxic chemicals found in tobacco smoke. While research suggests this these devices have their own dangers, including the reduced ability of the lungs to fight infection, a major cause for concern during the Covid-19 pandemic. But even with their risks, e-cigarette proponents believed that these products could present a safer alternative to combustible cigarettes, just as snus did for Swedes in the 1970s and 1980s. “People hoped that this would be true. would happen here, ”says John Pierce, a professor at UC San Diego who researches cancer and tobacco.
But in an article published in Pediatrics This month, Pierce and his colleagues are showing that’s not the case after all. Instead, young people who experiment with e-cigarettes are three times more likely than those who have never tried vaping to become daily cigarette smokers a few years later. And the more young people experiment with tobacco products, the more this probability increases. “We haven’t had this harm reduction thing,” says Pierce.
Pierce’s team analyzed data from the US Population Assessment of Tobacco and Health (PATH) study, a survey of nearly 50,000 Americans conducted annually by the National Institutes of Health and the Food and Drug Administration. They looked specifically at people aged 12 to 24 and tracked their responses over the four years between 2013 and 2017, tracking their consumption of tobacco products and their progress from occasional experimenters to daily users.
They found that just over 60 percent of respondents in this age group had tried a tobacco product at some point, and 30 percent had experimented with multiple products such as e-cigarettes, hookahs, and cigarillos. Among all the young people in the study, those who had tried many different products were 15 percentage points more likely to become daily cigarette smokers than those who had tried only one type of tobacco product. And teens who experimented with e-cigarettes before the age of 18 were more likely to become daily smokers than those who tried vaping later in life. In other words, the theory that this new product would deter young people from using cigarettes did not hold up.
