Promoting a new position paper titled “WHO Position on Tobacco Control and Harm Reduction,” Director General Dr. Tedros Adhanom Ghebreyesus claims e-cigarettes aren’t promoting harm reduction, via transitioning smokers to a safer source of nicotine, but are instead encouraging a new wave of addiction among young people.  

Instead of switching to e-cigarettes or nicotine pouches, the WHO recommends smokers make use of quit helplines and nicotine replacement therapies. But both these methods have notoriously low success rates and are not readily available or affordable in low- and middle-income countries (LMIC) where the majority of smokers live. LMICs often lack the public health infrastructure of countries like the United Kingdom or New Zealand, which have independently and successfully embraced products like e-cigarettes for tobacco harm reduction. LMICs are often more reliant on bodies such as the WHO for health and regulatory advice, placing a great responsibility on these organizations to provide sound, evidence-based guidance.   

In 2019, the WHO congratulated India, where there are more than 250 million tobacco users and around one million tobacco-related deaths per year, for its ban on e-cigarettes. In 2024, the WHO honored Brazil’s National Health Surveillance Agency with an award for reaffirming a ban on e-cigarettes. E-cigarettes are also banned in Argentina, Thailand, Brazil, Vietnam, and Mexico, where more than 70 million tobacco users live. Cigarettes, which are by far the most dangerous way of consuming nicotine, remain legal in all these countries. 

The WHO paper doesn’t provide any evidence that e-cigarettes or nicotine pouches are, in fact, just as or more harmful than smoking. The safer profile of these products is not just some self-serving claim from the tobacco industry trying to sell these alternatives. That vaping is safer than smoking is acknowledged by some of the WHO’s largest funders, such as the United States, the United Kingdom, and Canada. These countries have different regulatory regimes for nicotine products, but all of their leading health agencies, the Food and Drug Administration, the Office for Health Improvement and Disparities, and Health Canada, agree that e-cigarettes are safer than cigarettes. The gold standard for evidence-based medicine, the Cochrane Review, consistently finds e-cigarettes to be more effective than nicotine replacement therapies for smoking cessation. 

The UK’s National Health Service (NHS) and Cancer Research UK consistently promote e-cigarettes to smokers, regularly debunking the myths that these products are just as or more dangerous than cigarettes. The NHS even offers some smokers free vape kits as part of its “swap to stop” initiative. 

These efforts are bearing fruit. Smoking rates in the UK have declined significantly since the rise of e-cigarettes. In November 2025, the number of vapers in the UK surpassed the number of smokers for the first time. The spread of e-cigarettes, nicotine pouches, and heated tobacco products has given tens of millions of smokers who want to quit— but have failed through other methods—an alternative. Sweden has the lowest smoking and lung cancer rate in Europe because those who wish to use nicotine typically choose snus, an oral nicotine product that doesn’t involve combustion or inhaling smoke. 

There is also a wide-ranging body of evidence demonstrating that the kinds of restrictions Tedros is calling for, whether in the form of higher taxes or bans on e-cigarette flavors consumers prefer, result in more smoking of traditional cigarettes. That’s not a prescription for better public health.

Despite the overwhelming evidence that vaping is dramatically safer than smoking, the WHO persists in its demands that if countries don’t ban e-cigarettes outright, they should be subject to the same taxes and regulations as cigarettes. It should be commonsensical that products presenting vastly different risks should be regulated differently. But the WHO’s advice to put vapes, nicotine pouches, and other nicotine alternatives on a level playing field with cigarettes, if implemented in more countries, will only prolong and sustain death and disease among smokers who want to quit but don’t have the right options that might help them succeed. 

The post Why the World Health Organization’s anti-nicotine policy could keep millions smoking appeared first on Reason Foundation.

The latest National Youth Tobacco Survey found that 5.9 percent of middle and high school students were using e-cigarettes in 2024, down from 7.7 percent in 2023 and the lowest level of youth use recorded in a decade, and nothing close to what could reasonably be described as an epidemic. Rather than using the notion of a “child vaping epidemic” to justify tighter restrictions, Makary should focus on the 28.8 million adult smokers who face the most significant health risks and expand the number of FDA-authorized alternatives that can help them transition from combustible cigarettes to far less harmful products. 

Why weren’t the needs of adult smokers mentioned in this interview? Makary’s one-sided treatment of the issue contrasts sharply with Health and Human Services Secretary Robert F. Kennedy Jr., who, speaking only days before Makary, made clear that while shrinking the illicit vape market and protecting youth is a top priority, nicotine itself is not a carcinogen and products like e-cigarettes and nicotine pouches are “infinitely preferable to smoking.” 

As Makary’s own agency acknowledges, nicotine products exist on a continuum of risk, and not all carry the same level of harm. Combustible cigarettes remain the most dangerous form of nicotine use, while other products present far fewer health risks and can play a valuable role in helping adults quit smoking. Alternatives such as e-cigarettes are not risk-free, but they are significantly less harmful than smoking and help those who are not able to quit with nicotine replacement therapies like gums, lozenges, or patches. Supporting these options is a step toward better health outcomes, especially when the alternative is continuing a behavior that causes severe and preventable disease.

Many adult smokers remain unaware that switching completely to e-cigarettes can substantially reduce their exposure to harmful chemicals. A recent survey found that only about one in five U.S. smokers believes e-cigarettes contain fewer toxic chemicals than cigarettes, and even fewer recognize them as less dangerous. This knowledge gap persists despite endorsements from respected medical journals and conclusive evidence that complete substitution lowers toxicant exposure. If Makary is serious about reducing smoking-related deaths, part of his focus should be on correcting these misperceptions through targeted, evidence-based public education for adult smokers. 

The National Institutes of Health and Cochrane Review have found ample evidence through systematic reviews of randomized controlled trials illustrating that those who use e-cigarettes are more likely to stop smoking for at least six months when compared to those who use traditional nicotine replacement therapies. Despite strong evidence and endorsements from some of the most respected medical journals, U.S. policy continues to heavily restrict e-cigarettes through product bans, flavor prohibitions, and limited market authorizations. This stubbornness on e-cigarettes often ends up causing an uptick in tobacco sales. 

On The Conversation, Makary focused particularly on the problem of illicit disposable products imported from China and framed the issue primarily around youth use, which, as noted, is at an all-time low. The problem with focusing on the illicit market is that this problem itself stems from federal policy choices that limit the legal market. When FDA authorizations exclude the products that adult users prefer, such as certain flavors, device types, and nicotine strengths, consumers are more likely to turn to the unregulated market.

Economic and policy research shows that restrictive measures often fail to reduce use as intended. A Yale School of Public Health study found that local flavor bans reduced e-cigarette sales but increased cigarette purchases, calculating that for each 0.7 ml of e-liquid sales suppressed, an additional 15 cigarettes were sold. In areas with flavor restrictions for more than a year, adult-preferred cigarette brand sales rose 10 percent, and brands popular with underage users rose 20 percent.

The policy takeaway is clear: To reduce the spread of illicit products and improve public health outcomes, the FDA should authorize a broader range of regulated, appealing alternatives. When adult smokers have access to legal options that match their preferences, the economic incentives for illicit trade diminish. 

