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.

For as long as organized sports have existed, officials and players have attempted to profit by exploiting insider information or fixing games to win large sums of money. In 1978, Boston College basketball players participated in a point-shaving scheme orchestrated by the mafia. Even earlier, eight players for the Chicago White Sox were permanently banned from professional baseball after accepting money from a gambling syndicate to intentionally lose the 1919 World Series.

However, these types of gambling-related scandals have taken on greater significance in the wake of the Supreme Court’s 2018 decision in Murphy v. National Collegiate Athletic Association, which struck down as unconstitutional the Professional and Amateur Sports Protection Act, thereby allowing states to legalize sports betting. Can fans still have faith in the integrity of the games they love in a world where sports betting is legal and widely available?

The answer is that they should arguably have more faith in game integrity now than they did when such betting took place underground and without the oversight of gambling companies, leagues, and sports integrity monitoring organizations.

Before 2018, sports betting was less public, but it was a vast, illicit market operating in the shadows, estimated to be worth $80 billion to $150 billion per year. There was no regulatory framework, and no ability to detect suspicious play from large bets made on individual players’ performance. There were no real-time monitoring systems, no artificial intelligence (AI) algorithms flagging suspicious betting patterns, and crucially, no cooperation between bookmakers, law enforcement, and leagues.

What has changed is that legal sportsbooks are now required by law to monitor and report unusual betting activity to authorities. Actually, the recent NBA gambling scandals—including the 2024 case involving Toronto Raptors forward-center Jontay Porter—probably would have gone undetected without the help of sports integrity monitors like Sportradar. These services track betting activity to identify irregular patterns that may indicate match-fixing or other forms of misconduct. When betting markets on Porter’s individual plays saw abnormal betting action with unusually large wagers all predicting he would perform below expectations, the system worked as designed. Licensed bookmakers flagged the activity. The NBA and federal authorities investigated.

Sportradar is one of the leading integrity monitors, and its Universal Fraud Detection System, which monitors 30 billion odds changes annually across more than 600 betting operators, detected 1,329 suspicious matches globally in 2023—representing just 0.21% of all monitored events, or roughly one in 467 games. Of these suspicious matches, just 35 were in North America. Sports fans should take comfort in these figures, which indicate that American sports are among the least corrupt in the world.

When scandals surface, it’s tempting to say sports betting legalization is creating more corruption rather than examining the possibility that more cheats are being caught because of legalization.

Suppose legal sports betting is so corrosive to game integrity. Why are there no similar concerns in Europe, where sports betting is legal in 21 countries, with hundreds of licensed operators, or in countries such as Canada, Australia, and New Zealand? These countries have had legal, regulated betting markets for decades. Games are well attended, and sports remain integral to the social fabric. Scandals arise and are dealt with, but there’s no serious push to ban sports betting. On the other end of the spectrum, last year, China, where all sports betting is illegal, banned 38 soccer players and five club officials for life following an investigation that found 120 matches had been fixed.  

Banning sports betting so that it falls exclusively into the hands of criminals and offshore platforms won’t eliminate corruption; it may very well worsen it. The combination of individual and team integrity, law enforcement engagement, and tech-savvy monitoring means fans can and should have confidence that they live in one of the greatest countries to watch sports in the world, and trust that the games they’re watching are played fairly.

A version of this column first appeared at RealClearPolicy.

The post Legal sports betting didn’t create corruption. It exposed it. appeared first on Reason Foundation.

Earlier this year, the Food and Drug Administration (FDA) authorized the sale of Zyn nicotine pouches as “appropriate for the protection of public health.” This landmark decision wasn’t made lightly—it represents the culmination of an extensive scientific review demonstrating that these products can play a valuable role in reducing tobacco-related harm. 

The FDA’s authorization specifically recognizes that nicotine pouches can help adult smokers transition away from cigarettes. In Rhode Island, for example, smoking remains one of the leading causes of preventable death, with 1,800 deaths each year attributable to this habit. Making a can of nicotine pouches almost as expensive as a packet of cigarettes removes a crucial financial incentive for smokers trying to switch to a safer product.

