Whilst vaping has become much more accepted in the UK and is now endorsed by leading public health organisations, the same cannot be said in the USA.

In the UK, the gateway theory and youth uptake has been debunked on numerous occasions with figures and expert analysis showing the threat is negligible. Stories from across the pond however show a stark contrast with US headlines referring to youth uptake as an epidemic.

The commissioner of the Food and Drug Administration (FDA), Scott Gottlieb has now claimed that vaping products could face an “existential threat” if it continues.  Speaking at a forum in Maryland he said,

“I’ll tell you this. If the youth use continues to rise, and we see significant increases in use in 2019, on top of the dramatic rise in 2018, the entire category will face an existential threat,”

“It could be ‘game over’ for some of these products until they can successfully traverse the regulatory process. I think the stakes are that high.”

This news comes after a string of disputes and consequent regulations over e-liquid flavours in the USA. Many states now ban flavoured e-liquids with vapers now having to stick to menthol or tobacco.

UK and USA – Contrasting research

The attitudes towards vaping in the States have remained negative for a number of years now. The contrast between the USA and the UK is drastic. This is particularly poignant in terms of academic studies and research and specifically with regards to use in young people.

Two pieces of evidence from the UK are as follows:

“E-cigarettes are attracting very few young people who have never smoked into regular use, and e-cigarettes do not appear to be undermining the long-term decline in cigarette smoking in the UK among young people.” – Public Health England.

“Concerns about the risk of e-cigarettes potentially providing a ‘gateway’ into conventional smoking have not materialised to any significant degree.” Science and Technology Committee.

The following is from the USA:

“there is substantial evidence that e-cigarette use increases risk of ever using combustible tobacco cigarettes among youth and young adults” – National Academies of Science, Engineering and Medicine.

Writing for the Guardian, Professor Linda Bauld discussed the possible reasons for the disparity. Regulation differences, nicotine focus and the survey questioning methods were potential reasons which were explored.

Bauld signed off by stating: “We should not be forced to choose between protecting children and supporting the one in two adult smokers who will suffer and die prematurely from a smoking-related disease if they continue to smoke. The challenge in 2019 and beyond will be to ensure the right balance is struck.”