Research & Commentary: Misguided Massachusetts Vaping Ban is a Wet Blanket on Tobacco Harm Reduction

Published October 9, 2019

On September 24, 2019, Massachusetts became the first start to ban all vaping products, including devices containing nicotine, tobacco, and tetrahydrocannabinol (THC). Gov. Charlie Baker “called for a temporary four-month statewide ban” while authorities attempt to “identify” the cause of recent vaping-related hospitalizations. Unlike other recent bans on flavored e-cigarettes, the Bay State’s all-out prohibition includes all e-cigarette products, and bars medical marijuana dispensaries from selling THC-containing vaping devices. The ban will be “enforced by police.”

Although investigating vaping-related hospitalizations is worthwhile, a unilateral ban on all vaping devices will likely do more harm than good. Why? Because health departments throughout America have linked vaping-related lung illness to the use of illegal and counterfeit vaping devices containing THC. Moreover, these ill-considered bans will likely force adult vapers back to combustible cigarettes, which are infinitely more harmful than regulated e-cigarettes and vaping devices.

Once again, the Centers for Disease Control and Prevention (CDC) and several state health departments have linked recent vaping-illnesses to the use of vaping devices containing THC. In a late September, 2019 report, the CDC found that 76.9 percent of self-reporting patients “reported using THC-containing products.” The CDC findings underpin similar results from many states, including Connecticut, Minnesota, Oregon, Texas, Utah, and Wisconsin.

Further, the vast majority of recent THC hospitalizations are due to the use of illegal and unregulated THC cartridges. Perhaps the most infamous of these black-market products is Dank Vapes. Eager entrepreneurs can purchase empty packaging with the Dank Vape label online, as well as empty cartridges, which they can fill with who knows what, including unknown chemicals. Little is known about this shady company. However, one marijuana research company found Dank Vapes to be an illegal, unlicensed brand. Dank Vapes has already been implicated for putting a Wisconsin man into a coma. No doubt, more cases will emerge involving Dank Vapes.

For instance, the Utah Department of Health concluded 38 percent of self-reporting patients who were hospitalized due to THC used Dank Vapes. Further, the Utah Public Health Laboratory tested 39 vaping devices: 51 percent contained e-liquid nicotine and 49 percent contained THC. What’s more, 100 percent of nicotine-containing liquids “contained nicotine and none have shown unexpected compounds.” On the other hand, 90 percent “of the THC cartridges contained Vitamin E acetate.” There is little research on the effects of inhaling Vitamin E acetate, but it is a lipid, which are “highly toxic and have been associate with lung injury for years.” Regulated e-cigarettes and vaping devices do not contain oils.

In an instance of stunning hypocrisy, Massachusetts Lt. Gov. Karyn Polito emphasized the need to “educate youth and parents about the dangers of vaping.” Unfortunately, Polito’s call for action is more hallow than a drum. Why? Because Massachusetts spends almost none of the enormous funds it receives from tobacco settlement moneys on such programs. In 2019, the Bay State received an estimated $864.5 million in tobacco settlement payments and taxes, yet spent a pathetically low $4.2 million, or 0.004 percent on tobacco education and prevention programs. In fact, Massachusetts raised the cigarette tax by a $1 per pack in 2013. From 2013 to 2016, the Bay State collected an additional $542 million in cigarette taxes, however, “none of the cigarette revenue [went] directly into anti-smoking programs.”

Electronic cigarettes and vaping devices first entered the U.S. market in 2007. Since their introduction, an estimated three million Americans have used these tobacco harm reduction products to quit smoking. Moreover, a January 2019 study found e-cigarettes to be twice as effective as traditional nicotine replacement therapy in helping smokers quit.

Despite unfettered fear mongering, e-cigarettes are regulated. Since 2012, the U.S. Food and Drug Administration (FDA) has had authority to regulate e-cigarettes. In 2016, FDA issued deeming regulations, extending the agency’s regulatory authority to include e-cigarettes and other tobacco products. Since August 8, 2016, no e-cigarette product has come to market without first completing a premarket tobacco application (PMTA). Further, all existing products must have registered with the FDA by December 31, 2016. Other deeming regulations include the prohibition of sales to minors, child-proof packaging, ingredient listings, and a list of harmful and potentially harmful constituents. Finally, every e-cigarette manufacturer will have to complete the PMTA process by May 12 of 2020, according to a 2019 U.S. District Court ruling.

Lawmakers should also understand that restricting flavors in e-cigarettes will likely drive former smokers back to combustible cigarettes. Indeed, a 2017 study by the National Bureau of Economic Research examined the impact of flavor bans. The authors concluded banning flavors “would result in increased choice of combustible cigarettes.”

Unfortunately, disingenuous Massachusetts lawmakers have effectively vaporized tobacco harm reduction in response to hospitalizations that are overwhelmingly caused by unregulated, illegal vaping devices containing THC and other unknown chemicals. Further, rather than restricting adult choices to tobacco harm reduction products, lawmakers should allocate much more of existing tobacco moneys on tobacco control programs, including education and prevention.

The following articles provide more information on e-cigarettes and tobacco harm reduction.

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 101details 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.

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.

Podcast Series: Voices of Vapers
In this weekly podcast series, State Government Relations Manager Lindsey Stroud talks with researchers, advocates, and policymakers about tobacco harm reduction and electronic cigarettes. The series provides important information about the thousands of entrepreneurs who have started small businesses thanks to THRs and the millions of adults that have used electronic cigarettes and vaping devices to quit smoking tobacco cigarettes.

Research & Commentary: Largest Vaping Survey Finds Flavors Play Important Role in Tobacco Harm Reduction–commentary-largest-vaping-survey-finds-flavors-play-important-role-in-tobacco-harm-reduction
In this Research & Commentary, Heartland State Government Relations Manager Lindsey Stroud examines a survey of nearly 70,000 adult vapers in the United States. The survey was completed in response to the U.S. Food and Drug Administration’s recent Advanced Notice of Proposed Rulemaking seeking comment on the role of flavors in tobacco products. The authors found nearly 95 percent of survey respondents were at one time smokers and the majority reported using flavors at the point of e-cigarette initiation. Stroud compares this to other surveys. She concludes, “eliminating flavors will force [vapers] to vape only tobacco-flavored e-cigarettes, which would likely cause them to return to combustible cigarettes.” Stroud also found research has found e-cigarettes are a key tobacco harm reduction product and could help alleviate state budgets by mitigating health care costs.

Research & Commentary: Randomized Trial Finds E-Cigarettes Are More Effective Smoking Cessation Tool Than Nicotine Replacement Therapy–commentary-randomized-trial-finds-e-cigarettes-are-more-effective-smoking-cessation-tool-than-nicotine-replacement-therapy
Lindsey Stroud, a State Government Relations Manager at The Heartland Institute examines a study in The New England Journal of Medicine that finds e-cigarettes and vaping devices to be twice as effective as nicotine replacement therapy (NRT) in helping smokers quit cigarettes. Nearly 700 participants were studied over a 52-week period, with researchers finding that 18 percent of e-cigarette users reported abstinence, compared to 9 percent of those using NRT. Stroud writes that “these latest findings provide more valuable information on the public health role that e-cigarettes and vaping devices provide for the 38 million cigarette smokers in the United States,” an implores policymakers to regulate these devices in a way that promotes their usage.

Research & Commentary: Study Finds E-Cigarettes Would Prevent 6.6 Million Premature Deaths–commentary-study-finds-e-cigarettes-would-prevent-66-million-premature-deaths
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.

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.

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