Almost doubling the cost of nicotine pouches represents more than a misguided revenue grab projected to raise less than 0.1% of the budget; it’s also a policy decision with economic consequences. Such extreme taxation often leads to unintended market distortions, including increased cross-border shopping as Rhode Islanders seek more affordable options in neighboring states. This phenomenon reduces the anticipated tax revenue and harms local retailers.

Moreover, regressive taxation policies like this one disproportionately impact lower-income individuals, who are more likely to be current smokers seeking safer alternatives.

Perhaps most troubling is how this tax increase directly contradicts established public health objectives. Decades of research have consistently shown that harm reduction strategies—providing safer alternatives to high-risk behaviors—are more effective than prohibition-style approaches. The success of needle exchange programs, methadone treatment, and other harm reduction initiatives demonstrates that meeting people where they are, rather than where we wish they were, yields better health outcomes. 

Nicotine pouches represent a significant opportunity for tobacco harm reduction. Unlike combustible tobacco products, they don’t involve burning organic matter and the associated carcinogenic tar and smoke. Unlike traditional smokeless tobacco, they don’t require spitting and contain no tobacco leaf. While these pouches contain nicotine, which is highly addictive, it’s not the nicotine that kills smokers but the smoke itself, which is why pouches are a potentially game-changing tool for smokers who haven’t succeeded with traditional cessation methods like patches or gum. 

As with any nicotine product, there are understandable concerns about how nicotine pouches can be kept out of the hands of children. The FDA determined that Zyn, for example, did not present enough appeal to youth to outweigh the gains from saving smokers’ lives. The data bears this out: Less than two percent of middle and high-school students used a nicotine pouch in the last month, and overall youth tobacco use is at a 25-year low. The rapid declines in youth tobacco use show the success of both educational programs and the increase in the tobacco age to 21.

Instead of following the outdated playbook of punitive taxation pursued in Rhode Island, other states should align their policies with the FDA’s scientific determination that nicotine pouches can be a protective measure for public health. Lawmakers should avoid Rhode Island’s mistake and instead craft policies that support smokers in their journey toward better health outcomes.

The post Nicotine pouch taxes undermine efforts to help smokers quit appeared first on Reason Foundation.

The World Health Organization’s (WHO’s) performance during the COVID-19 pandemic was poor, with questionable public health guidance and a reluctance to hold the Chinese Communist Party to account for its role in the virus’s spread. As Zach Weissmuller reported at Reason.com:

The WHO also praised China for releasing the virus’s genome while neglecting to mention that it took them at least 17 days to do so. It didn’t report human-to-human transmission until late January—even though Chinese doctors suspected it at least a month earlier. Although the extreme lockdown of Wuhan likely saved thousands of lives, WHO scientists weren’t allowed into Wuhan until 3 weeks after the outbreak first came to light, leaving open many questions about measures the government took in the interim. Meanwhile, the WHO praised the country for its supposed openness.

Despite these failures, the WHO is encouraging members to sign a pandemic treaty that would threaten free speech and intellectual property if the U.S. were to remain a member.

While the WHO’s potential interference has diminished, remnants of its influence over American health policy remain. In the final days of the Biden administration, the Food and Drug Administration (FDA) resurrected a proposal to mandate the removal of almost all nicotine from cigarettes, a de facto cigarette ban. The FDA justifies its action based on modeling informed by the guesstimates of a handful of public health academics, claiming a vast number of smokers will quit and subsequently live longer.

The rule was initially pushed by former FDA Commissioner Scott Gottlieb in 2017. However, after Gottlieb left the first Trump administration to take on other projects, the ban was wisely cast aside. While Gottlieb was the first to advance the rule and Biden the one to try and push it over the line, the ban’s origins lie just as much with the WHO and its advisory note, titled “Global Nicotine Reduction Strategy,” published in 2015.

The FDA’s proposed rule follows the WHO’s playbook. “In alignment with this recommendation from the World Health Organization, this proposed rule would cover combusted cigarettes and certain other combusted tobacco products (i.e., cigarette tobacco, RYO tobacco, cigars other than premium cigars, and pipe tobacco),” said the FDA at the time.

