My 2016 year-end analysis of tobacco harm reduction focused on vaping, specifically on the observation that the mindspace around vaping had been taken over by tobacco controllers. Now, these have been pro-vaping tobacco controllers, who want to medicalize vaping as a “cure” for smoking (and after that has played out, presumably circle back to attack it). Nothing that happened in 2017 has changed my assessment.
That analysis was retrospective because not much stood out prospectively for 2017 other than predictable gradual trends. In retrospect, 2017 saw one abrupt change (which was also fairly predictable, though the magnitude was rather surprising), the huge popularity of heat-not-burn cigarettes. This was in populations that do not get a lot of attention in Anglophone and European discussions of tobacco products, and in places where vaping was rare. FDA’s four-year delay in the near-ban of vapor products was an important event, though its real significance is widely misperceived.
A prospective analysis of vaping for the coming year or two again has HnB as the most interesting issue. What is the future of vaping after HnB cigarettes – or “heated tobacco products” as their producers are trying to call them – become popular in populations where vaping is established?
The first question, which appears to be just semantics but has practical significance, is whether HnB products will be called “vapor products.” The few press reports to date have tended to refer to them as “e-cigarettes.” More precisely, the question is whether using a HnB will be called “vaping” or “smoking” (or, far less likely, something else entirely). “Vaping” is the natural and common word, from which constructions like “vapor products” will follow.
Many vapers and vaping pundits have opinions, usually negative, about whether HnB products should share vocabulary with extracted nicotine vapor products. Some cite technical reasons why this is not (or is) “right.” But this is misguided. Evolution of common usage is not a matter of right or wrong. Words mean what people agree they mean (after all, the “vapor” that vapers vape is not actually a vapor). Vaping opinion leaders might be able to influence how HnB is described, for tactical reasons, but technical rightness has nothing to do with that.
The reason there might be tactical issues is because if HnB shares a vocabulary with what we now call vaping, then views on HnB will influence how extracted nicotine vapor products are perceived. The success of HnB in East Asia suggests that once the products are approved for sale in the U.S. and Europe, they will become very popular. It is quite conceivable that they will overtake the popularity of current vaping, in many populations, in less than a year. Even if they do not, they will be The New Thing, and so will be all over the press and the favorite new target of tobacco control (focusing on smoking is just so 1990s).
HnB products will, initially and possibly always, be made and sold only by the major tobacco companies. If they are the popular new way to vape, then arguments that “vaping is not about ‘Big Tobacco’” will fall flat. It is already hard enough to parse the details that the majors only make some kinds of vapor products and do not own the space; it would become significantly harder. In addition, arguments about the chemistry and its minimal health effects will become more complicated with the addition of the aerosol from heated tobacco. It will probably be more difficult to convince policymakers to not extend smoking bans to include vaping (though this might happen regardless of vocabulary).
On the other hand, if HnB use is vaping, then vaping is about to explode in popularity. This is obviously good for harm reduction, regardless of vocabulary, but it could also be good for the cause of vaping. Of course, it will help a lot more if these new vapers can be persuaded to become advocates for their rights as consumers, in contrast with the complacency of almost all smokers. This might or might not happen. If they are seen, and continue to see themselves, as smokers who are just doing it differently, the impacts on enlightened thinking about vaping would probably be negative. (The possibility such people are labeled “vapers” but think of themselves as variant smokers seems contradictory, but it is a definite possibility.)
In short, calling HnB use “vaping” will narrow the psychological gulf between vaping and smoking, which will probably impose costs on current vapers but could possibly bring benefits as well.
My prediction is that it is more likely than not that the label “vaping” will stick to HnB use. If that happens, it will probably be harmful on net to the cause of vaping because it will increase baggage without dramatically increasing consumer activism. However, the net effect for the wider population will be good, extending the positive feelings about vaping that exist to a potentially more popular product.
That leads into the second question: Will what we currently call vaping end up in a Linux-like consumer niche? To expand the metaphor, smoking is like Windows, an inferior product that still thrives thanks to its huge installed base and the resulting network externalities (i.e., you can count on getting a cigarette anywhere because there is a market for cigarettes everywhere). HnB products are likely to become the macOS of the inhaled nicotine world: more expensive and captive to a particular company, but higher quality and, most important, you just turn it on and it does what it is supposed to do.
Meanwhile, a vaping system that is modular, adjustable and refillable with a million choices of liquid is a power-user tinkerer’s dream, like running Linux on a your laptop. Consumers who choose to run Linux are devoted to it, but that population is quite limited. When there was no choice but to tinker a bit, as with personal computers circa 1990, many consumers made the effort. But when a choice emerged, most people were happy to give up tinkering. Thus it seems possible that slick new HnB systems – in their role as iCigarettes – will attract many current and would-be users of extracted nicotine vaping (as cig-a-likes would have if they had delivered a high-quality vape).
The regulators might draw this out for a while, and because this is a trickier technology than simple e-cigarettes, there is no possibility that an unregulated industry will spring up. So we may not be talking about 2018. But most of this is likely to happen to some extent. Moreover, it is safe to guess that the majors who are rolling out these products see existing vapers as a promising target market. They are fewer than smokers, but on average are probably more likely to switch to the new products, especially if flavor bans take away one of the advantages of the old products. Dedicated power-user vapers are mostly prepared to weather bans and other restrictions on availability, and they will hardly even notice if the iCigarettes narrow their niche. But they may find that – if HnB use does not create vaping advocates – that their slowly-growing political power starts diminishing.