The Trump administration's vaping policy offers a valuable lesson for today's lawmakers: balancing youth protection with adult smokers' need for harm reduction requires compromise. As vaping rates rise and misconceptions about nicotine persist, policymakers must base regulations on science, open dialogue, and a commitment to public health and personal freedoms.
In 2019, Donald Trump stood with millions of adults who vape when rejecting a proposed federal ban on flavored e-cigarettes. Initially advocating for a flavor ban in September 2019 to curb youth e-cigarette use, Trump later reconsidered. On November 11, 2019, he tweeted about meeting representatives from the vaping industry, medical professionals, and state officials to devise a balanced solution. He emphasized that youth health, safety, and job preservation would be key considerations.
Trump subsequently held a contentious meeting with representatives from both the tobacco and vaping industries and anti-vape public health groups, joined by U.S. Senator Mitt Romney. Following the meeting, Trump announced his administration would raise the legal age for purchasing tobacco and vapor products from 18 to 21. In January 2020, he implemented a ban on flavored pod cartridge systems (in response to high rates of youth use) while allowing other flavored e-cigarette devices to remain on the market.
Policymakers should take note of Trump's efforts and pay more attention to adult vapers. Data from the Centers for Disease Control and Prevention (CDC) showed that in 2023, 7.7% of U.S. adults aged 18 or older were current e-cigarette users, the same percentage as youth e-cigarette users. Notably, only 1.9% of middle and high school students reported daily vaping, compared to 3.7% of adults. Meanwhile, 12.1% of adults still smoked combustible cigarettes, with 8.4% smoking daily -- clearly a far greater public health concern.
Adult vapers may have played a role in Trump's electoral success, as adult vaping rates rose significantly in key battleground states between 2016 and 2023. For instance, Georgia saw a 60.4% increase, from 4.8% of adults vaping in 2016 to 7.7% in 2023, while North Carolina experienced a staggering 90% rise, from 4.4% to 8.4%.
Despite this, federal regulations and disinformation campaigns have left many Americans -- both smokers and vapers -- misinformed about nicotine's health impacts. A 2018 Health Information National Trends Survey by the National Cancer Institute found that only 27% of adults correctly understood that nicotine is not the primary cause of smoking-related cancers, while nearly half incorrectly believed it was.
A 2023 global survey of more than 15,000 doctors from 11 countries revealed that 74% mistakenly thought nicotine causes illnesses such as lung cancer and chronic obstructive pulmonary disease (COPD). This widespread misunderstanding underscores the need for science-based public health education.
Polling data released in July 2023 by the Vapor Technology Association (VTA), conducted by Kellyanne Conway, highlighted the power of education. When informed about scientific evidence supporting e-cigarettes as a smoking cessation tool, American voters became less supportive of banning flavored vaping products. In Michigan, Pennsylvania, and Wisconsin, 75% of surveyed voters initially believed vaping was as harmful or worse than smoking. However, after learning about vaping's effectiveness, opposition to flavored vaping bans dropped significantly.
By 2023, 7.7% of U.S. adults were vaping, many having successfully quit smoking thanks to e-cigarettes. Studies consistently show that e-cigarettes are significantly less harmful than combustible cigarettes and more effective than traditional nicotine replacement therapies (NRT). A 2018 study found that e-cigarettes were nearly twice as effective as NRT products in helping adults quit smoking.
Additionally, e-cigarettes are cost-effective, especially for low-income smokers. A 2024 economic analysis concluded that using e-cigarettes as a cessation tool is more cost-effective than NRT products. The study recommended that policymakers consider offering financial support for e-cigarettes as a harm reduction strategy.
As lawmakers consider future tobacco regulations, they must recognize that effective public health policy is built on science, not stigma. Policymakers should prioritize facts over fear, ensuring access to life-saving alternatives like e-cigarettes while combating misinformation. By fostering informed dialogue and crafting regulations that reflect scientific reality, they can reduce smoking-related harm and support millions of Americans striving for healthier lives.