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Research & Commentary: Hawaii Flavor Ban Will Negate Public Health, Harm Military Members

February 27, 2019

Proposal would ban menthol cigarettes and flavors in tobacco products, including electronic cigarettes and vaping devices.

Hawaii lawmakers introduced a proposal that would ban menthol cigarettes and flavors in tobacco products, including electronic cigarettes and vaping devices. SB 1009 bans characterizing flavors including, but not limited to, “tastes or aromas relating to any candy, chocolate, vanilla, honey, fruit, cocoa, coffee, dessert, alcoholic beverage, menthol, mint, wintergreen, herb, or spice.” The legislation also prohibits the sale of tobacco products “that are in violation of federal [U.S. Food and Drug Administration] labeling requirements or that market to children.”

The bill intends to “reduce tobacco-related health disparities and address the youth vaping epidemic.” Vaping among youth did increase from 2017 to2018. However, such an extreme response to one year of data threatens the efficacy of a tobacco harm reduction tool that has helped millions of adult Americans quit smoking cigarettes.

Further, much of the data is inconclusive and relies on imprecise information. For example, the “2018 National Youth Tobacco Survey and the “2018 Monitoring the Future Survey” found an increase in the number of youth who say they vape more than one time per month, but this is a misleading figure because it doesn’t make clear whether a person had, for example, vaped twice and then never vaped again or vaped multiple times per day each day of the month.

Additionally, the vaping industry has a long history of supporting efforts to restrict youth access to e-cigarettes. The Consumer Advocates for Smoke-Free Alternatives Association (CASAA) supports age restrictions and “urges strict enforcement of laws” and the Smoke Free Alternatives Trade Association provides “Age to Vape” signage to vape shops endorsing local laws.

Associations representing vaping manufacturers also enforce banning sales and marketing to minors. The American E-Liquid Manufacturing Standards Association (AEMSA) “advocates electronic cigarette products for adult use only.”  AEMSA supports a “ban on sales to minors.” The Vapor Technology Association requires members to “refrain from knowingly marketing Vapor Products to Minors, which is strictly prohibited.”

Moreover, flavors are a significant factor in helping people quit combustible cigarettes. A 2016 CASAA survey of 37,343 e-cigarette users found 72 percent of respondents “credited tasty flavors with helping them give up tobacco.” A 2018 survey of nearly 70,000 American adult vapers produced similar results. Nearly 95 percent of the survey’s respondents reported “that they were ever smokers,” and many cited using flavors at the point of e-cigarette initiation.

Banning flavors would potentially harm the nearly three million American adults who have successfully used e-cigarettes to quit smoking. The figure could be significantly larger, as research finds e-cigarettes to be a more effective tool for cessation than traditional nicotine therapy. A 2019 study found e-cigarettes are “twice as effective as nicotine replacement at helping smokers quit.”

Hawaii is also home to more than 36,000 active duty military members. Historically, military personnel smoke more than civilians. In 2011, 24 percent of active duty personnel reported smoking, compared to just 19 percent of civilians. Thanks to vaping, daily smoking rates for servicemen declined to just 7.4 percent in 2015, compared to 12.9 percent for the general population. The same analysis found that 11.1 percent of service members were daily e-cigarette users, and in junior enlisted ranks, “nearly 20 percent are current e-cigarette users.” A flavor ban on e-cigarettes in Hawaii would almost surely negate this progress.

Banning flavors in e-cigarettes would essentially eradicate tobacco harm reduction in Hawaii. As e-cigarettes are 95 percent safer than combustible cigarettes, their use could help reduce health care costs related to smoking, as well as improve local economies by providing new business opportunities. Moreover, Hawaii’s large military population would be severely impacted because a ban would likely reverse the trend of declining smoking rates among service members. Lawmakers should promote the use of these products and oppose ludicrous bans that could vaporize the e-cigarette industry.

The following articles provide more information about tobacco harm reduction.