Efforts that focus only on cracking down on illegal supply while limiting lawful access will continue to drive consumers toward unregulated products, undermining both safety and public health goals. Mackary’s call for collaboration and evidence-based regulation should fully extend to vaping policy, replacing fear-driven narratives with strategies grounded in public health evidence and economic insight.

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This proposed rule would ban the sale of more than 99.9 percent of cigarettes currently sold in the U.S. by demanding tobacco companies remove almost all of the nicotine from their cigarettes. Banning an addictive product used daily by almost 30 million adults and worth tens of billions of dollars is replete with risk.

The U.S. cigarette market is a valuable prize for China and Mexican cartels seeking to diversify their revenue sources. Chinese cigarettes are products of the China National Tobacco Corporation. This state-owned monopoly generates between nine and 12 percent of the CCP’s revenue, making it one of the largest companies in China. A cigarette ban could increase these revenues as the Marlboro man disappears in favor of brands such as Chunghwa and Hongtashan smuggled in through American ports of entry.

No other country has yet experimented with a mandatory nicotine reduction in cigarettes. New Zealand passed legislation in 2022 enacting the same policy, but it was repealed before it could come into effect after the election of a conservative government.

A few places have banned tobacco outright, with predictably disastrous consequences. The Kingdom of Bhutan was the first to do so in 2004 and was widely praised by bodies such as the World Health Organization (WHO). In 2021, the ban was repealed after smoking among youths rose and a profitable black market developed. During the COVID-19 pandemic, South Africa banned tobacco, but there was no significant reduction in smoking because illicit cigarettes flooded in from neighboring Zimbabwe.

A ban on cigarettes isn’t just counterproductive; it’s unnecessary. A “smoke-free country” is classified by the WHO as one where fewer than five percent of the population smokes. The U.S. has already achieved a nearly smoke-free generation with its youths, with just 1.4 percent of middle and high school kids saying they’ve tried a cigarette in the past 30 days. There is universal knowledge of the dangers of smoking. Cigarettes are taxed and highly regulated, and there are hardly any public places left in the U.S. for smokers to light up indoors.

For those smokers who would like to quit but so far have not been able to do so, it’s carrots, not sticks, that should be on the FDA’s agenda. The FDA should inform smokers that they can still get the nicotine they want without the smoke that may kill them if they switch to an e-cigarette, nicotine pouch, or heated tobacco product. All these products are vastly safer than cigarettes and could save millions of lives. Thanks to a combination of media misinformation and the FDA’s failure to provide the public with accurate information, a majority of the public and smokers believe alternatives like e-cigarettes are just as or more dangerous than smoking. 

Because the FDA failed over the past four years to authorize a sufficient number of American e-cigarettes for sale, a wave of illicit and unregulated vapes from China flooded in to satisfy consumer demand. Should the FDA achieve its goal of banning cigarettes, there’s little doubt what happened in the vape market will be repeated, only on a significantly larger scale.

The past four years of the FDA’s tobacco regulation resulted in a chaotic marketplace rife with illegally imported products, American companies fighting for years for their products to be authorized, growing misperceptions of the risks of different nicotine products, and the FDA having to defend itself in front of the Supreme Court for refusing to authorize e-cigarettes in non-tobacco and menthol flavors.

President-elect Trump’s new administration will inherit an unenviable state of affairs. However, there is also a significant opportunity to correct previous errors. The FDA’s rule to slash nicotine in cigarettes should be abandoned, and the agency should instead focus on protecting public health by providing accurate information about safer alternatives for smokers trying to quit and ensuring a well-regulated marketplace that is less vulnerable to smugglers and criminal networks.

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The economic and employment impacts of the FDA’s rule could be devastating for many. The FDA is justifying this rule with a model of projected benefits that claims to prevent 48 million youth and young adults from starting smoking by the year 2100 and lead to 12.9 million Americans quitting smoking one year after the rule is implemented.

So, is such a radical and unprecedented policy worth it to achieve such enormous public health benefits, and is it likely to be as successful as the FDA projects? In a word, no.

America’s youth smoking rate is already one of the lowest in the world. Only 1.4 percent of middle and high school students tried a cigarette in the past month, a decline of almost 60 percent from 2020, which was the year the FDA chose to derive its inputs on youth smoking for its model of projected benefits. The FDA’s model, primarily based on eight experts guessing what they believe will happen in response to the policy, assumes the policy will be implemented in 2027, a year in which it’s not unrealistic to assume youth smoking could already be statistically indistinguishable from zero. If that is indeed the case, then the FDA’s model will have massively overshot the projected benefits of preventing youth from picking up smoking, and the policy will be focused entirely on removing choice from adult smokers.  

However, there are still further assumptions in the FDA’s plan that are unlikely to materialize. According to the FDA, when the ban on regular cigarettes comes into effect, around half of smokers will switch to safer nicotine alternatives like e-cigarettes, nicotine pouches, and heated tobacco. The success of the FDA’s plan in large parts depends on a competitive market in these products that consumers find satisfying and know are safer than smoking cigarettes.

“The FDA also recognizes the importance of ensuring broad and equitable access to all the tools and resources that can help smokers quit,” Brian King, head of the Center for Tobacco Products at the FDA, told journalists in a press conference announcing the rule.

The deep irony is that for the last four years, the FDA has been denying smokers access to the most effective tools for quitting, namely e-cigarettes, by banning most of the domestic vape market. A flood of vapes from China has come to fill the gap, which the FDA is now desperately trying to interdict with the help of other agencies.

Despite an overwhelming amount of evidence on both the relative safety of e-cigarettes and their effectiveness in helping smokers quit, the majority of the public still believes these products are no different from regular cigarettes.

The gap between reality and public misperception indicates the FDA’s failure to communicate accurate information, especially when understanding such information is critical to the success or failure of the biggest prohibition in the agency’s history and the largest in America since the 1970s.

The FDA’s model gives short shrift to the idea there will be a substantial illicit market for cigarettes. With almost 30 million smokers and a market worth tens of billions, the FDA is betting that criminals won’t capitalize on an opportunity to meet demand as they have with vapes and illicit drugs. It’s a bold assumption that goes against the grain of history and experience. When South Africa banned cigarette sales during the COVID-19 pandemic, most smokers continued using cigarettes smuggled in from neighboring countries despite prices soaring 240 percent.  

Hopefully, the incoming Trump administration will force the FDA to detach itself from abstract models based on guesswork and instead pursue tried and proven strategies to help those smokers who wish to quit do so.

The post FDA’s fantasy modeling doesn’t justify ban on cigarettes appeared first on Reason Foundation.

Flavored tobacco is allegedly responsible for a litany of harms, including an ”epidemic” of youth use. Advocates claim banning these products will have few to no negative consequences. But since then-Mayor Michael Hancock vetoed the last ban in 2021, the picture of tobacco use in Colorado and across the country has changed dramatically, and a ban now makes even less sense.

According to the Healthy Kids Colorado Survey (HKCS), vaping among high schoolers fell 46 percent from 16.1 percent in 2021 to 8.7 percent in 2023. Youth smoking remains low at 3.1 percent. Even among the minority of youth who vape, only one in five say they do so because they’re available in flavors, whereas 52 percent do so because a friend or family member used them. Among those who smoke cigarettes, a minority of 30 percent use menthol cigarettes. 

