Legislation in Florida has been sent to Gov. Rick DeSantis which would ban the sale of flavored vapor products. Senate Bill 810 would require permits for persons or corporations, enact a retail fee for the sale of vapor products, and would prohibit persons “from selling, delivering, bartering, furnishing, or giving flavored liquid nicotine products to any other person.” Menthol and tobacco flavors would still be available for retail sale.
 

Proponents of the legislation are responding to youth e-cigarette use, as well as recent vaping-related lung injuries. Although addressing youth use of age-restricted products is laudable, banning flavors in e-cigarettes will significantly stunt adult access to tobacco harm reduction products. The legislation will also not have any significant impact on vaping-related lung illnesses, as these incidents have been largely linked by the use of illicit, black market vapor products containing tetrahydrocannabinol (THC). Moreover, banning flavors would eliminate almost $1 billion in economic activity in the Sunshine State, as well as remove thousands of jobs.

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Smoking-related health issues costs Florida $8.64 billion in annual health care costs, including $1.51 billion in Medicaid costs. According to the Florida Health, 28,600 Floridians die annually from smoking-related illnesses and “another 20 suffer from one or more serious illnesses from smoking.”

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Electronic cigarettes and vapor devices have emerged as an effective tobacco cessation tool, and as of August 2018, have helped an estimated three million smokers quit combustible cigarettes. A January 2019 study noted the use of e-cigarettes to be twice as effective in helping smokers quit, compared to traditional nicotine replacement therapy, such as gum and patches.

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Despite fearmongering, e-cigarettes are a tobacco harm reduction product that are significantly less harmful than combustible cigarettes. Numerous public health organizations, including Public Health England (PHE), Royal College of Physicians, National Academies of Sciences, Engineering, and Medicine, American Cancer Society, and U.S. Food and Drug Administration (FDA)—have acknowledged there is a reduced harm associated with e-cigarettes and vaping devices, compared to traditional tobacco products. PHE even found the use of e-cigarettes to be an estimated “95% safer than smoking.”

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E-cigarettes and vapor products have also been an economic boon to the Sunshine State. In 2018, the vapor industry’s total economic impact to Florida was over $1.4 billion, including more than $82 million in state taxes. In the same year, the industry created 5,353 direct vaping-related jobs, which generated $198 million in wages. A flavor ban would cripple this industry as a majority of sales of vapor products are flavored. In 2016, 78 percent of e-liquid sales were flavored and 69 percent of disposable vapor product sales were flavored and menthol products.

Although this legislation is intended to help curb youth e-cigarette use, there is no evidence that flavor bans generate such results. Lindsey Stroud analyzed the impact of flavor bans in Santa Clara County, California, which banned flavored tobacco products to age restricted stores in 2014. Despite the ban, youth use of e-cigarettes increased after the ban went into effect. For example, in 2015-16, 7.5 percent of Santa Clara high school students reported current use of e-cigarettes. In 2017-18, this increased to 10.7 percent.

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Further, there is no evidence that youth use e-cigarettes products solely due to flavors. In analysis of five state surveys on youth e-cigarette use, only 15.6 percent of high school students cited using e-cigarettes because of flavors. These findings are similar to an analysis of the 2019 National Youth Tobacco survey, which found only 22.4 percent of middle and high school students cited flavors as a primary reason for e-cigarette use, whereas 55.3 percent reported curiosity and 30.8 percent claimed to use an e-cigarette because a “friend or family member used them.”

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Although lawmakers intend for the legislation to address recent vaping-related hospitalizations, banning flavors is unlikely to such illnesses. As of February 18, 2020, 119 cases of vaping-related lung illnesses have been reported to the Florida Department of Health (FDH), including two deaths. FDH does not include any other information, including age, gender, or substance vaped. This is alarming as the Centers for Disease Control and Prevention (CDC) and state health departments have overwhelmingly linked such illnesses to the use of illegal, unregulated products containing THC, often obtained through black market sources.

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For example, as of January 14, 2020, the CDC has released data on 2,022 hospitalized vaping-related lung illnesses cases, noting that 82 percent of patients reported using vapor products containing THC, and 33 percent reported exclusive use of THC-containing vapor products. These findings are consistent with other state health department findings. Banning flavors will not address vaping-related lung illnesses as the suspected products that are causing the most harm are often found through black market channels.

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Perhaps most problematic with the legislation is that Florida lawmakers are attempting to restrict adult access to effective smoking cessation tools, yet dedicate very little in existing tobacco moneys on programs that can help Floridians quit. For example, in 2019, Florida received an estimated $1.5347 billion in revenue generated by tobacco settlement payments and tobacco taxes. In the same year, the Sunshine State dedicated only $70.4 million of state funds, or less than one percent of tobacco moneys, on tobacco control and prevention programs. It is disingenuous that lawmakers would restrict access to tobacco harm reduction products, while allocating so little of existing tobacco dollars on programs that can both help smokers quit and educate youth on the dangers of tobacco and vapor products.

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A flavor ban in Florida would decimate a billion-dollar industry, while denying adults access to tobacco harm reduction products that are significantly less harmful than combustible cigarettes. Further, such draconian proposals will not impact youth vaping, or recent vaping-related lung illnesses. Rather than restricting adult access to tobacco harm reduction tools, lawmakers should divert more than one percent of existing tobacco moneys towards tobacco control and prevention programs, including educational campaigns that could actually reduce youth e-cigarette use.

 

Nothing in this analysis is intended to is intended to influence the passage of legislation, and it does not necessarily represent the views of Tobacco Harm Reduction 101. For more information on vapor products in Florida, please visit Tobacco Harm Reduction 101’s Florida page at www.thr101.org/florida.