Vaping, E-Cigarettes, and Public Policy Toward Alternatives to Smoking
https://www.heartland.org/publications-resources/publications/vaping-e-cigarettes-and-public-policy-toward-alternatives-to-smoking
For decades, lawmakers and regulators have used taxes, bans, and burdensome regulations as part of their attempt to reduce the negative health effects of smoking. Recently, some have sought to extend those policies to electronic cigarettes. This booklet from The Heartland Institute urges policymakers to re-think that tax-and-regulate strategy. Policymakers should be mindful of the extensive research that supports tobacco harm reduction and understand bans, excessive regulations, and high taxes on e-cigarettes often encourage smokers to continue using more-harmful traditional cigarette products.

Podcast Series: Voices of Vapers
https://www.heartland.org/multimedia/podcasts?fromDate=&toDate=&q=voices+of+vapers
In this weekly podcast series, State Government Relations Manager Lindsey Stroud talks with researchers, advocates, and policymakers about tobacco harm reduction and electronic cigarettes. The series provides important information about the thousands of entrepreneurs who have started small businesses thanks to THRs and the millions of adults that have used electronic cigarettes and vaping devices to quit smoking tobacco cigarettes.

Research & Commentary: Largest Vaping Survey Finds Flavors Play Important Role in Tobacco Harm Reduction
https://www.heartland.org/publications-resources/publications/research--commentary-largest-vaping-survey-finds-flavors-play-important-role-in-tobacco-harm-reduction
In this Research & Commentary, Heartland State Government Relations Manager Lindsey Stroud examines a survey of nearly 70,000 adult vapers in the United States. The survey was completed in response to the U.S. Food and Drug Administration’s recent Advanced Notice of Proposed Rulemaking seeking comment on the role of flavors in tobacco products. The authors found nearly 95 percent of survey respondents were at one time smokers and the majority reported using flavors at the point of e-cigarette initiation. Stroud compares this to other surveys. She concludes, “eliminating flavors will force [vapers] to vape only tobacco-flavored e-cigarettes, which would likely cause them to return to combustible cigarettes.” Stroud also found research has found e-cigarettes are a key tobacco harm reduction product and could help alleviate state budgets by mitigating health care costs.

Research & Commentary: Electronic Cigarettes
http://heartland.org/policy-documents/research-commentary-electronic-cigarettes 
Heartland Institute Senior Policy Analyst Matthew Glans examines electronic cigarettes, tobacco harm reduction, and various proposals to regulate e-cigarette use. E-cigarettes have become one of the most popular nicotine replacement products and a key building block in tobacco harm reduction strategies.

Nicotine without smoke: Tobacco harm reduction
https://www.heartland.org/policy-documents/nicotine-without-smoke-tobacco-harm-reduction
This report aims to provide a fresh update on the use of harm reduction in tobacco smoking, in relation to all non-tobacco nicotine products but particularly e-cigarettes. It concludes that, for all the potential risks involved, harm reduction has huge potential to prevent death and disability from tobacco use, and to hasten our progress to a tobacco-free society. 

Research & Commentary: New CDC Report Finds Vaping Helps Smokers Quit
https://www.heartland.org/policy-documents/research-commentary-new-cdc-report-finds-vaping-helps-smokers-quit
A report released by the Centers for Disease Control and Prevention (CDC) found only 0.4 percent of the people who had never smoked tobacco in a CDC study group are current vapers, which the report defines as using a vaping device either every day or some days. The CDC report, the first of its kind, estimates e-cigarette use among U.S. adults using a nationally representative household survey. The report finds only 3.4 percent of adults who have never smoked have tried an e-cigarette; 12.6 percent of Americans have tried an e-cigarette; and fewer than 4 percent of the U.S. population are regular e-cigarette users.

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, visit the Budget & Tax News website, The Heartland Institute’s website, our Consumer Freedom Lounge, and PolicyBot, Heartland’s free online research database.

The Heartland Institute can send an expert to your state to testify or brief your caucus, host an event in your state, or send you further information on a topic. Please don’t hesitate to contact us if we can be of assistance! If you have any questions or comments, contact Lindsey Stroud, a state government relations manager at The Heartland Institute, at lstroud@heartland.org or 757/354-8170.

Author
Lindsey Stroud joined The Heartland Institute in 2016 as a Government Relations Coordinator. In 2017, Lindsey was named State Government Relations Manager.
lstroud@heartland.org