Tobacco Harm Reduction 101: A Guidebook for Policymakers

Published July 23, 2019

For years, The Heartland Institute has promoted the use of electronic cigarettes and vaping devices as tools for tobacco harm reduction (THR). On several occasions, Heartland experts have provided testimony and analysis for policymakers on the merits of these effective THR tools.

Unfortunately, policy makers continue to pass burdensome regulations and excessive taxes on vaping products. Even worse, some states are considering prohibiting these devices, even for adults.

Moreover, all of these misguided policies are being advanced despite numerous public health groups, including the Royal College of Physicians, Public Health England, and the American Cancer Society noting e-cigarettes and vaping products are significantly less harmful than combustible cigarettes.

Heartland State Government Relations Manager Lindsey Stroud has written a new policy booklet, Tobacco Harm Reduction 101: A Guidebook for Policymakers, as a much-needed resource for lawmakers. In general, it will help state and local lawmakers understand the tremendous health potential e-cigarettes provide for current smokers.

E-cigarettes and vaping devices were introduced in the United States in 2007. Despite ample evidence proving their efficacy and public health benefits, THR products are constantly undermined by policy makers and other groups. Rather than focusing on their potential to dramatically reduce smoking-related health care problems (and costs), policymakers erroneously equate e-cigarettes with combustible tobacco cigarettes.

This policy booklet aims to inform key stakeholders, including policymakers, about THR products, specifically e-cigarettes and vaping devices. It also debunks many of the myths associated with e-cigarettes, including false assertions about “popcorn lung,” formaldehyde, and youth vaping.

In short, this policy booklet will help lawmakers make well-informed decisions about laws and regulations concerning e-cigarettes and vaping devices.


  1. Understanding Nicotine
    1. No Serious Harm from Nicotine
    2. Lessons Learned from Smokeless Tobacco
  2. E-Cigarette Basics
  3. Public Health Benefits of E-Cigarettes
    1. E-Cigarettes Among Military Members
  4. E-Cigarette Economics
  5. Current E-Cigarette Regulations
  6. Current Taxes on E-Cigarettes
    1. Wholesale Taxes
    2. Per-Milliliter Taxes
  7. Negative Effects of E-Cigarette Taxes
    1. An Unreliable Revenue Source
    2. Regressive Effects
  8. Tobacco Tax Dollars Wasted
  9. Youth Vaping and E-Cigarette Use
    1. Questionable Studies
    2. Ineffective Taxes
    3. Unintended Consequences
  10. Debunking Common E-Cigarette Myths
    1. Myth: E-Cigarettes and Vaping Don’t Help Smokers Quit
    2. Myth: E-Cigarettes Are Just as Dangerous as Combustible Tobacco
    3. Myth: Formaldehyde in E-Cigarettes Poses Health Risks
    4. Myth: E-Cigarettes Cause ‘Popcorn Lung’
    5. Myth: E-Cigarettes Cause Seizures
    6. Myth: E-Cigarette Flavorings Are Meant to Seduce Youth
    7. Myth: E-Cigarette Manufacturers Target Youth
  11. Conclusion
  12. Appendix
    1. Map: Current Taxes on Vapor Products per State and Washington DC
    2. Tobacco Moneys by State for 2018, 2019
    3. Tobacco Harm Reduction State Definitions