Cigarette smoking was understood to be dangerous decades before we responded in a serious way. Decades of denial, of tobacco industry deceit and dodging by politicians, separated scientific understanding from public-health response.
Only in the past few years did we begin to even acknowledge the opioid epidemic that began 20 years ago with the overprescription of pain medication, and only now is it beginning to be combated seriously.
In both cases, the cost of delay is almost beyond imagination. In the half-century from 1965 to 2014, nearly 21 million people died prematurely due to smoking or exposure to secondhand smoke, according to the Centers for Disease Control and Prevention. By the time Big Tobacco was forced to disgorge some ill-gotten profits, there wasn’t nearly enough to go around — even if what they forfeited had all been devoted to public health.
And though the opioid epidemic in some places may at least be cresting, on average, 130 Americans die every day from opioid overdose, the CDC reports. Again, even after Purdue and other contributors to the carnage are sued and bled, what’s left won’t begin to compensate for the human and economic wreckage.
“We’ve seen this movie before,” says Rep. Raja Krishnamoorthi (D-Ill.).
The second-term congressman from the outskirts of Chicago (his district includes the runways but not the terminal of O’Hare Airport, he sometimes points out) became alarmed in February when the 2018
National Youth Tobacco Survey reported “a startling rise in youth e-cigarette use.” In just one year, the share of high school students using the devices rose from 11.7 percent to 20.8 percent — representing a total of 3.6 million middle and high school students, the survey reported.
His alarm intensified this month, when preliminary survey results showed that the share of high school students using e-cigarettes had climbed to more than one-fourth in 2019. It ratcheted up further when the CDC reported a wave of unexplained serious lung illnesses and even deaths associated with vaping.
And it became personal when his 14-year-old son told him that he has been approached at least 20 times during his first three weeks as a ninth-grader by kids asking if he wants to vape.
As chairman of the House Oversight Subcommittee on Economic and Consumer Policy, Krishnamoorthi is somewhat better positioned to respond than other worried fathers might be. Already in July he held hearings during which Native American tribal officials and high school students, among others, testified to efforts by Juul, the biggest e-cigarette company, to win customers.
One witness, ninth-grader Caleb Mintz, told the subcommittee that, after a Juul representative met with students in his school, classmates who were already vaping breathed “a sigh of relief because now they were able to vape without any concern” and nonusers were more inclined to try it “because now they thought it was just a flavor device that didn’t have any harmful substances in it.”
“We ended that program in the fall of 2018,” a Juul official testified. More broadly, the company says it tries to keep its product away from kids and emphasizes the benefits of e-cigarettes for people who are trying to quit smoking traditional cigarettes.
Some adults may in fact benefit. Some adults may prefer the cotton-candy and mint flavors that make e-cigarettes so attractive to young people. Some struggling small vaping shops may go out of business if they can’t sell flavored pods. Some . . .
Well, you get the idea. As the government contemplates how to combat youth vaping, a countercampaign is already underway.
As it gathers steam, we should keep a few facts in mind, also courtesy of the CDC: Nicotine is “highly addictive and can harm adolescent brain development.” E-cigarettes can contain “other harmful substances besides nicotine.” And the long-term health effects of e-cigarettes are far from understood.
So, yes, we have seen this movie before. If it ends in 10 or 20 or 30 years with someone calculating the mortality and morbidity casualties of vaping, we won’t be able to say we didn’t see it coming.