For context, 12 percent of Colorado high schoolers binge drink at least once a month, and 13 percent use marijuana, according to HKCS. However, proposals to ban pineapple-flavored hard seltzers or blackberry banana kush have not been forthcoming from the Denver City Council. According to the 2024 National Youth Tobacco Survey, youth tobacco use nationwide is at a 25-year low, an achievement won within the framework of a legal and regulated marketplace.  

Because youth tobacco use is plummeting, it’s worth noting that bans on flavored products may backfire and increase smoking. Bans on all flavored tobacco products, including flavored e-cigarettes, actually increase the number of cigarettes purchased. According to a 2023 study by researchers at Yale, Georgetown, and the University of Missouri, for every flavored e-cigarette pod not sold because of a flavor ban, 12 additional cigarettes are sold. Since e-cigarettes are significantly safer than combustible cigarettes, as the Food and Drug Administration (FDA) acknowledges, and are the most popular method for quitting smoking, flavor bans represent a significant threat to public health. 

“There’s unintended negative effects that are really important to think about,” said Michael Pesko, who co-authored the research, commenting on a similar proposal in Kansas City, Missouri. The Kansas City Council decided to hold the ban for further study.

Flavored tobacco bans can also come at a hefty financial price. When Massachusetts became the first state to ban flavored tobacco products in 2020, it lost $125 million in cigarette and smokeless tobacco revenue in the first fiscal year, as purchases of cigarettes and other tobacco products soared in neighboring New Hampshire and Rhode Island. Some small businesses, such as hookah lounges, face the threat of closure because almost all hookah is flavored.

Perhaps the most troubling aspect of Denver’s flavor ban is that it would deny residents access to products the FDA has authorized as “appropriate for the protection of public health.” The FDA has authorized 34 e-cigarette products for sale, some menthol-flavored, as well as several smokeless tobacco products and heated tobacco products in a variety of flavors. The agency authorized these products because, after an extensive review, they found that they were beneficial to public health because they are safer than cigarettes, help smokers quit, and do not have any significant appeal to youth.

Prohibitions always have a superficial appeal but are often not evidence-based policies. Instead, “evidence” is mustered to support a preordained conclusion. Betting on prohibition to deliver a safer, healthier future for kids has a poor record. The Denver City Council should avoid making a costly mistake and reject a tobacco flavor ban.     

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A fundamental argument from special interest groups supporting the banning of menthol cigarettes is that they pose a danger to youth above and beyond that of regular cigarettes because they more easily entice them to start smoking and become dependent. However, new research finds this argument lacking.

Our recent Reason Foundation study determined whether menthol cigarette sales led to higher rates of youth smoking than non-flavored cigarette sales. It evaluated the relation to smoking rates among adults and youth. State-level wholesale cigarette data from 2008 to 2020 was used to compare the number of actual packs sold, whether menthol or regular cigarettes, to the government’s estimates of past 30-day smoking rates.

States with more menthol cigarette consumption relative to all cigarettes generally had lower rates of both adult and youth smoking. Montana, for example, had the highest youth smoking rate in the country but the lowest share of menthol sales as a percentage of the total cigarette market.

On the other side of the coin, Hawaii had the highest percentage of menthol cigarettes sold but the second-lowest youth smoking rate in the country.

Data is also disproving the argument that menthol is more addictive. Menthol smokers use fewer cigarettes per day, and data from Vanderbilt University Medical Center shows no difference in the quit rates between menthol smokers and non-menthol smokers.

Today, youth smoking in America is minimal, with fewer than two percent of kids puffing on a cigarette in the past month, according to the Centers for Disease Control and Prevention. But banning millions of adults from their products of choice would help fuel the illicit tobacco market, handing a massive profit opportunity to criminal entities, especially Mexican cartels. If the menthol ban moves forward, overstretched border and law enforcement officers will likely soon find themselves spending more of their resources to police an influx of tobacco products. There are, however, cheaper and less costly alternatives to the prohibition being pushed on the administration.      

Brian King, head of the Food and Drug Administration’s (FDA) Center for Tobacco Products, acknowledges the widespread misperceptions around the risks of vaping compared to smoking but has taken no action to correct them. The FDA’s lack of interest in the health benefits of vaping over smoking is incredibly discouraging.

For example, the prestigious Cochrane Review found e-cigarettes to be significantly more effective in helping smokers quit than traditional nicotine replacement therapies such as nicotine patches. Absent concerted efforts to inform and incentivize menthol smokers to switch to less harmful nicotine alternatives, a prohibition will undoubtedly enlarge the already substantial illicit tobacco market as it has in other countries that have experimented with menthol bans.    

Rejecting or accepting a menthol ban should be based on the evidence, health benefits and relevant tradeoffs involved. President Biden shouldn’t be cowed by bureaucrats at the FDA or single-issue pressure groups into a policy blunder that would not produce significant health benefits while costing state and federal revenue and increasing crime and policing in minority communities.   

With youth smoking almost eliminated in the United States, cigarette advertising already banned, tobacco taxes at record highs, and a proliferation of safer alternatives to smoking available and being developed, the case for a new era of cigarette prohibition is weaker than at any time in recent history. But, the risk of unintended consequences of a menthol ban, particularly in minority communities where we can expect the illicit market to be concentrated, is still very real.

The post Biden administration should reject the proposed menthol ban appeared first on Reason Foundation.

The FDA rule banning flavored cigars, introduced on April 28, 2022, would also prohibit menthol cigarettes. The rule currently sits with the U.S. Office of Management and Budget (OMB), which is responsible for reviewing the costs and benefits of the policy before it’s sent back to the FDA to be finalized. The rule could be finalized in the coming days.

The FDA claims flavored cigars are an incredibly enticing prospect for kids, and to mitigate the risks of youth smoking, these products should be banned. If there ever was any truth to this claim in the past, it’s certainly not the case today.

According to the 2023 National Youth Tobacco Survey by the Centers for Disease Control and Prevention, just 1.8 percent of high school students have puffed on a cigar in a given month. These numbers are dramatically lower than other substances kids shouldn’t be using, such as alcohol or marijuana, clocking in at 22.7 and 15.8 percent, respectively. Tobacco researchers consistently find that the overall use of cigars is both low and almost entirely confined to adults. 

“We presented evidence to OMB that FDA’s proposed flavored cigar ban dramatically fails to meet the criteria necessary for such a ban under the Tobacco Control Act, offering little or no public health benefit while having a devastating economic impact on the industry,” said CAA President David Ozgo in a statement.

Massachusetts and California are the only states to have banned flavored tobacco products. But neither state saw sufficient reasoning for a total ban on flavored cigars and made exceptions for these products based on the sale location or the price. 

A federal prohibition of flavored cigars would likely result in the same problems we expect to see from a ban on menthol cigarettes: a rise in illicit market sales trafficked from locations where the products are legal, such as Mexico. When combined with the proposed ban on menthol cigarettes, the prohibition of flavored cigars would give an enormous profit opportunity to cartels already engaged in drug smuggling, gun running, and human trafficking. 