Following the World Health Organization’s guidance, the FDA’s plan would ban more than 99% of cigarettes, small cigars, and pipe tobacco.

The FDA also points to the WHO’s guidance that the ban be combined with providing behavioral support, nicotine replacement therapies (NRT), and other medications for smokers denied legal access to cigarettes. The pharmaceutical industry’s smoking cessation products are unpopular and less effective compared to offerings consumers prefer, such as vapes and nicotine pouches, which the industry has lobbied to place under stricter regulations. Indeed, Pfizer has funded research claiming that denicotinized cigarettes used in combination with pharmacotherapies increase smoking cessation rates, research that has been cited by the only company making products that would comply with the FDA’s rule. 

No country has implemented such a radical policy, so no real-world evidence suggests it will work out as the FDA says it will. When a similar policy was advanced in New Zealand in 2022, it was abandoned after the election of a conservative government. Left unchecked, the FDA would have America serve as a guinea pig for a dangerous policy experiment.

The risks of the policy are clear, with law enforcement already warning it could mean disaster and “a gift with a bow and balloons to organized crime cartels with it, whether it’s cartels, Chinese organized crime, or Russian mafia. It’s going to keep America smoking, and it’s going to make the streets more violent,” Rich Marianos, former assistant director of the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives and the current chair of the Tobacco Law Enforcement Network, told Fox News. 

The WHO itself recognized these concerns in a 2018 report, highlighting fears over increased illicit trade, relapses by ex-smokers thanks to low-priced black market cigarettes, and declining tax revenue, but continues to believe these risks will be worth the benefit.

On April 2, 2025, FDA Commissioner Martin McKary told staff in an all-hands meeting that the agency needed a new approach: “Challenging what we believe to be true, challenging deeply held assumptions that lack evidence, and allowing experts to debate new approaches to old problems is exactly what we need right now.” 

The Trump administration is swiftly junking some costly and unnecessary regulations advanced by the Biden administration. Trump was right the first time to ditch an untested, potentially dangerous policy, and it is in keeping with McKary’s mission to base policy on sound evidence, not intuitions, hopes, and optimistic models, to do so again. 

The post Trump should end WHO’s sway over the FDA appeared first on Reason Foundation.

Data from Massachusetts’ Multi-Agency Illegal Tobacco Task Force shows a surge in illegal vape seizures from 71,746 in 2022 to 308,100 in 2024. The number of cigarette packs seized during that time declined significantly from 18,483 to 5,029, and cigar seizures stood at 152,075, more than in 2023 but less than in 2022. The task force says it is seizing so many illegal products that it’s having difficulty storing and destroying them, with smugglers becoming ever more sophisticated in avoiding their investigations.

When Massachusetts banned flavored tobacco in June 2020, the move was paired with a 75 percent wholesale tax on e-cigarettes and hailed as a triumph for public health. 

“The Massachusetts law sets a tremendous example that other states and the entire nation should follow in order to stop the tobacco industry’s predatory targeting of kids and communities of color once and for all,” said the then-head of the Campaign for Tobacco-Free Kids, Matthew Myers, in a press release. 

Following the latest task force report, some of the ban’s most vigorous opponents highlighted that the predictions they made when the ban passed are coming to fruition. 

“These numbers are absolutely staggering and prove what NECSEMA [the New England Convenience Store & Energy Marketers Association] has warned from the start—Massachusetts has created the perfect environment for illegal smuggling,” said Peter Brennan, executive director of NECSEMA. 

So far, only California has followed Massachusetts’s example, and it’s easy to see why.

Compare tobacco use in Massachusetts to a state without a flavor ban like Michigan. Since 2020, smoking in Massachusetts has fallen by just 1.3 percentage points, whereas in Michigan, it fell by 4.8 percentage points. Youth vaping,  a significant motivation for the Massachusetts ban, has fallen substantially. However, the decline of youth vaping since 2019 was a nationwide trend not unique to Massachusetts, with some non-flavor ban states like neighboring New Hampshire experiencing equally impressive declines.

