ARIZONA PROPOSAL TO CLASSIFY E-CIGARETTES AS TOBACCO PRODUCTS IS DISSERVICE TO PUBLIC HEALTH

January 29, 2019

KEY POINTS

  • A new proposal introduced in the Grand Canyon State aims to regulate electronic cigarettes and vaping devices as tobacco products to address the increased number of young people using these products.

  • Since their introduction in 2007, e-cigarettes and vaping devices have been subject to numerous local, state, and federal regulations, taxes, and even bans.

  • The same public health groups that first identified the link between cancer and smoking cigarettes have found e-cigarettes to be substantially less harmful than combustible tobacco cigarettes.

    • In 2015, Public Health England found e-cigarette use to be “95% safer than smoking.”

    • The Royal College of Physicians came to the same conclusion in 2016, stating hazards from e-cigarettes were “unlikely to exceed 5% of the harm from smoking tobacco,” and these products have created “a massive opportunity for consumer – as well as healthcare – led revolution in the way nicotine is used in society.”

    • In 2018, the National Academies of Sciences, Engineering, and Medicine released a report that found “substantial evidence that completely switching from regular use of combustible cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.”

  • The use of vapor products could save Arizonans money. A 2015 analysis found Medicaid savings could have amounted to $48 billion in 2012 if e-cigarettes had been adopted in place of combustible tobacco cigarettes by all Medicaid recipients who currently smoke.

  • Arizona currently use little funding from existing tobacco settlements and taxes on education and tobacco control efforts.

  • Of the additional taxes that have been levied on tobacco products in 1994 and 2002, only 23 percent and 5 percent of additional tax revenue is dispersed into the Health Education Account, which “provides funding for education and prevention programs about tobacco use and chronic disease.”

  • The majority of the funding from the increased cigarette tax goes to the Medically Needy Account and the Proposition 204 Protection Account, which provides “funding for Medicaid services.”

A new proposal introduced in the Grand Canyon State aims to regulate electronic cigarettes and vaping devices as tobacco products to address the increased number of young people using these products. However, legislation classifying e-cigarettes or tobacco harm reduction (THR) as tobacco products would be a disservice to public health. Policymakers should refrain from such synchronization of tobacco products and regulate THRs based on their level of harm.

Since their introduction in 2007, e-cigarettes and vaping devices have been subject to numerous local, state, and federal regulations, taxes, and even bans. Numerous fear-mongering campaigns have attempted to falsely claim these products aren’t safe or that their efficacy as smoking cessation aids are nonexistent. Existing data prove these efforts are misguided, at best.

The same public health groups that first identified the link between cancer and smoking cigarettes have found e-cigarettes to be substantially less harmful than combustible tobacco cigarettes. In 2015, Public Health England found e-cigarette use to be “95% safer than smoking.” The Royal College of Physicians came to the same conclusion in 2016, stating hazards from e-cigarettes were “unlikely to exceed 5% of the harm from smoking tobacco,” and these products have created “a massive opportunity for consumer – as well as healthcare – led revolution in the way nicotine is used in society.” In 2018, the National Academies of Sciences, Engineering, and Medicine released a report that found “substantial evidence that completely switching from regular use of combustible cigarettes to e-cigarettes results in reduced short-term adverse health outcomes in several organ systems.”

Additionally, increased use of THRs could save Arizonans money. A 2015 analysis examined e-cigarettes’ effect on Medicaid spending. The study found Medicaid savings could have amounted to $48 billion in 2012 if e-cigarettes had been adopted in place of combustible tobacco cigarettes by all Medicaid recipients who currently smoke.

A 2017 study examined a smaller number of Medicaid recipients quitting using a sample size of “1% of smokers [within] demographic groups permanently” switching. In this analysis, the author estimates that Medicaid savings “will be approximately $2.8 billion per 1 percent of enrollees” over the next 25 years.

While the intention of the proposal is to make a positive impact on tobacco use, Arizona currently use little funding from existing tobacco settlements and taxes on education and tobacco control efforts. In 2018, the state “received $437.5 million in tobacco settlement payments and taxes.” In the same year, Arizona spent “$17.8 million in state funds to tobacco prevention,” or “27.6 percent of the Centers for Disease Control and Prevention’s (CDC) annual spending target.” In fiscal year 2019, Arizona will spend even less on tobacco control programs ($17.3 million, or 26.9 percent of CDC’s target spending).

Of the additional taxes that have been levied on tobacco products in 1994 and 2002, only 23 percent and 5 percent of additional tax revenue is dispersed into the Health Education Account, which “provides funding for education and prevention programs about tobacco use and chronic disease.” The majority of the funding from the increased cigarette tax goes to the Medically Needy Account and the Proposition 204 Protection Account, which provides “funding for Medicaid services.” Should lawmakers in Arizona really want to address youth tobacco use, they could utilize current tobacco moneys and provide more funding for tobacco control efforts, including youth education.

While addressing young people’s use of e-cigarettes is laudable, many lawmakers continue to fail to understand that the THR industry has already self-imposed regulations to deter use among younger Americans. The Smoke Free Alternatives Trade Association provides “Age to Vape” signage to vape shops endorsing local laws “to show that [the] industry supports sensible age restrictions.” Consumers for Smoke-Free Alternatives is an advocacy group that “supports laws that prohibit underaged sales and urges strict enforcement of laws” that ban access to e-cigarettes for young people. Similarly, the Vapor Technology Association, which represents vaping manufacturers, requires members to “refrain from knowingly marketing Vapor Products to Minors, which is strictly prohibited.”

Rather than imposing burdensome tobacco regulations on THR products, lawmakers in Arizona should regulate THRs based on their relative harm. Arizona lawmakers truly concerned with addressing youth tobacco use should promote policies that would divert more tobacco settlement payments and taxes to education programs.

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 or Tobacco Harm Reduction 101.

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