“We are concerned that Mexican transnational criminal organizations, and other criminal elements, could seek to exploit black market opportunities that such policies could create. If FDA moves forward with such policies, it must take steps to mitigate this risk,” Sens. Marco Rubio (R–FL), Bill Cassidy (R–LA), Ted Budd (R–NC), and Bill Hagerty (R–TN) wrote to FDA Commissioner Robert Califf in July. 

These concerns are well-justified, but the senators will indeed end up disappointed by any potential efforts to control the illegal tobacco market. Just as law enforcement has proven incapable of interdicting drug trafficking at the border, it’s doubtful the authorities will be able to cope with a fresh surge in new illicit products.

Tobacco prohibitions worldwide frequently fail to deliver on the benefits their advocates claim for them. Bhutan banned all tobacco in 2004 but abandoned prohibition in 2020 after the policy failed. South Africa banned tobacco during the COVID-19 pandemic and suffered a wave of smuggling. When the European Union banned menthol cigarettes, Poland, which had the biggest menthol market in the E.U., experienced no statistically significant change in cigarette consumption as smokers sourced cigarettes from neighboring countries or switched to non-menthol cigarettes.

With few to no public health benefits and significant risks of increasing the illicit market, it’s difficult to ascertain the administration’s rationale for banning flavored cigars. Adults who prefer a flavored cigar are not imposing significant health or fiscal costs on non-smokers.

The post A flavored cigar ban could cost 16,000 jobs, industry report finds appeared first on Reason Foundation.

The Family Smoking Prevention and Tobacco Control Act (TCA) of 2009 outlawed the manufacture, distribution, and sale of cigarettes with “characterizing flavors” other than menthol. Supporters of the TCA claimed cigarettes flavored like candy, fruit, and clove disproportionately appeal to minors, facilitating smoking initiation and dependence. As a result of the TCA, regulating tobacco products was, for the first time, put under the purview of the Food and Drug Administration (FDA).

Partly the result of an extraordinary alliance between Philip Morris and the Campaign for Tobacco-Free Kids, the TCA erected enormous regulatory barriers to introducing new tobacco products. Raising costs for competitors and banning flavors while exempting menthol cigarettes mainly appeased Philip Morris, the only tobacco company in favor of the bill. Tobacco control activists viewed the exemption of menthol as a missed opportunity and have long sought to convince the FDA to ban menthol cigarettes outright. The Biden administration is now intent on delivering this policy. When the TCA was being considered, the president of the Campaign for Tobacco-Free Kids (CTFK), Matthew Myers, explained why he opposed banning menthol cigarettes.“If you immediately withdrew a product, so many people use and are addicted to, you can’t say for certain what the reaction will be,” said Myers, who went on to warn that such a ban could lead to illegal trafficking.

Section 907 of the TCA authorizes the FDA to establish a product standard requiring tobacco manufacturers to eliminate menthol from their products if it is “appropriate for the protection of public health.”

To meet these criteria, the FDA must consider:

• The risks and benefits to the population as a whole, including users and non-users of tobacco products;
• The increased or decreased likelihood that existing users of tobacco products will stop using such products; and
• The increased or decreased likelihood that those who do not use tobacco products will start using such products.

To address these considerations, the Tobacco Products Scientific Advisory Committee (TPSAC), a creation of the TCA, was charged with reviewing the scientific evidence regarding menthol and recommending future regulation to the FDA. In 2011, the TPSAC published its review of menthol cigarettes, concluding that they have a negative effect on public health.

A separate review by the FDA published in 2013 found: “Menthol in cigarettes is likely associated with increased initiation and progression to regular use of cigarette smoking.” However, FDA’s evaluation found “little evidence to suggest that menthol cigarettes are more or less toxic or contribute to more disease risk to the user than nonmenthol cigarettes.”

Considering menthol cigarettes are not more dangerous than nonmenthols when it comes to their toxicological makeup, FDA must demonstrate why these products are deserving of prohibition compared to nonmenthol cigarettes, which are responsible for most smoking-related deaths and disease in the United States.

On April 22, 2022, the FDA announced it would pursue a ban on the sale of menthol cigarettes. The announcement came as new data from the 2021 National Youth Tobacco Survey (NYTS) revealed the current smoking rate among middle and high school students at a record low of 1.5%. Of those students who smoke, the majority, 61%, use nonmenthol cigarettes.

Nevertheless, claims made against menthol should be considered and reviewed to see if critics’ claims are borne out in the real world. Suppose the association between menthol cigarettes, increased youth initiation, and dependence is as strong as tobacco control activists suggest. In that case, there should be signs of it in the national data.

Employing National Survey on Drug Use and Health (NSDUH) data from the Substance Abuse and Mental Health Services Administration (SAMHSA) and industry distribution figures, Reason Foundation examined whether there was a strong positive relationship between the distribution of menthol cigarettes and youth cigarette smoking. The data covered all 50 states and Washington, D.C., for 2008–2020.

The resulting analysis found:

• States with more menthol cigarette consumption relative to all cigarettes have lower rates of child smoking;
• States with higher per capita distribution levels of cigarettes of all types have higher rates of both adult and child smoking;
• In general, the metric analyses show consistent nonpredictive relationships between relative menthol cigarette consumption rates and use of any age group; and,
• The only predictive relationship is between adult and child smoking rates, and since we do not expect children to cause their parents to smoke, we conclude that states with higher rates of adult cigarette smoking cause higher rates of youth use.

The data demonstrate that menthol cigarette distribution does not increase youth smoking initiation any more than regular cigarette distribution.

This study concludes that menthol cigarette availability does not pose a greater threat to public health than regular cigarette availability.

From these findings, we can infer that the best way to lower the youth smoking rate is to reduce the adult smoking rate in concurrence with the public health literature. But any consideration of menthol prohibition should be made in the context of extremely low youth use of the product, the lack of association between menthol use rates in states and youth smoking, the costs of enforcing prohibition, especially for minority communities, and other less costly ways of reducing smoking, such as increasing the availability of safer nicotine alternatives like e-cigarettes and traditional smoking cessation services.

Full Study: Menthol Myths Revisited

The post Study: Menthol cigarettes do not increase youth smoking more than other cigarettes appeared first on Reason Foundation.

The FDA recognizes a “continuum of risk” when it comes to nicotine products, with cigarettes being the most dangerous and products like e-cigarettes and oral nicotine being far less dangerous. To be sold in the United States, these nicotine products must apply to the FDA and be found to provide a net benefit to public health. The FDA has already authorized several such products, including e-cigarettes, snus, heated tobacco products, and products in flavors like menthol, mint, and wintergreen. 

Flavors and adult preferences 

• Most smokers who switch to safer nicotine alternatives use flavored products, a study in Nicotine & Tobacco Research finds. The FDA authorizes several of these products as appropriate for the protection of public health because they are safer than cigarettes, help smokers quit, and don’t increase youth use of nicotine.
• Another study in Nicotine & Tobacco Research shows that smokers who switch to e-cigarettes are likelier to quit smoking successfully when using a flavored product. 
• According to modeling cited by the FDA, almost half of the benefits of a policy banning menthol cigarettes would come from menthol smokers switching to safer nicotine products, like e-cigarettes, with menthol flavoring. 
• Survey data published in Addictive Behaviors shows that if flavored e-cigarette products were banned, 28 percent of vapers say they would still buy them on the black market. Almost 20 percent say if their preferred flavors were prohibited, they’d switch back to smoking cigarettes, which is significantly more dangerous than vaping.  

