Policy Tip Sheet: Tobacco Harm Reduction 101: Maryland

Published January 12, 2020

Since their introduction to the U.S. market in 2007, e-cigarettes and vaping devices—tobacco harm reduction products that are 95 percent safer than combustible cigarettes—have helped more than three million American adults quit smoking.

1. Economic Impact
According to the Vapor Technology Association, in 2018, the industry created 1,243 direct vaping-related jobs, including manufacturing, retail, and wholesale jobs in Maryland, which generated $54 million in wages alone.[1] Moreover, the industry has created hundreds of secondary jobs in the Old Line State, bringing the total economic impact in 2018 to $389,390,600. In the same year, Maryland received more than $31 million in state taxes attributable to the vaping industry. These figures do not include sales in convenience stores, which sell vapor products including disposables and prefilled cartridges. In 2016, sales of these products in Maryland eclipsed $10 million.[2]

2. State Health Department Data
As of December 24, 2019, the Maryland Department of Health (MDH) has reported 57 cases of vaping-related lung illnesses. Although other state health departments have provided additional patient information—including age, gender, and substances vaped—MDH has only reported the total number of cases, but did note that vitamin E acetate had been found in the lung fluid of three Maryland patients. Vitamin E acetate has been linked to vaping products containing tetrahydrocannabinol (THC). The Heartland Institute gives MDH a grade of D for information available on vaping-related lung illnesses.

3. More Information Needed
The most recent report on youth e-cigarette use in Maryland is from the 2017 Maryland Youth Risk Behavior Survey.[3] In 2017, 35.3 percent of Maryland high school students reported using a vapor product on at least one occasion in the 30 days prior to the survey. Only 1.5 percent of Maryland high school students reported daily e-cigarette use. More data is needed to understand the effects of public health campaigns on youth e-cigarette use.  

4. Youth Sales Miniscule
From January 1, 2018 to September 30, 2019, the U.S. Food and Drug Administration (FDA) administered 4,063 tobacco age compliance inspections in Maryland, in which the agency used a minor in an attempt to purchase tobacco products.[4] Of those, 782, or 19 percent, resulted in a sale to a minor. Of the violations, 182 (23 percent of violations and 4 percent of all compliance checks) involved the sale of e-cigarettes or vaping devices. The number of violations involving sales of cigars and cigarettes were 217 and 375, respectively, during the same period.

5. Misspent Money
In 2019, Maryland received an estimated $525 million in tobacco taxes and tobacco settlement payments. In the same year, the state spent only $10.5 million, or 2 percent, on funding tobacco control programs, including education and prevention.[5]


Policy Solution
Electronic cigarettes and vaping devices have proven to be tremendous tobacco harm reduction tools, helping many smokers transition away from combustible cigarettes. Despite recent fearmongering, their use is significantly safer than traditional cigarettes, as noted by numerous public health groups including the Royal College of Physicians,[6] Public Health England,[7] and the American Cancer Society.[8] Rather than restricting their use, and undoubtedly reducing public health gains and millions of dollars in economic output, lawmakers should dedicate existing tobacco funds on programs that actually reduce youth use.


Key Points:
1. Maryland’s vaping industry provided more than $389 million in economic activity in 2018 while generating 1,243 direct vaping-related jobs. Sales of disposables and prefilled cartridges in Maryland exceeded $10 million in 2016.

2. As of December 24, 2019, MDH has reported 57 cases of vaping-related lung illness. MDH reports do not offer details on age, gender, or substances vaped. MDH earns a D for its reporting on vaping-related lung illnesses.

3. In 2017, only 1.5 percent of Maryland high school students reported using vapor products daily. More data is needed.  

4. Only 4 percent of FDA retail compliance checks in Maryland resulted in sales of e-cigarettes to minors from January 1, 2018 to September 30, 2019.

5. Maryland spends very little on tobacco prevention. In 2019, Maryland dedicated only $10.5 million on tobacco control, or 2 percent of what the state received in tobacco settlement payments and taxes.



[1] Vapor Technology Association, “The Economic Impact of the Vapor Industry MARYLAND,” 2019, https://vta.guerrillaeconomics.net/reports/d87faa01-f87e-4155-86dc-b1de384fb662?.

[2] Teresa W. Wang et al., “National and State-Specific Unit Sales and Prices for Electronic Cigarettes, United States, 2012-2016,” Preventing Chronic Disease, Centers for Disease Control and Prevention, August 2, 2018, https://www.cdc.gov/pcd/issues/2018/17_0555.htm.

[3] Centers for Disease Control and Prevention, “High School YRBS Maryland 2017 Results,” 2017, https://nccd.cdc.gov/youthonline/App/Results.aspx?LID=MD.

[4] U.S. Food and Drug Administration, “Compliance Check Inspections of Tobacco Product Retailers,” September 30, 2019, https://www.accessdata.fda.gov/scripts/oce/inspections/oce_insp_searching.cfm.

[5] Truth Initiative, “Tobacco use in Maryland,” June 28, 2019, https://truthinitiative.org/research-resources/smoking-region/tobacco-use-maryland-2019.

[6] Royal College of Physicians, Nicotine without Smoke: Tobacco Harm Reduction, April 2016, https://www.rcplondon.ac.uk/projects/outputs/nicotinewithout-smoke-tobacco-harm-reduction-0.

[7] A. McNeill et al., “Evidence review of e-cigarettes and heated tobacco products 2018,” Public Health England, February 2018, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684963/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf.

[8] The American Cancer Society, “What Do We Know About E-Cigarettes?” June 19, 2019,  https://web.archive.org/web/20190806152535/https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html.


For more information, please refer to:

Tobacco Harm Reduction 101: A Guidebook for Policymakers
This booklet from The Heartland Institute aims to inform key stakeholders on the much-needed information on the benefits of electronic cigarettes and vaping devices. Tobacco Harm Reduction 101 details the history of e-cigarettes, including regulatory actions on these products. The booklet also explains the role of nicotine, addresses tax policy and debunks many of the myths associated with e-cigarettes, including assertions about “popcorn lung,” formaldehyde, and the so-called youth vaping epidemic.



Nothing in this Policy Tip Sheet is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute. For further information on this and other topics, visit the Budget & Tax News website, The Heartland Institute’s website, and PolicyBot, Heartland’s free online research database.

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