Whatever the intentions of the flavor ban, it’s clear that the alleged benefits were overstated, and Massachusetts is bearing a significant cost in lost revenue and increased criminality. Tobacco excise taxes in the Bay State fell from $526.6 million in 2020 to $354.3 million in 2024.

The report catalogs a series of investigations, searches, and prosecutions to clamp down on the illicit market but points out that the Commonwealth’s high tax rates on tobacco products remain a strong incentive for smugglers to import products from low-tax states. In 2019, Massachusetts was ranked 12th in the nation for inbound cigarette smuggling, but by 2022, it jumped to fourth. According to the Tax Foundation, around 40 percent of cigarettes sold in Massachusetts are smuggled in from out of state.

To help crack down on the illicit trade, the task force recommends, among other changes, the creation of new criminal provisions to punish people who sell tobacco products without a license. Because enforcement funding is unlikely to be increased significantly, and Massachusetts borders states with lower tobacco taxes or no flavor bans, it’s doubtful these new measures would significantly impact the illicit market.

Though legislators have little appetite to repeal the flavor ban, some of its worst effects could be ameliorated by exempting safer alternatives to cigarettes that have received authorization for sale from the Food and Drug Administration. These products include e-cigarettes, nicotine pouches, and heated tobacco in flavors other than tobacco that the agency has deemed to be “appropriate for the protection of public health,” meaning the benefits they present to adult smokers trying to switch to a safer product outweigh the risks of youth using them. 

Giving smokers legal options for safer nicotine alternatives could make some dent in the illicit market and would be a win for health. Other states considering flavored tobacco prohibitions should closely examine Massachusetts and see if it’s a situation they’re sure they want to replicate.

The post The failure of Massachusetts’ tobacco flavor ban appeared first on Reason Foundation.

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.

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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.     

The post Denver should reject a flavored tobacco ban appeared first on Reason Foundation.

Youth vaping was declared an “epidemic” by former U.S. Surgeon General Jerome Addams in 2018. Six years later, it’s clear the language of epidemics no longer accurately describes patterns of youth vaping, if it ever did.

Two questions arise from the rapid decline of youth vaping. First, what caused such a substantial fall in the number of kids experimenting with vaping? Second, how should policymakers, regulators, and commentators respond to this trend?

There’s no single answer as to why kids no longer find vaping as attractive as they once did. Critics of vaping are quick to point to the number of e-cigarettes the Food and Drug Administration (FDA) has purged from the legal market and decisions in some states to ban flavored e-cigarettes outright. 

These answers are hardly convincing. Since a handful of states and the FDA started cracking down on flavored e-cigarettes, a wave of single-use flavored vapes flooded in from China to replace products that were previously legal. Disposable flavored vapes, mostly sold in the gray and black market, now account for around 60 percent of all e-cigarette sales. The influx invited hearings in Congress and raised concerns about fly-by-night companies skirting FDA regulation.

But even as flavored vapes remain ubiquitous in most of the country, youth vaping continues to decline. A more likely explanation for the lack of youth interest in e-cigarettes is a combination of an increase in the tobacco age to 21, greater engagement among parents and educators to prevent their kids from vaping, and the reality that some teen trends fall out of fashion as quickly as they rise.

The youth vaping epidemic may be over, but smoking still causes hundreds of thousands of preventable deaths, and while youth tobacco use should always be a concern for policymakers, when the facts change, policy should follow. In 2017, Georgetown University Medical Center estimated that 6.6 million premature deaths could be avoided if smokers switched to vaping. Seven years later, both federal and state governments have failed to maximize the public health gains that vaping offers. 

Companies trying to get their vaping products authorized by the FDA and into the hands of adult smokers who want to quit face regulatory barriers so high that more than 99 percent of product applications submitted to the FDA have been rejected. Because of unclear public health messaging, most adults incorrectly believe vaping nicotine is just or more dangerous than smoking, despite overwhelming evidence to the contrary.

