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September 28, 2017

An increasing number of public health officials from around the world are urging smokers to use electronic nicotine delivery systems, including electronic cigarettes and vaporized tobacco products, to aid in smoking cessation. In September, NHS Health Scotland issued a joint statement with a dozen other health agencies, in which it noted, “[T]here is now agreement based on the current evidence that vaping e-cigarettes is less harmful than smoking tobacco.”


“E-cigarettes have been around for a number of years now and we are learning more and more about them, but I think it is safe to say that they are a lot safer than cigarettes,” said Dr. Andrew Fraser, director of public health science at NHS Health Scotland, in an interview with BBC Scotland.


The statement from NHS Scotland is the latest declaration by a prominent public health group urging the use of vapor products, but it’s certainly not the only one. In September 2017, University College London, with support from Cancer Research U.K., found, “Success rates for quitting smoking are at their highest level for a decade,” with much of the success attributed to ENDS.


The report was welcomed by George Butterworth, tobacco policy manager at Cancer Research U.K. He stated, “Research has shown that e-cigarettes are the most popular way to quit. The evidence so far tells us they’re much safer than smoking, and are helping many people beat their addiction.”


The latest evidence is consistent with earlier research conducted by other public health groups. In 2015, Public Health England urged officials to promote the use of e-cigarettes after finding that such products “are 95% safer than tobacco cigarettes.”


Although many international public health groups have backed vapor products, their future in the United States is uncertain. In 2016, the Food and Drug Administration (FDA) applied its regulatory authority over e-cigarettes and vaping devices, “deeming” them as tobacco products. The adjustment requires manufactures of vapor products created after 2007 to submit pre-market tobacco applications (PMTA). The process requires expensive scientific research on the potential health hazards associated with ENDS, and FDA then must approve the applications in order for ENDS manufacturers to continue the distribution of their products after August 8, 2022. According to the American Medical Association House of Delegates, the expected cost, according to FDA, of each PMTA is $350,000.


Some states have also chosen to apply draconian taxes to vaping products, significantly creating a negative impact on the industry. In 2016, Pennsylvania passed a 40 percent tax on the wholesale price of vapor products. The tax has “caused more than 100 vapor product businesses to close, resulting in the loss of several hundred jobs in the industry.”


In 2010, 8.7 percent of U.S. health care spending, about $170 billion per year, was attributable to tobacco cigarettes. E-cigarettes could help offset health care costs, an argument J. Scott Moody, chief executive officer and chief economist at State Budget Solutions, made in a 2015 Policy Analysis. Moody examined the associated costs of tobacco cigarette smoking on Medicaid spending and estimated that if e-cigarettes had been adopted in place of tobacco cigarettes, savings to Medicaid expenses could have amounted to $48 billion by 2012.


Policymakers should continue to analyze the growing body of literature on e-cigarettes and vaping devices and understand the importance of vapor products as tools for tobacco harm reduction. Rather than demonize e-cigarettes, state officials should welcome their use and refrain from imposing unnecessary regulations on them and from treating them as though they are similar to combustible cigarettes.

Nothing in this Research & Commentary is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute.

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