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Research & Commentary: Oregon’s Misguided Flavor Ban Is Disservice to Public Health, Unlikely to Reduce Recent Hospitalizations

October 10, 2019

Two state agencies in Oregon are currently determining rules to enforce a temporary ban on the sale of flavored vaping products.

On October 4, Oregon Gov. Kate Brown ordered “state agencies to enact a temporary ban on the sale of flavored vaping products.” Although the Oregon Health Authority (OHA) and the Oregon Liquor Control Commission have yet to enact a ban, rules are expected to be published in the second week of October.

In her executive order, Brown alluded to an “epidemic” among youth using electronic cigarettes and vaping devices, and addressed recent vaping-related hospitalizations and possible deaths. Two such deaths have been reported in Oregon.

Although addressing youth use of age-restricted products is laudable, flavor bans are ineffective measures to reduce youth e-cigarette use. Further, many state health departments and the Centers for Disease Control and Prevention (CDC) have linked a majority of vaping-related lung injury cases to the use of illicit and unregulated vaping devices containing tetrahydrocannabinol (THC).

The Heartland Institute examined the effects of flavor bans, finding these measures to have no impact on youth e-cigarette use. For example, Santa Clara County, California, banned flavored tobacco products to age-restricted stores in 2014. Despite this, youth e-cigarette use increased. In the 2015-16 California Youth Tobacco Survey (CYTS), 7.5 percent of Santa Clara high school students reported current use of e-cigarettes. In the 2017-18 CYTS, this increased to 10.7 percent.

Additionally, eliminating flavors will likely lead former smokers back to more harmful, combustible cigarettes. A 2018 survey of nearly 70,000 American adult vapers found flavors to be integral to e-cigarette use. In fact, 83.2 percent and 72.3 percent of survey respondents reported vaping fruit and dessert flavors, respectively. Further, only 20 percent of respondents reported using tobacco flavors at the point of e-cigarette initiation.

Despite the desire to address recent vaping-related hospitalizations, Oregon’s flavor ban will likely lead to even more hospitalizations because it does absolutely nothing to diminish use of the products causing the outbreak of hospitalizations: illicit THC products.

OHA has linked Oregon’s two deaths to such products. On September 3, OHA announced “the individual, who died in July, had recently used an e-cigarette or vaping device containing cannabis purchased from a cannabis dispensary.” On September 26, OHA announced the second Oregon death, stating it was “an individual who had been hospitalized with respiratory symptoms after vaping cannabis products.”

These findings are similar to an October 3 CDC report examining recent hospitalizations nationally. CDC was able to gather information on 578 of the supposed 1,080 hospitalizations. Of the 578 patients, 78 percent “reported using THC-containing products, with or without nicotine-containing products.” Further, only 17 percent of the 578 reported “exclusive use of nicotine-containing products.”

In 2007, electronic cigarettes and vaping devices debuted on the U.S. market. Since their introduction, e-cigarettes have helped an estimated three million American adults quit smoking. Moreover, until the past few months, e-cigarettes were not linked with any significant adverse health effects. Indeed, the American Cancer Society noted in June 2019 “e-cigarette use to be significantly less harmful for adults than smoking regular cigarettes … because e-cigarettes do not contain or burn tobacco.”

Even more alarming, although Brown wants to address youth use of e-cigarettes, Oregon directs very little of existing tobacco moneys to tobacco control programs. For example, in 1996, through Measure 44, “Oregon became the fourth state to enact a tobacco tax through an initiative.” Although public health groups claim sin taxes “discourage tobacco use,” Measure 44 directed a measly 10 percent of the revenue received from the tax increase to tobacco control programs. 

Further, Oregon first sued tobacco companies in 1997 and was a plaintiff in the 1998 Master Settlement Agreement (MSA). Under the MSA, the four largest tobacco manufacturers must pay the suing states annual payments in perpetuity. The payments are based on tobacco sales; smokers are essentially paying the MSA payments to the states. From 1999 and 2016, Oregon “received $1.4 billion in MSA payments.”  Even more alarming, in 2019, Oregon received an estimated $338.8 million in MSA payments and tobacco taxes, yet the state dedicated only $10 million, or 0.02 percent, to tobacco control programs.

It is ludicrous for lawmakers to restrict adult access to tobacco harm reduction products. Flavor bans will not reduce recent vaping-related illnesses. Moreover, if lawmakers truly care about youth e-cigarette use, they should dedicate more than 0.02 percent of already existing tobacco moneys to education and prevention programs.

The following articles provide more information on e-cigarettes and tobacco harm reduction.

Tobacco Harm Reduction 101: A Guidebook for Policymakers
https://www.heartland.org/publications-resources/publications/latest-heartland-policy-booklet-addresses-vaping-myths
This booklet from The Heartland Institute aims to inform key stakeholders on the much-needed information on the benefits of electronic cigarettes and vaping devices. Tobacco Harm Reduction 101details the history of e-cigarettes, including regulatory actions on these products. The booklet also explains the role of nicotine, addresses tax policy and debunks many of the myths associated with e-cigarettes, including assertions about “popcorn lung,” formaldehyde, and the so-called youth vaping epidemic.

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.

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.

Research & Commentary: Centers for Disease Control and Prevention Link Major of Vaping-Related Hospitalizations to THC Product
https://www.heartland.org/publications-resources/publications/research--commentary-centers-for-disease-control-and-prevention-link-majority-of-vaping-related-hospitalizations-to-thc-products
In this Research & Commentary, Heartland State Government Relations Manager Lindsey Stroud examines the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report which found nearly 77 percent of vaping-related hospitalizations are due to the use of tetrahydrocannabinol products. These findings are similar to what have been reported in other states, including Connecticut, Oregon, Texas, and Utah.

Research & Commentary: Flavor Bans Do Not Reduce Youth E-Cigarette Use
https://www.heartland.org/publications-resources/publications/research--commentary-flavor-bans-do-not-reduce-youth-e-cigarette-use
In this Research & Commentary, State Government Relations Manager Lindsey Stroud examines the California Youth Tobacco Survey results from 2017-18, finding youth vaping has increased in several California localities that have restricted access to flavored tobacco product. Stroud finds youth vaping has increased in both Santa Clara and Contra Costa counties. Stroud also notes that banning flavored e-cigarettes is likely to reduce the number of adult smokers switching from combustible cigarettes to tobacco harm reduction devices, and could lead former smokers back to cigarettes.

Research & Commentary: Qualitative Study on E-cigarettes Shows More Evidence of Tobacco Harm Reduction
https://www.heartland.org/publications-resources/publications/qualitative-study-on-e-cigarettes-shows-more-evidence-of-tobacco-harm-reduction?source=policybot
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud examines a study, published in The International Journal of Environmental Research and Public Health in June 2016, that provides additional evidence showing e-cigarettes and vaporized nicotine products (VNPs) are an effective tobacco harm-reduction tool.

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 Heartland’s government relations department, at governmentrelations@heartland.org or 312/377-4000.