E-cigarettes are a public health conundrum. Most e-cigs contain nicotine, the research on their health effects is in its infancy, and the FDA is only just beginning to evaluate vaping products with a view to regulating them. All of this complicates the development of effective policy and messaging on e-cigarettes. Steve Lux, MS, a retired senior health educator at Northern Illinois University, outlines how colleges can approach it. For a selection of credible resources, scroll down.
1. Resist conveying that e-cigarettes are good or bad
There seems to be a concerted effort in the US to link the use of e-cigarettes to the same degree of harm that comes with traditional cigarettes. Many health-related agencies and programs have jumped on the anti-e-cig bandwagon in the last few years, in part because it’s easier. Seldom are things black and white. We tend not to like shades of grey; it makes for more difficult communications to our target audience. However, the more nuanced and less aggressive approach is more effective than black/white, good/bad, healthy/unhealthy.
The Framework Convention Alliance, an international organization focusing on eliminating tobacco- related harm, acknowledges the many areas of dispute regarding e-cigarettes. Nevertheless, it concludes that “e-cigarettes are almost certainly considerably less hazardous for individuals than cigarettes” (policy briefing, 2014).
2. Develop policy specific to e-cigarette use
E-cigarette use should be a separate issue from tobacco use. We are seeing campuses lump the use of e-cigs in with regular tobacco smoking in terms of policy. Again, that’s the easy way out. The reasoning behind this seems to be that if an e-cig user is using in public, the particles exhaled might be harmful to non-users around them. This seems a weak argument, for these reasons:
- In research involving tobacco, the secondhand-smoking risk in social settings is much lower than the risk to others who reside in the home of a smoker.
- E-cigarette exhalations contain mainly water vapor, and small amounts of other substances that may or may not have a negative effect.
- Some e-cigs do not contain nicotine; some users see them more as a social behavior than a drug delivery system; and some as an alternative to “smoking.”
3. Develop messaging that respects individuals and nuance
Students are constantly being confronted with their own personal experience flying in the face of what health “experts” say. This is complicated. There is no easy answer and no one answer for all. We don’t want to equivocate, but we should be helping our students by providing information that will help them make the choice that is right for them. Often, students can be motivated by instant gratification and what their peers are doing. Some, later may look for information about health. This is normal! We owe early adopters and risk takers a full, nuanced, and complicated answer on e-cigarettes and other substances. We need to present as much credible information as we can, and qualify that information, provide options, and help them make the best decision for them— not the best decision we would make or that we’d want our kids to make.
4. Seek out diverse and nuanced sources
Ask the tough questions, do diligent work, go for the nuanced, factual answers. Many government and national organizations in the US have come out strongly against e-cig use of any kind (NIH, NIDA, ACS, ALA, etc.). It is difficult to find what I consider to be rational, thoughtful, and data-based information pieces about e-cigs that can help you craft information that provides a real service to your students.
Look at non-US sources (e.g., from Canada, Great Britain, and other European countries), which often have a very different perspective on health issues. The Framework Convention Alliance, also called the Framework Convention Alliance for Tobacco Control (fctc.org), is a confederation of nearly 500 organizations from more than 100 countries.
My pick of credible resources:
- Policy briefing (Framework Convention Alliance, 2014)
- E-cigs’ inconvenient truth: It’s much safer to vape (Rolling Stone, 2015)
- Smoke Screen: Are e-cigarettes safe? (Scientific American, 2014)
- Wacky British idea: Why not tell the truth about e-cigarettes? (Forbes, 2015)
- The vape debate: What you need to know (WebMD, 2016)