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Research & Commentary: Proposed Flavor Ban on Tobacco Harm Reduction Products Would Be Disservice to Public Health

January 3, 2019

California proposal to ban flavors in electronic cigarettes ignores public health groups' findings and threatens tobacco harm reduction.

Lawmakers in California have proposed legislation that would prohibit tobacco retailers “from selling, offering for sale, or possessing with the intent to sell or offer for sale, a flavored tobacco product.” The legislation would include banning flavorings in e-cigarettes and vaping devices, which are also called tobacco harm reduction (THR) products, and impose fines for failure to comply.

Lawmakers insist the legislation is designed to “curb the usage of [THR] products by young people.” While surveys indicate youth vaping in 2018 was higher than in 2017, much of the youth vaping data is inconclusive and relies on faulty information. For example, both the 2018 National Youth Tobacco Survey and the 2018 Monitoring the Future Survey found increases in youth vaping occurring more than one time per month, but this is a misleading figure because it doesn’t make clear whether a person vaped twice and then never vaped again or vaped multiple times per day every single day of the month.

More notably, youth combustible cigarette smoking is at an all-time low, with “only 3.6 percent of high school seniors smoking daily, compared to 22.4 percent two decades ago.” The often-repeated assertion youth vaping leads to the use of combustible tobacco in the future is not valid. As Campaign for Tobacco Free Kids points out, the U.S. high school smoking rate decreased from 2009 to 2016, from 17.2 percent to 7.6 percent, despite the fact that during this period, e-cigarettes became more widely available.

While preventing youth access is a laudable goal, California already has restrictions in place to do so. In 2016, the Golden State became the second state in the nation to increase the purchasing age of tobacco products, including THR products, from 18 to 21.

Vaping advocates overwhelmingly support banning the sale of e-cigarettes to minors. The Smoke Free Alternative Trade Association provides “Age to Vape” signage to vape shops endorsing local laws, “to show that [the] industry supports sensible age restrictions.” More than 1,300 companies participated in the program in 2015.

The Consumers for Smoke-Free Alternatives Association (CASAA) is another advocacy group that “supports laws that prohibit underaged sales and urges strict enforcement of laws” that ban access to e-cigarettes for young people.

Similarly, the Vapor Technology Association, which represents vaping manufacturers, requires members to “refrain from knowingly marketing Vapor Products to Minors, which is strictly prohibited.”

As a disruptive technology, e-cigarettes and vaping devices provide relief to millions of smokers as an effective cessation product. Flavors are necessary to THR. A 2016 CASAA survey of 27,343 e-cigarette users found 72 percent of respondents “credited tasty flavors with helping them give up tobacco.” In the largest vaping survey conducted to date, which consisted of nearly 70,000 American adult vapers, researchers found flavors play a vital role in the use of e-cigarettes. Nearly 95 percent of the respondents reported “that they were ever smokers,” and many cited using flavors at the point of initiation. There is real concern that should former smokers be forced to use only the flavors that simulate traditional tobacco cigarettes, they will return to cigarettes.

A 2015 R Street Policy Study concluded the presence of flavorings in electronic cigarettes greatly helps smokers quit using traditional tobacco cigarettes. The author notes that concerns over “flavoring as a tool to recruit children are overblown,” and the author states there is no “evidence that suggests children are drawn to tobacco products specifically because of flavor.”

Electronic cigarettes have been examined extensively over the past several years, and numerous public health organizations have found these products to be significantly less harmful than combustible cigarettes, with some urging their use as replacement for combustible cigarettes.

Numerous organizations including Public Health England, the National Academies of Sciences, Engineering, and Medicine, and the American Cancer Society have acknowledged the reduced harm of electronic cigarettes. In 2016, the Royal College of Physicians found the “long-term health risks associated with smoking [e-cigarettes] … are unlikely to exceed 5% of those associated with smoked tobacco products.”

Rather than limit THR products for the millions of adult smokers addicted to combustible cigarettes, policymakers should embrace and promote the use of e-cigarettes. These products have served as effective cessation devices that have been proven repeatedly to improve public health.

 

The following articles provide more information about e-cigarettes and 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.

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: Public Health Officials Urge Use of Electronic Nicotine Delivery Systems
https://www.heartland.org/publications-resources/publications/public-health-officials-urge-use-of-electronic-nicotine-delivery-systems
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud notes the importance of NHS Health Scotland’s joint statement encouraging the use of electronic nicotine delivery systems (ENDS) as an alternative to tobacco products. NHS Health Scotland, Public Health England, and other groups have found ENDS are 95 percent less harmful than tobacco 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.

Nicotine Without Smoke: Tobacco Harm Reduction
https://www.heartland.org/policy-documents/nicotine-without-smoke-tobacco-harm-reduction
This report provides an update on the use of tobacco harm reduction strategies related to non-tobacco nicotine products, particularly e-cigarettes. The authors conclude for all the potential risks involved, harm reduction has significant potential to prevent death and disability caused by tobacco use and to hasten the nation’s progress toward a tobacco-free society.

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, 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 Heartland’s state government relations manager, 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