Lawmakers in Alabama are considering increasing the smoking age from 19 to 21. Proponents of the change claim it would help curb smoking rates, but the proposal would also extend the age to “alternative nicotine products,” including e-cigarettes, vaping devices, and smokeless tobacco, thereby disregarding the public health benefits provided by these products. If successful, this effort would not only limit adults’ choices, it would negatively impact the state, which would lose tax revenue provided by these products. Further, it would create an incentive for adults to purchase tobacco, e-cigarettes, and vaping devices in neighboring states, taking even more money away from Alabama’s coffers.
In nearly every other sense, individuals are considered adults at 18. They can serve in war, are tried as adults in courts, and they can accumulate massive debt in contractual agreements, such as student loans, which in 2016 averaged about $30,000. If individuals aged 18–20 can join the military and be tried as an adult in court, shouldn’t they be permitted to choose to use tobacco products?
Increasing the tobacco age limit has not proven effective in deterring consumption. The National Institute on Drug Abuse noted 58 percent of high school seniors reported consuming alcohol in 2015, and 35 percent reported using marijuana. Both of these substances are illegal for persons aged 21 and under to use in every state, yet their illegality does not indicate a connection between lower consumption rates and age restrictions.
Regarding tobacco use, the Centers for Disease Control and Prevention reports nearly 90 percent of tobacco users started by age 18. Research also shows underage youth rely on “social sources” for tobacco products, including siblings, friends, parents, and strangers; age restrictions won’t solve this problem. The U.S. Drug and Food Administration found “86% of 15 to 17 year olds obtained cigarettes by asking someone else for cigarettes or being offered cigarettes by someone.”
Perhaps the most important issue with the Alabama proposal is that it would include tobacco harm reduction (THR) products, including e-cigarettes, vaping devices, and smokeless tobacco, such as snus. Literature and studies continue to indicate these products are significantly less harmful than combustible cigarettes and therefore should be regulated differently.
For instance, in a 2009 BioMed Central study, after analyzing “the relative risk of cancer among smokeless tobacco users, compared with non-users of tobacco,” the authors found “very little evidence” of a greater risk of cancer by smokeless tobacco products. Brad Rodu, a senior fellow at The Heartland Institute, has more than 20 years of experience researching smokeless tobacco. According to Rodu’s research, smokeless tobacco is “at least 98 percent safer than smoking, even though most Americans are misinformed about the differences in risk.”
Additionally, e-cigarettes and vaping devices are also important THR products that should not be included in mandates regulating tobacco. E-cigarettes and vaping pose a significantly lower health risk than combustible tobacco. In 2018, the National Academies of Sciences, Engineering, and Medicine found e-cigarette use to result in “reduced short-term adverse health outcomes in several organs.” Other public health organizations had reached the same conclusion. In 2017, NHS Health Scotland found using e-cigarettes is “less harmful than smoking.” In 2016, the Tobacco Advisory Group of the Royal College of Physicians in the United Kingdom determined the health hazards associated with THR products are “unlikely to exceed 5% of the harm [caused by] smoking tobacco.” In 2015, Public Health England declared e-cigarette use as roughly “95% safer than smoking.”
THR products such as e-cigarettes and vaping devices could alleviate costs to states’ budgets, too. J. Scott Moody, chief executive officer and chief economist at State Budget Solutions, estimates Medicaid savings could have amounted to $48 billion in 2012 if e-cigarettes had been adopted in place of combustible cigarettes by all Medicaid recipients who currently consume tobacco products.
Lawmakers in Alabama should avoid limiting adults’ choices and instead consider promoting THR products, a decision that would likely help to improve health outcomes in the Yellowhammer State.
The following documents provide additional information about tobacco harm reduction.
Vaping, E-Cigarettes, and Public Policy Toward Alternatives to Smoking
For decades, lawmakers and regulators have used taxes, bans, and burdensome regulations as part of their attempt to reduce the negative health effects of smoking. Recently, some have sought to extend those policies to electronic cigarettes. This booklet from The Heartland Institute urges policymakers to re-think that tax-and-regulate strategy. Policymakers should be mindful of the extensive research that supports tobacco harm reduction and understand bans, excessive regulations, and high taxes on e-cigarettes often encourage smokers to continue using more-harmful traditional cigarette products.
Research & Commentary: Washington State’s Tax Proposal Ignores E-Cigarettes’ Public Health Benefits
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud examines a proposal by lawmakers in Washington State to implement a 60 percent floor tax on e-cigarettes and vaping products. Stroud argues such legislation ignores the potential health gains that tobacco harm reduction products provide and will significantly impact vaping businesses in the state.
Research & Commentary: Cities and Sates Consider Increasing Tobacco Age Limit to 21, Regulating ENDS as Tobacco Products
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud examines the states and municipalities that are considering increasing their smoking age from 18 to 21. Stroud says such laws fail to substantially curb consumption, and she argues the inclusion of tobacco harm reduction tools, such as e-cigarettes and vaping devices, would negatively impact the health gains these products have been repeatedly shown to provide.
Research & Commentary: Study Finds E-Cigarettes Would Prevent 6.6 Million Premature Deaths
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud examines an October 2017 Tobacco Control study that found electronic nicotine delivery systems (ENDS) might help extend life for millions of people. The authors of the study found there was an estimated 6.6 million fewer deaths and more than 86 million fewer-life-years lost over a ten year period because of ENDS products. Stroud concludes the use of ENDS could also help improve the budgets of numerous state programs, including Medicaid.
Research & Commentary: Public Health Officials Urge Use of Electronic Nicotine Delivery Systems
In this Research & Commentary, Heartland Institute State Government Relations Manager Lindsey Stroud notes the importance of NHS Health Scotland’s joint statement encouraging the use of electronic nicotine delivery systems (ENDS) as an alternative to tobacco products. NHS Health Scotland, Public Health England, and other groups have found ENDS are 95 percent less harmful than tobacco cigarettes.
Research & Commentary: Qualitative Study on E-cigarettes Shows More Evidence of Tobacco Harm Reduction
In this Research & Commentary, Heartland Institute State Government Relations Manger Lindsey Stroud examines a study, published in The International Journal of Environmental Research and Public Health in June 2016, that provides additional evidence showing e-cigarettes and vaporized nicotine products (VNPs) are an effective tobacco harm-reduction tool.
E-Cigarette Primer for State and Local Lawmakers
Joel Nitzkin provides evidence e-cigarettes work as a tobacco harm reduction modality and reviews the arguments against them. He closes with recommendations for actions state and local lawmakers should and should not consider regarding tobacco harm reduction and e-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. For further information on this and other topics, visit the Budget & Tax News website, The Heartland Institute’s website, our Consumer Freedom Lounge, and PolicyBot, Heartland’s free online research database.
The Heartland Institute can send an expert to your state to testify or brief your caucus, host an event in your state, or send you further information on a topic. Please don’t hesitate to contact us if we can be of assistance! If you have any questions or comments, contact John Nothdurft, Heartland’s government relations director, at [email protected] or 312/377-4000.