Legislators and the FDA should shift their focus from out-of-date narratives and misbegotten policy responses. Banning flavored e-cigarettes hands the market to bad actors, and higher e-cigarette taxes remove the incentive for adult smokers to switch to a safer product.

The FDA has belatedly recognized the problem of misperceptions of e-cigarettes and is currently investing resources to discover how best to communicate to adult smokers that not all nicotine products carry the same level of risk. But the slow pace of change and lack of interest in reforming the FDA’s regulatory processes means that many of more than 30 million adult smokers in the U.S. will continue to do so for longer than they otherwise would.

Youth vaping has declined at a steady clip since 2019. Still, many lawmakers, anti-vaping campaigners, and media outlets continue to frame vaping as a dangerous epidemic threatening America’s children, ignoring the benefits these products present to adult smokers trying to quit. The continuing panic over youth vaping is not cost-free. 

The post The youth ‘vaping epidemic’ is over appeared first on Reason Foundation.

Members of Congress vented frustration at the FDA over the chaotic U.S. vape market at a Senate Judiciary hearing on June 12. Spearheaded by Sen. Dick Durbin (D-Ill.), the hearing was titled “Combatting the Youth Vaping Epidemic by Enhancing Enforcement Against Illegal Cigarettes.” Officials from the FDA, the U.S. Department of Justice, anti-tobacco groups, and the e-cigarette industry all appeared to present testimony.

Senators showed Dr. Brian King, the FDA’s chief tobacco regulator, pictures of illegal vapes being sold less than a mile from the FDA’s headquarters with no apparent consequences. King insisted that the FDA needs more resources to tackle the illicit market, pointing to a new multi-agency task force established two days before the hearing that would crack down on illegal vapes. Senators worried that such a large, unregulated market was targeting kids and could threaten public health and were bewildered as to how the market has gotten so out of the FDA’s control. 

While claims of widespread youth vaping are disputable—youth vaping has dropped more than 60 percent since 2019—the issue of illegal e-cigarettes is a real one. Because the FDA fails to authorize them, almost all e-cigarettes sold today in the United States are illegal. The rise of flavored disposable vapes flooding the market from China was particularly concerning to the committee. These vapes have become increasingly prevalent since 2019 and could make up as much as 50 percent of the total e-cigarette market.  

But why are so many vapes illegal in the first place, given that they’re substantially safer than cigarettes? The answer lies in what Sen. John Cornyn (R-Texas) described during the hearing as the FDA’s “Kafkaesque” regulatory process for authorizing e-cigarettes on the U.S. market. Every model and flavor of e-cigarette must have its own application submitted to the FDA at enormous expense. Each product must demonstrate it is appropriate for the protection of public health in that the benefits for adult smokers will outweigh the risk of youth using the product.

None have met this threshold so far, according to the FDA. Exactly how a non-tobacco-flavored e-cigarette can surpass this barrier remains unclear. Earlier this year, the U.S. Court of Appeals for the 5th Circuit concluded that the agency had instituted a de facto ban on vape flavors via these regulatory hurdles.

Legitimate companies find it almost impossible to comply with the current regulatory regime. However,  companies less willing to stick to the rules have stepped into the breach to satisfy consumer demand, resulting in a huge gray and black market.

“Look, if we’re going to establish a byzantine labyrinth of regulations to do this stuff, then for heaven’s sake, at least make the regime work,” Sen. Mike Lee (R-Utah) told King. “The worst thing you can do is set those up so as to choke out U.S. producers that are trying to comply with the law and then open the floodgates so that the illegal Chinese products can move in and be sold unabated.”

The only legal vapes on the market today are sold in tobacco flavors, and few people use them. There remains a backlog of e-cigarette product applications, including applications from the former market leader, Juul. To compare, new cigarettes are authorized regularly. 

Durbin and fellow Democrats criticized the FDA for not cracking down on the supply of illegal vapes and demanded that all flavored e-cigarettes be immediately removed from the market. However, as Sen. Thom Tillis (R-N.C.) pointed out, even if the FDA leveraged the enforcement options available to the agency, it still isn’t enough to create a functioning legal market. 