Youth vaping and unintended consequences of flavor bans

• While youth tobacco use is always of deep concern, fortunately, youth smoking is at a generational low of 1.6 percent in the United States, according to the Centers for Disease Control and Prevention, and youth vaping has fallen by more than 50 percent since its peak in 2019 to below 10 percent in 2022.
• According to the CDC, the primary reasons young people say they vape, include peer influence, curiosity, and stress—not flavors.
• Banning flavored nicotine products can produce unintended consequences. Yale University’s Abigail Friedman found that after San Francisco banned flavored products, the odds of San Francisco area youth smoking doubled.
• The Massachusetts Multi-Agency Illegal Tobacco Task Force claims the state’s flavored tobacco ban has created the need for harsher criminal penalties to help law enforcement deter the growing illicit market. The state also lost $125 million in tax revenue in the first year of the ban, according to the Tax Foundation. 

Key Takeaway

To maximize the benefits to public health, legislators should refrain from policies, like banning flavors, that decrease smokers’ interest in safer alternatives to cigarettes.

The post Flavored products play an important role in tobacco harm reduction appeared first on Reason Foundation.

The Illicit Market and Youth Smoking

Massachusetts’ ban on flavored tobacco products went into effect in June 2020. Jacob James Rich, a researcher with the Center for Evidence-Based Care Research at the Cleveland Clinic and a policy analyst at Reason Foundation, analyzed the ban’s impact by comparing cigarette sales in Massachusetts and its bordering states before and after the ban was implemented. His research found a net increase in cigarette sales of 7.2 million packs within Massachusetts and its bordering states in the 12 months after the ban (July 2020 to June 2021) compared to sales in the year leading up to the June 2020 ban.

Massachusetts saw a 15.6 million pack increase in non-menthol cigarette sales in 2021, likely due to smokers switching to other products after the flavored tobacco ban’s implementation. The following graphic illustrates Rich’s findings, broken down at the county level.

Additionally, with consumers turning to neighboring states and black markets, according to the Tax Foundation, Massachusetts lost $116 million in cigarette tax revenue in the first 12 months of the ban.

Massachusetts has the sixth-highest cigarette tax in the country and the third-highest rate of inbound cigarette smuggling. The state’s Multi-Agency Illicit Tobacco Task Force is seizing so many flavored tobacco products that their most recent report requested more space to store them and asked for new criminal penalties to make it easier for them to crack down on smuggling and those possessing flavored tobacco products with intent to sell.

A further increase in the price of cigarettes provides yet more incentives for cross-border smuggling of cigarettes from neighboring states with lower excise taxes. In addition to boosting the illicit tobacco market, those smokers who buy their cigarettes within Massachusetts would face a substantial increase in their cost of living. Because smokers are disproportionately from lower-income backgrounds, an increase in the cigarette tax is especially regressive. 

Furthermore, an additional cigarette tax is not required to deal with the problem of youth smoking, which is at a generational low. According to the Centers for Disease Control and Prevention’s (CDC) 2021 Youth Risk Behavior Survey, only 3.5 percent of Massachusetts high schoolers said they had smoked a cigarette in the past 30 days, and just 0.5 percent smoked frequently. Enforcement of the age of purchase for tobacco products and continued anti-smoking education is more than sufficient to end what little remains of youth smoking in the state.

In place of tax increases, Massachusetts could further reduce its already low adult smoking rate by implementing a strategy of tobacco harm reduction by ensuring safer nicotine alternatives authorized by the Food and Drug Administration, such as e-cigarettes and snus, are available to those adult smokers who want to quit. 

Premium Cigars

S.1848 would double the wholesale tax on cigars, including premium cigars. Given that the bill’s stated intent is to protect youth from nicotine, it’s unclear why premium cigars, which have almost no appeal to youth, are being targeted for such a large tax increase. According to the National Academies of Sciences, Engineering, and Medicine, past 30-day use of premium cigars among minors is 0.1 percent. 

While hazardous because of the process of combustion, premium cigars present little threat to public health due to the patterns of use among their smokers. In contrast to cigarette smoking, cigar use is an occasional behavior. Among premium cigar smokers, 60.3 percent reported smoking on only one or two days in the past 30 days, and just 7.6 percent smoke frequently. 

Raising taxes on premium cigars would not improve health outcomes for young people. Such a large tax increase would, however, have a substantial impact on Massachusetts cigar stores and lounges as customers likely turn to neighboring states to avoid substantial price hikes, as has been the case with cigarette smokers.

The post Massachusetts’ proposed cigar tax increase would not improve health outcomes appeared first on Reason Foundation.

In Sept. 2021, Utah banned the sale of e-cigarettes with a nicotine concentration higher than 3%, mostly in response to the rise in youth vaping. Most of the vaping market consists of e-cigarettes that have nicotine in the 4% to 6% range. Now, Utah’s Department of Health and Human Services (DHHS) is considering changes as part of a settlement resulting from a legal challenge by the Utah Vapor Business Association.

The proposed rule change would allow the sale of any e-cigarette authorized by the U.S. Food and Drug Administration (FDA), regardless of its nicotine strength. The FDA has already approved several e-cigarettes for sale that exceed Utah’s nicotine cap. 

Utah’s caps on nicotine in e-cigarettes limit the public health potential of e-cigarettes, which can be used to help smokers switch to safer options because e-cigarettes don’t provide the nicotine that a regular cigarette can deliver.

A study published in the journal Nicotine & Tobacco Research found that smokers who tried switching to vaping were far more likely to quit cigarettes when using a higher-nicotine e-cigarette than those of a lower strength. Research also suggests that limiting vapers to lower-nicotine vapes can lead them to vape more to get their desired nicotine. 

Some fear revising Utah’s nicotine limits could induce more young people to vape. Fortunately, there’s little reason to suggest this would be the case. Youth vaping has fallen by almost 50% across the country since 2019 despite 48 states having no limit on nicotine in e-cigarettes. Ensuring access to safer, effective alternatives for adult smokers need not and has not come at the expense of reducing youth vaping. 

There are around 170,000 smokers in Utah, and the state sees 1,300 smoking-related deaths each year. Whether intended or not, nicotine caps for e-cigarettes encourage smokers to continue using combustible cigarettes rather than switching to better alternatives. Utah’s rule is especially nonsensical given that no nicotine limits exist on other harm-reduction products like nicotine pouches. 

Utah has an opportunity to reduce the number of smoking deaths by revising restrictions on nicotine vapes while informing the public about the existence of these safer alternatives. E-cigarettes are safer than cigarettes because while nicotine may be addictive, it’s the burning of tobacco and the toxicity of the resulting smoke that makes cigarettes so lethal. Because there is no burning tobacco, e-cigarettes are dramatically less harmful. As public health researcher Michael Russell once said, “People smoke for the nicotine, but they die from the tar.” 

