The PPI is a non-profit organisation that works as a public policy think tank. It is seen as ‘left-wing’ in the United States, although this makes it pretty centre ground in UK terms. Founded it in 1989, the Washington Post calls it "a centrist Democratic institution."
To date, the majority of those in favour of supporting vaping in America appear to come from the right of the political spectrum. The PPI’s report marks a substantial shift in opinion coming from the Democrat side of the debate.
From the outset, the report notes that cigarette smoking rates fell sharply from 2013 to 2017 as the use of electronic cigarettes increased sharply. The link between the two appears to be obvious when the history of smoking rates is taken into consideration: “The share of American adults using tobacco products fell steadily from 42.4 percent in 1965 and 30.1 percent in 1985 to 20.9 percent in 2005. This progress slowed from 2005 to 2011.”
It highlights that one of the serious objections to vaping is that it contains (though not necessarily uses) nicotine: “Since nicotine addiction is a serious hurdle for most people trying to quit smoking, some public health advocates view the nicotine in e-cigarette vapours as a positive tool to help people quit smoking. In this view, e-cigarettes offer a much less harmful addiction than regular cigarettes for people already addicted to nicotine. In response, some sceptics claim that e-cigarette use, especially by young people, may be a gateway to smoking regular cigarettes.”
The report contains some excellent analysis, including this on the supposed gateway effect: “We also use statistical analysis to test the proposition that e-cigarettes are a ‘gateway drug’ to smoking regular cigarettes, especially for middle school and high school students. Fundamentally, the gateway proposition appears inconsistent with basic data on smoking rates: The young adults ages 18 to 24 whose use of cigarettes declined sharply from 2013 to 2017 included millions of people who began using e-cigarettes as adolescents in the preceding years.”
“If e-cigarettes were a gateway to cigarette smoking, their large increases in e-cigarette use as adolescents should have been followed by rising cigarette smoking rates as they aged into the 18 to 24-year-old group. These data and our analysis of other data on adolescents appear to refute the gateway proposition, a conclusion also consistent with findings by other researchers.”
The opposition to vaping often pours cold water on claims that it helps smokers to quit cigarette use. The report references studies demonstrating the efficacy of ecigs and backs it up with analysis of the part vaping must have played in the drops in smoking rates leading them to state that “75 percent of the additional decline in cigarette smoking rates” is “unexplained by factors other than the increased use of e-cigarettes”.
The report concludes:
- Up to 70 percent of the accelerating decline in smoking rates is attributable to vaping
- No reasonable evidential basis for concerns that e-cigarettes are a gateway
- Vaping is highly effective in helping people stop smoking cigarettes
- E-cigarette users incur lower healthcare costs
- E-cigarette users and ex-smokers who used e-cigarettes to quit smoking results in longer lifespans
- The value of the additional years of life associated with using e-cigarettes is much greater than the additional healthcare costs
- The increase in e-cigarette use results in large productivity benefits, mainly from lower rates of illness
The sizeable document is available for free online and is linked to below.