Early in the hearing, Durbin claimed that tobacco companies invented e-cigarettes to hook a new generation of kids to nicotine and reverse the steady decline in cigarette sales. In reality, the e-cigarette market as we know it today was started by a Chinese chemist named Hon Lik, himself a heavy smoker, as a way of trying to quit. His initial invention birthed an industry that continuously innovates to improve standards and consumer satisfaction and has become the most popular and effective method for smokers to quit cigarettes.

Efforts to further restrict e-cigarettes will not just prove ineffective, but they may have unintended consequences. Two papers released the same week as the hearing suggest bans on flavored e-cigarettes may increase smoking among teens and adults below the age of 25.

Despite the contentious hearing, it’s unlikely the FDA will make any substantive changes that allow for more legal adult options in e-cigarettes. However, these decisions, in some form or another, may be taken out of the FDA’s hands. The Supreme Court is set to decide on June 20 whether to take on a case challenging the FDA’s current regulatory regime of e-cigarettes, which could fundamentally alter the regulatory landscape for nicotine products. 

The post Congress spotlights the FDA’s “Kafkaesque” vaping regulation appeared first on Reason Foundation.

The main point of contention surrounds the WHO’s position on e-cigarettes. In the weeks before this year’s WNTD, WHO released a report titled “Hooking the next generation: How the tobacco industry captures young customers.” The document contains recommendations and calls to action that would strike most people as unobjectionable, such as ensuring tobacco products aren’t sold or marketed to kids. 

But the report also frames e-cigarettes, nicotine pouches, and heated tobacco products as threats to public health without any recognition that they are safer than smoking or that they have helped tens of millions of smokers across the world kick cigarettes for good. The report compares claims that e-cigarettes are less harmful than combustible cigarettes with the tobacco industry’s past messaging about low-tar cigarettes being less dangerous and says that there’s insufficient evidence to conclude these alternatives are effective in helping smokers quit.

Shortly after the report’s publication, Dr. Sarah Jackson, the principal research fellow for the Tobacco and Alcohol Research Group at University College London, challenged WHO’s negative take on e-cigarettes. “Large evidence reviews, conducted independent of industry, consistently conclude that while vaping is not risk-free, it poses only a small fraction of the risks of smoking tobacco,” Jackson told the Science Media Research Center. Jackson also referenced the Cochrane Review, which concluded that vaping is more effective than nicotine replacement therapies, such as gums or patches, for smoking cessation.

WHO’s report is of a piece with its wider messaging on safer nicotine alternatives. WHO’s explainer on e-cigarettes erroneously links nicotine vapes to incidents of lung damage and death that were found to be caused by tainted illicit marijuana cartridges. The most basic question of whether e-cigarettes are safer than cigarettes is not answered on WHO’s website. WHO also claims e-cigarettes haven’t been shown to be effective for smoking cessation at the population level and that there is “alarming evidence” on the negative health effects of vaping.

For policy recommendations, if e-cigarettes aren’t banned outright, WHO recommends banning all flavors other than tobacco, raising taxes, and “limiting the concentration and quality of nicotine.” In a series of articles published at Medium, veteran journalist Marc Gunther highlighted brazen examples of misinformation from the WHO. In April 2024, the WHO tweeted that vaping increases your risk of seizures, typically within 24 hours. The study was based on a small sample of self-reports with no evidence of causality. Neal Benowitz, a professor of medicine at the University of California, San Francisco, who specializes in nicotine, wrote in 2020 that the study shouldn’t discourage smokers from switching to vaping.

Another WHO tweet in March 2024 claimed it’s a myth that e-cigarettes and heated tobacco products are safer alternatives to cigarettes. Even regulators that have been hostile to e-cigarettes, such as the U.S. Food and Drug Administration, concede that the basic science demonstrates e-cigarettes to be safer than cigarettes.

Referring to WHO’s social media messaging and website content, Gunther told the YouTube show RegulatorWatch, “They have both spread unwarranted fear about the risks of e-cigarettes, and they discourage people from using e-cigarettes as a way of quitting smoking even though there’s really strong independent evidence that for many, many people e-cigarettes have become the best way to quit smoking.”