E-cigarettes aren’t just safer than traditional cigarettes; according to the most exhaustive reviews of the scientific evidence, they’re more effective in helping people quit smoking than nicotine replacement therapies, such as nicotine patches. If every smoker in America switched to vaping, the country could avoid 6.6 million premature deaths, according to a study in Tobacco Control. And for Utah, encouraging more smokers to switch to safer alternatives could dramatically reduce the state’s current annual 1,300 smoking-related deaths.

Reforming Utah’s unnecessary and outdated nicotine cap would save lives and accelerate the demise of traditional cigarettes. DHHS should be applauded for re-examining this issue, and state regulators should embrace the potential of vaping to improve public health. 

The post How Utah can reduce smoking-related deaths appeared first on Reason Foundation.

Since the FDA was tasked with regulating tobacco products in 2009, a host of safer nicotine alternatives to combustible cigarettes have entered the market. The FDA has authorized products like e-cigarettes, oral, and heated tobacco products, including some flavored products, as part of a harm reduction strategy so that smokers who are unwilling or unable to quit cigarettes through traditional methods can switch to safer forms of nicotine. 

But local authorities still have the power to ban these products despite having undergone extensive scientific review. Should localities decide to ban these products, smokers would be denied access to safer alternatives to cigarettes that have been demonstrated to help smokers quit. Preemptively reserving the power to prohibit categories of products to state legislatures avoids the unintended consequences of inconsistent local prohibitions, which can disrupt a state’s public health goals and distort the broader economy through increases in the illicit tobacco trade and pushing purchases to other jurisdictions.

How state preemption protects public health 

• Local governments that ban FDA-authorized products that are legally available in other jurisdictions deny residents the fundamental right to improve their health which could have negative impacts on the state’s overall healthcare spending.
• The overwhelming majority of adult smokers who switch to safer nicotine products to quit smoking use flavored products, several of which are authorized by the FDA as appropriate for the protection of public health.
• Survey data shows that 28 percent of vapers would source flavored products from the illicit market if banned, and almost 20 percent would switch back to smoking traditional cigarettes. 

Unintended consequences of local prohibitions

• Yale University’s research found that after San Francisco banned flavored tobacco products, the odds that San Francisco area youth would smoke increased. 
• A study of seven California cities with flavored tobacco sales restrictions found these bans were not associated with decreased youth e-cigarette use.
• Restrictive laws on safer alternatives to cigarettes can produce negative interactions between law enforcement and the public leaving police departments open to litigation.

Takeaway: To maximize the benefits to public health, state legislators should preemptively reserve their state’s right to regulate nicotine products.

The post State tobacco and nicotine preemption and public health promotion appeared first on Reason Foundation.

Since the Food and Drug Administration (FDA) was tasked with regulating tobacco products in 2009, a host of safer nicotine alternatives to cigarettes have entered the market, including e-cigarettes, modern oral nicotine, and heated tobacco. The FDA has authorized these products as part of a harm reduction strategy so that smokers who are unwilling or unable to quit cigarettes through traditional methods can switch to safer forms of nicotine. The FDA recognizes a “continuum of risk” in nicotine products, with cigarettes being the most dangerous and e-cigarettes, heated, and oral nicotine products being far less dangerous. 

Because these products are substitutes for traditional cigarettes and pose a fraction of the risk, it’s necessary to tax them differently. Cigarette taxes are often labeled “sin taxes,” but taxes on safer alternatives to cigarettes should be considered “virtue taxes,” as they penalize consumers for switching to safer products. Safer nicotine alternatives do not pose risks to bystanders through second-hand smoke, and they lower future healthcare expenditures on smoking-related diseases. Because smokers are disproportionately from lower-income backgrounds, taxes on safer nicotine alternatives don’t just disincentivize switching, they also represent a regressive form of taxation.

What is risk-proportionate taxation, and what are the benefits? 

• Taxing nicotine and tobacco products proportionate to their risk means taxes on safer products should always be substantially lower than those on cigarettes if they are to be taxed at all.
• The wider the tax gap between cigarettes and safer alternatives, the more smokers are incentivized to switch, improving their short- and long-term health. 
• Under a system of risk-proportionate taxation, regular smokers who switch from cigarettes to safer alternatives would save significant sums of money.

What are the costs of taxing safer nicotine products at the same rate as cigarettes?

• After almost a decade of empirical research, the evidence is clear that higher taxes on safer nicotine products like e-cigarettes result in more smoking of traditional cigarettes.
• For every e-cigarette pod unsold due to an excessive e-cigarette tax, 1.9 extra cigarette packs will be sold.
• For every three pregnant women who don’t use e-cigarettes due to increased taxes, one will smoke cigarettes instead, causing significantly more harm. 

Key takeaway

To maximize the benefits to public health and advance the economic well-being of consumers, policymakers should keep taxes on safer nicotine products lower than those on combustible cigarettes.

The post Taxes on tobacco alternatives undermine harm reduction efforts appeared first on Reason Foundation.

Cigarette smoking in the U.S. has decreased steadily over the decades. The most pronounced decline in smoking has been among young people, with just 1.6 percent of middle school and high school students saying they have smoked a cigarette in the past month according to the Centers for Disease Control and Prevention (CDC). Adult smoking has also collapsed to 11.5 percent, the CDC finds.

Despite these successes, there is a fresh impetus to ban menthol cigarettes on the alleged grounds that these menthol products are particularly attractive to youth, harder to quit, and increase health inequities. 

Of the small population of youth smokers, almost 60 percent use a non-menthol product, according to the CDC survey. While it’s true that the majority of black Americans who smoke use menthol products, black youth smoke at lower rates than other groups of young people, the CDC finds.

In fact, the American Cancer Society finds a major reason for the narrowing of cancer disparities between the black and white populations is that black Americans have quit smoking at a faster rate or have refused to start smoking in the first place in greater numbers than whites. And evidence from Vanderbilt University also shows no difference in quit rates between menthol and non-menthol smokers regardless of race. 

Criminal justice reforms and fiscal concerns 

• In 2020, Massachusetts became the first state to ban the sale of menthol cigarettes. Sales of cigarettes in the neighboring states of New Hampshire and Rhode Island skyrocketed, and Massachusetts lost $125 million in tax revenue in its 2021 fiscal year. However, Massachusetts’ smoking rate barely budged, with a decline of just 0.5 percentage points in 2021. 
• According to the Massachusetts Multi-Agency Illegal Tobacco Task Force, the menthol ban has created the need for harsher criminal penalties to help deter the growing illicit market, and it says more storage space needs to be leased to house confiscated products.  
• Because minority smokers disproportionately use menthol products, minority communities are acutely vulnerable to the illicit menthol market, which could increase police interactions between communities of color and law enforcement. 

A harm-reduction alternative to menthol prohibition

The U.S. Food and Drug Administration has authorized several e-cigarettes, oral tobacco, and heated tobacco products as “appropriate for the protection of public health” because they’re safer than cigarettes and help smokers quit. Allowing adults to use these products can reduce smoking rates more effectively than menthol bans, without unintended consequences.

Key takeaway

With adult and youth smoking rates reaching generational lows and still falling, there is little reason to risk the severe unintended consequences of using the blunt force of prohibition to reduce smoking rates further. 

