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Research & Commentary: ‘Vaping 21’ Laws Favor Cigarettes over Tobacco Harm Reduction

March 6, 2019

Legislation restricting access to vaping products, yet not combustible cigarettes, is a disservice to public health.

By the end of February 2019, more than 200 bills had been introduced in multiple states aimed at regulating, taxing, or prohibiting e-cigarettes.

In response to media campaigns by the U.S. Food and Drug Administration and U.S. Surgeon General, state lawmakers have introduced flavor bans, draconian taxes, and proposals to restrict access to tobacco products to persons 21 years old or older.

Strangely, legislators in Connecticut, Iowa, and Nebraska are proposing to increase the age to purchase e-cigarettes and vaping devices from 18 to 21, but they are not proposing a similar increase to the age required to purchase combustible tobacco cigarettes—even though these products are significantly more harmful. The fact that state lawmakers would restrict access to less harmful cigarette alternatives while allowing access to their more harmful counterparts indicates many lawmakers don’t understand how effective e-cigarettes are as a tobacco harm reduction product.

Since their introduction to the U.S. market in 2007, electronic cigarette devices have helped an estimated three million U.S. adults quit smoking combustible tobacco cigarettes. A 2019 study found e-cigarettes are “twice as effective” as traditional nicotine replacement therapy in helping smokers quit.

Despite being unable to advertise reduced harms, many public health groups have found e-cigarettes to be substantially less harmful than traditional tobacco cigarettes, including Public Health England; Royal College of Physicians; National Academies of Sciences, Engineering, and Medicine; and the American Cancer Society. Even Mitch Zeller, director of the Center for Tobacco Products at the U.S. Food and Drug Administration, has noted that people switching from combustible cigarettes to e-cigarettes “would be good for public health.”

The numerous bills proposed in states across the country were crafted in response to a campaign based on only one year of youth vaping data, which are, at best, questionable. While the data indicate youth vaping increased from 2017 to 2018, the data from both the “2018 National Youth Tobacco Survey” and the “2018 Monitoring the Future Survey” are unclear and should not be used as a basis for public policy decisions. For example, the authors of both studies found an increase in youth who reported vaping more than one time per month, but the data did not distinguish between a person who reporting vaping twice in a single month and those who might have vaped every single day for several months.

The evidence overwhelmingly shows that there is no reason to believe a large proportion of young people use electronic cigarettes then transition to combustible tobacco cigarettes. According to Dr. Michael Siegel, a professor at the Boston University School of Public Health,  a January 2019 study in the Journal of the National Cancer Institute “found no evidence that vaping is a gateway to smoking among youth.” Siegel found the authors of the study “were unable to report a single youth out of the 12,000 in the same who was a cigarette naïve, regular vaper at baseline who progressed to become a smoker at follow-up.”

Siegel also found that while “ever use of e-cigarettes increased the risk of smoking initiation, recent use of e-cigarettes (within the past 30 days) did not increase the risk of smoking.” It is important for lawmakers to understand that this finding is significant, as “the most definitive study to date of the [youth] issue fails to provide any evidence to support that” youth e-cigarette use leads to combustible tobacco cigarette use.

While restricting minors’ access to e-cigarettes is a laudable goal, lawmakers should understand the e-cigarette industry does not want kids to use their products and that they have made numerous efforts to keep young people away from their products. For example, associations such as the Smoke Free Trade Alternatives Trade Association and the Consumers for Smoke-Free Alternatives Association, which represent vape shops and e-cigarette users, respectively, support legislation that restricts youth e-cigarette access.

E-cigarettes are a less harmful alternative to smoking and can save states money by reducing health care costs associated with smoking. They also strengthen economies by providing growing business opportunities.

Rather than regulating tobacco harm reduction products into extinction, lawmakers should promote their use as an alternative to combustible cigarettes.

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: Vaping Taxes and Bans Hurt Smokers Trying to Quit
https://www.heartland.org/publications-resources/publications/research--commentary-vaping-taxes-and-bans-hurt-smokers-trying-to-quit
In this Research & Commentary, Heartland Institute Senior Policy Analyst Matthew Glans and State Government Relations Manager Lindsey Stroud examine vaping bans and taxes and consider how such measures block or limit what is for many smokers an effective method for halting the use of tobacco cigarettes.

Research & Commentary: Randomized Trial Finds E-Cigarettes Are More Effective Smoking Cessation Tool Than Nicotine Replacement Therapy
https://www.heartland.org/publications-resources/publications/research--commentary-randomized-trial-finds-e-cigarettes-are-more-effective-smoking-cessation-tool-than-nicotine-replacement-therapy
Lindsey Stroud, a State Government Relations Manager at The Heartland Institute examines a study in The New England Journal of Medicine that finds e-cigarettes and vaping devices to be twice as effective as nicotine replacement therapy (NRT) in helping smokers quit cigarettes. Nearly 700 participants were studied over a 52-week period, with researchers finding that 18 percent of e-cigarette users reported abstinence, compared to 9 percent of those using NRT. Stroud writes that “these latest findings provide more valuable information on the public health role that e-cigarettes and vaping devices provide for the 38 million cigarette smokers in the United States,” an implores policymakers to regulate these devices in a way that promotes their usage.
 

Research & Commentary: Study Finds E-Cigarettes Would Prevent 6.6 Million Premature Deaths
https://www.heartland.org/publications-resources/publications/research--commentary-study-finds-e-cigarettes-would-prevent-66-million-premature-deaths
Heartland Institute State Government Relations Manager Lindsey Stroud examines an October 2017 Tobacco Control study that found electronic nicotine delivery systems (ENDS) might help extend life for millions of people. The authors of the study found there was an estimated 6.6 million fewer deaths and more than 86 million fewer-life-years lost over a ten year period because of ENDS products. Stroud concludes the use of ENDS could also help improve the budgets of numerous state programs, including Medicaid.

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, 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 Arianna Wilkerson, a state government relations manager at Heartland, at awilkerson@heartland.org or 312/377-4000.

Author
Lindsey Stroud is a state government relations manager at The Heartland Institute.
lstroud@heartland.org