Even though a half-million Americans die every year from smoking-related illness, roughly 17 percent of U.S. adults continue to smoke.
It’s encouraging that new options have come to the market in recent years for those who find they just can’t quit the habit. Electronic cigarettes and other vapor devices deliver nicotine without the negative effects of tar and carcinogens. While vaping isn’t completely safe, the best evidence suggests it’s about 95 percent safer than smoking cigarettes.
But state and local governments, along with the U.S. Food and Drug Administration, haven’t always been so welcoming to e-cigarettes as a major advance in public health. A new report from the R Street Institute examines local taxes, regulations and public-information campaigns in 52 of the largest U.S. cities, assigning letter grades that assess whether local rules are likely to encourage tobacco harm reduction.
In that respect, Indianapolis performs poorly in the report, earning a grade of D-. While some of the regulations Indiana has imposed on e-cigarettes—such as prohibiting sales of vapor products to those under 18, mandating child-safety caps on products, and setting manufacturing standards that parallel those of food-processing businesses—are reasonable, others are less so.
For instance, the state requires e-fluid makers to keep multiple samples of each production batch. This turns out to be very costly, given the profusion of flavors and concentrations of nicotine. Also of concern are statements by officials that mislead the public about the risks of vaping, such as state Attorney General Greg Zoeller’s campaign to add e-cigarettes to the Indiana smoking ban statute.
An overview of the scores finds some interesting trends. For example, just nine of the 52 cities currently levy an excise tax on vaping products. But that figure certainly could rise, particularly as local governments seek to replace the cigarette-tax revenue they’ve become hooked on.
The cities scoring lowest—including Boston, Philadelphia, Chicago and all the California cities studied—tended to treat cigarettes and vaping products as equivalent, or even banned vaping in venues specifically designed for e-cigarette use. Some cities were the worst in terms of treating vaping as the equivalent of cigarettes. In dead last was Minneapolis, whose local tax structure inexplicably favors cigarettes over vapor products.
The top score went to Virginia Beach, aided by a 2010 court decision that held the commonwealth’s smoking ban did not apply to e-cigarettes. A number of cities in Arizona and New Mexico also were recognized with high marks for policies conducive to tobacco harm reduction.
Policymakers understandably have concerns about e-cigarettes, including whether vaping will attract new customers who are not current smokers. To date, research both here and in Europe suggests this is exceedingly rare. Meta-analysis of studies with populations of millions of vapers show less than a 1 percent recruitment rate of those who never smoked.
This is crucial, as smoking-cessation products currently on the market combine to produce about a 7 percent success rate—which is to say, a 93 percent failure rate. Meanwhile, millions of vapers already use e-cigarettes to cease or significantly curtail their smoking. Public policy should recognize this reality and, at the very least, do no harm.
And as the Royal College of Physicians recently concluded, “with sensible regulation, electronic cigarettes have the potential to make a major contribution towards preventing the premature death, disease and social inequalities in health and smoking,” adding, “harm reduction provides an opportunity to improve the lives of millions of people.”
Indianapolis General Assembly, take note.•
Smith is a senior fellow with the R Street Institute.