The post Unintended consequences of proposed menthol prohibition appeared first on Reason Foundation.

The intention behind S299 to limit tobacco use, especially among youth, is to be applauded. However, the track record of such prohibitions should raise significant concern that the proposed ban would unintentionally promote inequalities in the criminal justice system, push New Jersey’s sales and tax revenue to other jurisdictions, and increase the illicit tobacco trade in the state while failing to improve public health. 

Case Studies: Massachusetts, Canadian Provinces, and the European Union

Massachusetts’ ban on flavored tobacco products went into effect in June 2020. My colleague Jacob Rich of the Center for Evidence-Based Care Research at the Cleveland Clinic analyzed the flavored tobacco ban’s impact by comparing cigarette sales in Massachusetts before and after the ban was implemented. His research found a net increase in cigarette sales of 7.2 million packs within Massachusetts and its bordering states in the 12 months after the ban (to June 2021) compared to sales in the year leading up to the June 2020 ban. 

Massachusetts experienced a 15.6 million pack increase in non-menthol cigarette sales in 2021, likely due to smokers switching to other products after the flavored tobacco ban according to the Tax Foundation. Massachusetts lost $125 million in tobacco tax revenue in its 2021 fiscal year.

Flavored tobacco bans in other countries have yielded similar unintended results. According to a study published by the Journal of Law and Economics, Canadian provinces’ menthol prohibition implemented from 2015-17 significantly increased non-menthol cigarette smoking among youths, resulting in no overall net change in youth smoking as they substituted products rather than quit. “Difference-in-differences models using national survey data return no evidence that provincial menthol cigarette bans affected overall smoking rates for youths or adults,” wrote the study’s authors. 

The world’s largest experiment in menthol prohibition is the European Union, which includes 27 countries and had a population of 447 million people as of 2020. The EU menthol ban became effective in May 2020. Before the ban, Poland had the largest menthol cigarette market in the EU, making up 28 percent of total menthol sales. An analysis of Poland funded by the Norwegian Cancer Society in partnership with the Polish Ministry of Health found no statistically significant decline in overall cigarette sales in Poland after the ban. “We find that menthol cigarette sales fell at least 97% after the menthol cigarette ban across Poland and standard cigarette sales replaced them,” wrote the study’s authors. 

Youth Cigarette Use and Criminal Justice Concerns

Advocates for the prohibition of menthol cigarettes correctly observe a disproportionate number of Black smokers choose a menthol product. It’s hoped the ban will dramatically reduce the Black smoking rate, especially among youth. Fortunately, youth smoking overall has fallen to a generational low, and the Black youth smoking rate in particular. According to the Centers for Disease Control and Prevention’s (CDC) 2021 High School Risk Behavior Survey, the smoking rate for Black and Asian youth in New Jersey was zero percent, and the smoking rate for white and Hispanic youth was 6.3 and 2.7 percent, respectively. The CDC’s National Youth Tobacco Survey shows that of the minority of youth who do smoke, 61.2 percent use non-menthol cigarettes. 

From a public health standpoint, it’s hard to ascertain why non-menthol cigarettes, which are equally dangerous, will not be subjected to prohibition, and menthol products will be especially as non-menthol cigarettes are more popular among both youth and adult smokers. Because menthol cigarettes are overwhelmingly the choice of Black smokers, prohibition will necessarily lead to a concentration of the illicit tobacco market in the Black community. Massachusetts is already experiencing demands for further criminalization to tackle the unintended consequences of prohibition. The state’s Multi-Agency Illicit Tobacco Task Force is seizing so many black market flavored tobacco products they’re requesting more space to store them and are asking for new criminal penalties to make it easier for them to crack down on the smuggling and those possessing flavored tobacco products with intent to sell.

When the Biden administration announced the possibility of a federal ban on menthol cigarettes, the American Civil Liberties Union and other civil rights groups warned prohibition could disproportionately impact people of color, trigger criminal penalties, and prioritize criminalization over public health and harm reduction. The National Organization of Black Law Enforcement Executives (NOBLE), Grand Council of Guardians (GCGNY), National Association of Black Law Enforcement Officers (NABLEO), and Law Enforcement Action Partnership (LEAP) have argued that prohibitions of all kinds disproportionately affect communities of color. 

In place of prohibition, New Jersey can further reduce its already low smoking rate by implementing a strategy of tobacco harm reduction by ensuring safer nicotine alternatives authorized by the Food and Drug Administration, such as e-cigarettes and snus, are available to those adult smokers who want to quit.

The post New Jersey’s S299 would bring the consequences of tobacco prohibition appeared first on Reason Foundation.

The FDA recognizes a “continuum of risk” when it comes to nicotine products, with cigarettes being the most dangerous and products such as e-cigarettes and oral nicotine being far less dangerous. To be sold in the U.S., these nicotine products must submit an application to the FDA and be found to provide a net benefit to public health. Several such products have already been authorized by the FDA, including e-cigarettes, snus, and heated tobacco products. Oral nicotine or nicotine pouches have gained increasing popularity among smokers wishing to switch to a safer form of nicotine. Nicotine pouches are small bags of non-tobacco-derived nicotine that the user places between the gum and lip. As there is no inhalation of tobacco smoke, nicotine pouches represent a dramatically safer alternative to combustible cigarettes.

Taxation Considerations

• Smokers who switch to nicotine pouches are dramatically reducing their risk of smoking-related disease, relieving the state’s healthcare system of future treatment for these conditions.
• Increasing taxes on nicotine pouches discourages smokers from switching to a less dangerous alternative. An optimal harm reduction strategy should ensure nicotine product users don’t face additional costs, so smokers have both a health and financial incentive to switch.
• Because smokers seeking to switch from cigarettes to nicotine pouches are disproportionately from low-income backgrounds, taxes on nicotine pouches are regressive in nature.

Flavor Restriction Considerations

• All nicotine pouches on the market are sold in flavors other than tobacco. Flavors are a key element in satisfying adult smokers. Research has shown that banning flavors in reduced-risk nicotine products, such as nicotine pouches, leads to increases in cigarette sales. A ban on non-tobacco flavored nicotine pouches is tantamount to a ban on the entire product category.
• Fortunately, youth interest in nicotine pouches is minimal, with just 1.4 percent of youth having tried a nicotine pouch in the past 30 days.

Takeaway: To maximize the benefits to public health, legislators should refrain from policies that decrease the appeal of nicotine pouches to adult smokers, either through price increases or flavor restrictions.

The post Modern oral nicotine and tobacco harm reduction appeared first on Reason Foundation.

A survey sent to “community leaders” by the New York Health Department asked, “What is your opinion about a policy that would end the sale of all tobacco products in New York within 10 years?” and, “What is your opinion about a policy that would ban the sale of all tobacco products to those born after a certain date? For example, those born after the year 2010 or later would never be sold tobacco.”

Tobacco prohibition is frequently considered necessary to save the next generation from smoking. A “smoke-free society” is defined by the European Union and the United Kingdom as fewer than five percent of the population smoking. By that definition, according to the Centers for Disease Control and Prevention, New York has already achieved a smoke-free generation. Just 4.2 percent of youth have reported smoking once in the past month, and just 0.6 percent reported smoking daily. A ban on all tobacco in 2023 instead aims at the choices of adult New Yorkers. 

