Bentley
University economist Dhaval Dave and colleagues at the City University of New
York and Cornell have authored an article titled “News That
Takes Your Breath Away: Risk Perceptions During an Outbreak of Vaping-Related
Lung Injuries,” published by the National Bureau of Economic Research. It analyzes the effect of actions taken by the
CDC.
Dave
et al. describe the federal response to EVALI: “Statements issued by the CDC
during the early ‘crisis’ period were direct and clear suggesting that
individuals should stop using all vaping products in the late summer of
2019.” (emphasis added).
The
CDC was silent on marijuana until December 10, 2019, when it acknowledged in a tweet that “products
that contain THC, particularly from informal sources…play a major role in the
current lung injury outbreak.” The
agency had delayed focusing public attention on cannabis products for over
three months, as it was clear by early September to many observers, including
me (here) and Boston
University’s Dr. Michael Siegel (here), that the lung
injuries were unrelated to nicotine-based e-cigarettes and vaping products
which had been used by tens of millions of consumers for some 10 years with no
serious lung problems.
Figure
5 in Dave’s article, seen above, shows the effect of the anti-vaping
misinformation campaign that has been supported since 2012 by the transfer of hundreds
of millions of dollars from the FDA to the National Institutes of Health to cooperating
university researchers. This scheme has
generated hundreds of laboratory and epidemiologic studies reporting
exaggerated or downright false vaping harm.
The
chart shows the success of the misinformation campaign from 2012 to 2019. The percentage of Americans viewing
e-cigarettes as more harmful than cigarettes grew at a consistent rate of about
two percentage points per year.
The
2019 EVALI debacle took the public’s fear of nicotine e-cigarettes and vaping
products to new heights. As Dave et al.
write, “the immediate impact…was to increase the fraction of respondents who
perceived e-cigarettes as more harmful than smoking by about 16 percentage
points.” After the CDC issued its
December 10 tweet emphasizing “the role of THC e-cigarette products,
e-cigarette risk perceptions were partially revised downwards.”
That
downward movement was minimal, as Figure 6 from the analysis illustrates:
Dave
et al. generously refer to the CDC’s delayed identification of marijuana as the
cause of EVALI as “precautionary” but they suggest that it may have had “unintended
consequences. More targeted advice about the risks of THC e-cigarettes might
have more effectively reduced the use of those products, potentially preventing
EVALI cases. Moreover, the increase in e-cigarette risk perceptions might
discourage adult smokers from using e-cigarettes…the increase in e-cigarette
risk perceptions might slow the downward trend in youth smoking.”
By
not announcing early on that contaminated marijuana products cause EVALI, the
CDC increased the number of injuries and deaths. The agency inaction also discouraged smokers
from switching and might have even encouraged teens to smoke.