Gunther fears the WHO’s messaging will have the biggest impact on low- and middle-income countries that lack a well-developed public infrastructure and rely on the WHO for accurate information and sound policy recommendations. His fears are not without cause. In 2021, Dr. Harsh Vardhan, India’s health and welfare minister at the time, was awarded the WHO Director-General’s Special Recognition Award for driving forward legislation banning all e-cigarettes and heated tobacco products in India.

“Fundamentally, in the advice they give to other countries, they’re terrible on e-cigarettes,” Gunther said “Then, in their public communications, they’ve consistently spread fear and minimized the benefits of e-cigarettes.” According to polling from Ipsos conducted for the We Are Innovation think tank, three-quarters of smokers globally incorrectly believe vaping is just as harmful or more harmful than smoking.

If the WHO continues to promote messaging that is out of sync with the best scientific evidence and guidance, it should be discounted as a credible source of information for governments trying to give their citizens the best options to improve their health.

The post The World Health Organization risks credibility with inaccurate attacks on vaping appeared first on Reason Foundation.

Cigarette tax advocates use many popular arguments to make their case, arguing that taxes deter people from smoking, encourage people to quit, and cover the costs of smoking-related diseases in the healthcare system. However, any benefits must be weighed against the regressive nature of these taxes as most smokers have lower incomes, and higher taxes could cause an increase in illicit sales.

In Rhode Island, one in five cigarette packs sold is from out of state. 

Taxes on e-cigarettes can be even more detrimental. Many people misunderstand the potential benefits of e-cigarettes, believing they are just as or more harmful than cigarettes. However, e-cigarettes are safer than traditional cigarettes and help smokers quit, as acknowledged by the Food and Drug Administration and health agencies in countries from the United Kingdom to Canada. The prestigious Cochrane Review concludes e-cigarettes are more effective than traditional nicotine replacement therapies in helping smokers quit cigarettes.

Because e-cigarettes are substitutes for traditional cigarettes, policies that make e-cigarettes more expensive incentivize people to continue smoking cigarettes instead of switching to a safer alternative. 

A growing body of evidence shows how harmful e-cigarette taxes can be on public health. An analysis of Minnesota’s 95 percent e-cigarette tax found 32,400 more smokers than there would have been without the tax.

A separate study focusing on young adults aged 18-25 found e-cigarette taxes were associated with reduced vaping but were similarly associated with increases in smoking. These effects are also seen in youth aged 18 or younger, with the authors concluding that “the unintended effects of… taxation may considerably undercut or even outweigh any public health gains.”

Just as revealing as the empirical literature is how financial analysts reacted when the United Kingdom announced a new vape tax in March, with experts at Citibank believing higher taxes on vapes are good news for the bottom line of two big tobacco companies. The higher the e-cigarette tax, the higher the likelihood that people will smoke traditional cigarettes. 

Rhode Island already suffers from an illicit vape market thanks to its prohibition of flavors other than tobacco, which is also set to be codified in the budget. However, implementing such a high vape tax would supercharge the illicit market, especially as it is set to be higher than taxes in New Hampshire, New York, Massachusetts, and Connecticut. Rhode Island’s legitimate vape retailers who are helping people quit smoking and providing employment opportunities while doing so would be severely impacted. When Pennsylvania introduced a 40 percent vape tax in 2016, 110 vape shops shut their doors within one year. 

Around 1,800 Rhode Islanders die every year from smoking-related diseases. Many smokers wish to quit cigarettes but find products like nicotine patches and gums, which have a 90 percent failure rate, unsatisfying and therefore fail. E-cigarettes are a critical tool for reducing the harm associated with smoking. A fundamental principle of tobacco tax policy should be that less dangerous products are taxed significantly lower than the most dangerous products. If these taxes aim to improve public health, the vape tax should be substantially lowered or scrapped altogether. Rhode Island does not need to raise revenue off the backs of people trying to quit smoking.

The post Rhode Island Gov. McKee’s proposed e-cigarette tax is a bad approach to public health appeared first on Reason Foundation.

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. 

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