Mountain climbing is dangerous. Skiing is dangerous. But the long arm of the law doesn’t reach out and say folks can’t climb or ski. There’s a basic logic to this: If you know the risks, and you’re still willing to take your chances, you should be allowed to do what you want. It’s your life, after all.
So why doesn’t this logic apply to vaping?
Two weeks ago, Governor Charlie Baker pushed through a ban on vaping. Although it applies only to those who sell e-cigarette supplies, and it’s for only four months, the net effect for most who vape is that they can no longer engage in the practice. Some are heading to New Hampshire for their supplies, and others might turn to the black market. But for the rest, vaping is no longer an option.
At the time of the ban, there was a near panic over a spate of lung-related illnesses and deaths, all of which seemed to be tied to vaping. Doctors and public health professionals had no idea what was going on and Baker’s ban was borne out of this confusion. The argument was that a ban was warranted because, in fact, no one knew what the risks were.
Fair enough. But the Internet and social media are wonderful things and the fact is that today pretty much everyone — and most certainly vapers — is aware of these once-unknown risks. The news of those illnesses and deaths have been trumpeted everywhere. So does the ban still make sense? If folks want to vape — knowing, as they now do, that they might face imminent hospitalization — shouldn’t they be allowed to do so?
It’s their lives, after all.
I go back and forth on this one, in part because it’s more complicated than just knowingly taking a risk.
For one, it’s an addictive risk. Most vapers use the devices to inhale nicotine, and sometimes at levels far greater than cigarettes. There’s a widespread belief among vapers that vaping doesn’t have the same risks as cigarettes, in large part because they don’t have cigarette cancer-causing tars and other harsh ingredients. But nicotine itself is dangerous, capable of causing much harm, including adverse effects on “the heart, reproductive system, lung, kidney, etc. (as well as) carcinogenic potential,” according to the National Institutes of Health.
Granted, even with potentially addictive substances, we usually let adults make their own decisions. But in the case of vaping, manufacturers — Juul is the prime example — targeted their products to kids, with child-friendly flavors such as mint, mango, and fruit. And those kids, almost by definition, are unable to make reasoned, mature decisions about what risks they should and shouldn’t take. Yet an addictive habit picked up as a teen is extraordinarily hard to shake as an adult. Juul was going as young as it could so it might create a life-long consumer — and that’s appalling.
Still, if we could keep e-cigarettes out of the hands of kids, one could make the case that we should allow adults to vape if they wish. We do so with conventional cigarettes, coupling their sales with grim warnings on every pack. That, it seems, is the direction that Governor Gina Raimondo of Rhode Island went. After Baker put in place his ban, she followed with one of her own, but one that was more narrowly drawn, targeting the flavored e-cigs that most seemed to appeal to kids. Her approach seems to be the more reasoned.
I’m no fan of the industry. I’ve never smoked or vaped. But an essential tenet of freedom is the right to take risks. We don’t have the right to impose those risks on others (hence, bans on smoking in bars or restaurants), but adults — presumably capable of making reasoned choices for themselves — should have the right to impose those risks on themselves. The public health community was delighted when Baker imposed his ban, and I understand why — they see all issues like this through the lens of morbidity and mortality.
But if adults want to vape — and they do so knowing not only the long-term risks but also the potential short-term issues — they should be able to do so. Baker should issue a new ban, one more narrowly tailored to protect kids, and let adults do what they want.
This column first appeared in the Boston Globe on October 7, 2019.