This trial balloon by the Health Department suggests it would not just include cigarettes. It would also include premium cigars, used almost exclusively by adults, and safer nicotine products like e-cigarettes and oral nicotine products, several of which are authorized by the Food and Drug Administration as “appropriate for the protection of public health” because they are safer than cigarettes and help smokers quit. 

In 2020, New York banned the sale of flavored e-cigarettes. But prohibition hasn’t stopped the black market sale of these products. Last year, in the town of Auburn, the police department raided Mohamed Algamel’s smoke shop, seizing thousands of illicit vape cartridges and untaxed cigarettes. The illegal sale of flavored vapes is common across New York City’s bodegas, and New York is the top destination in the country for cigarette smuggling. 

Tobacco prohibitions are not novel in the United States, but these proposals by the Health Department would be the most radical. Research shows bans on products like these do not work.

In 2020, Massachusetts banned the sale of flavored tobacco products, including menthol cigarettes. Reason Foundation research found an explosion of cigarette sales in neighboring states like New Hampshire with lower tobacco taxes and no flavor ban after the Massachusetts ban.

Outside of the U.S., some countries have experimented with total tobacco bans, and the results are always the same. The Kingdom of Bhutan banned tobacco in 2004, and South Africa did the same in 2020 during the COVID-19 pandemic. Both countries suffered a massive increase in tobacco smuggling. A 2011 study in the International Journal of Drug Policy concluded that claims that Bhutan’s ban would “induce tobacco consumption to cease or nearly cease have not occurred.” Bhutan abandoned tobacco prohibition in 2020.  

Despite erecting fences and introducing military patrols on its border, South Africa failed to stem the flow of illicit cigarettes from neighboring Zimbabwe. South Africa lost between $300 and $500 million in tobacco taxes in a five-month period before prohibition was ended. A separate analysis of the ban found more than 90 percent of South Africa’s smokers surveyed continued to smoke after prohibition.

Supporters of tobacco bans in the United States often claim it is only sellers who would face penalties under any prohibition scheme. That is not true. Simply avoiding cigarette taxes is a Class E felony in New York City and can result in two-to-five years in prison. Prohibition always requires enforcement, and ordinary New Yorkers, not Big Tobacco executives, would suffer if cops are further deputized to be the tobacco police. Do we really need more Eric Garners?

In, Massachusetts, the state’s Multi-Agency Illicit Tobacco Task Force is seizing so many black market flavored tobacco products they’re requesting more space to store them and are asking for new criminal penalties to make it easier for them to crack down on the smugglers and buyers.

New York is furiously debating how to both control crime and get the state’s budget under control. Tobacco prohibition would worsen both problems, potentially costing the state $2 billion annually in tax revenue. Much loved institutions among New York’s cigar enthusiasts like Club Macanudo could see their doors close thanks to prohibition. Not to mention the dozens of premium cigar shops across the state selling products that have nearly zero appeal to youth.

Data from failed prohibition efforts show that banning tobacco products would hurt New York’s consumers, fail to produce the promised positive health outcomes, and increase law enforcement presence in minority communities.

The post New York Gov. Hochul should learn from failed tobacco bans appeared first on Reason Foundation.

In the summer and fall of 2019, there was a spate of 2,739 lung injuries and 68 deaths related to vaping. The outbreak was a surprise. Nicotine vaping products had been available on the U.S. market since 2007 and in large parts of the world, yet no similar incidents had been recorded. Patients suffering from these injuries were mostly in their late teens and twenties and reported vaping illicit cannabis oils. State health departments quickly found a recurring ingredient in the cannabis oils they were testing, vitamin E acetate. 

Vitamin E acetate, a thickening agent, was being used by black-market cannabis sellers to dilute their products and extend their supply. Vitamin E acetate was not found in any legally sold nicotine e-cigarettes. But as more cases emerged, the CDC’s warnings didn’t distinguish between the dangers of illicit marijuana products and legally purchased nicotine vapes.

The CDC labeled the condition e-cigarette, or vaping, product use-associated lung injury, or EVALI. Marijuana vaping products are not referred to as e-cigarettes, a term used to describe the nicotine vaping devices many smokers use to quit cigarettes. A media frenzy surrounded the outbreak that reflected the lack of clarity from the CDC. Popular e-cigarette brands were shown in television news segments about sick or dying patients even though these brands did not produce e-cigarettes containing cannabis oils.

In September 2019, the CDC compounded its error by advising all Americans to refrain from vaping entirely, regardless of whether the product was nicotine or illicit cannabis oil. The problem with such overly broad guidance was that millions of Americans were using e-cigarettes to quit smoking or contemplating switching from smoking cigarettes to vaping nicotine. It took five months for the CDC to relent and drop its all-encompassing anti-vaping guidance in January 2020. But most of the public still blamed e-cigarettes for the EVALI outbreak rather than tainted cannabis oils.

Michael Pesko, one of the world’s most preeminent researchers on e-cigarettes, recently urged the House Energy and Commerce Committee to hold CDC accountable for the confusion. Pesko, associate professor of economics at Georgia State University, points to a petition of 75 scientists asking the CDC to rename EVALI. He co-authored an editorial in the journal Addiction, arguing public health officials need to correct the misinformation surrounding e-cigarettes. The CDC has, so far, refused to do so. 

The CDC’s EVALI response also compares poorly to that of Public Health England, which has since split into the United Kingdom Health Security Agency (dealing with pandemics) and the Office for Health Improvement and Disparities (dealing with things like vaping). In Oct. 2019, Public Health England informed the British public that the lung injuries in the United States resulted from illegal cannabis products, and their advice on e-cigarettes remained unchanged—while not risk-free, e-cigarettes are far less harmful than smoking.

A Cornell University study published in 2022 tried to quantify the public health damage done by the EVALI episode. Using a population health model, the report found:

“From our estimated e-cigarette demand models, we conclude that the information shock reduced e-cigarette demand by about 30 percent. We also estimate that the information shock decreased the use of e-cigarettes for smoking cessation, again by about 30 percent. Over time, the reduced smoking cessation due to the information shock will in turn increase smoking-related illness and death.”

The researchers estimated that 450,000 life years will be lost as a result of fewer smokers switching to e-cigarettes due to the information shock surrounding EVALI.

Chairman of the House Oversight and Accountability Committee Rep. James Comer (R-KY) recently informed the Food and Drug Administration (FDA) that his committee would investigate the agency’s bungling of tobacco regulations. “FDA must also clearly and accurately communicate information regarding the relative risk that products, to include ENDS and smokeless products, pose—and do not pose—to the adult nicotine product user population,” Comer wrote.

To correct the widespread misperceptions of nicotine vaping and ensure public health agencies don’t repeat past errors, Comer should extend his committee’s oversight to the CDC’s role in the EVALI crisis.

Without congressional oversight, there’s little chance the CDC will be held to account for its EVALI and vaping mistakes. If there’s no accountability, the agency is more likely to mislead the public again and worsen public health outcomes.

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