Electronic cigarettes have quickly become one of the most popular tobacco replacement products, with the total market expected to hit $1.7 billion in 2015. E-cigarettes have proven effective at helping smokers reduce their cigarette use or quit altogether and thus are expected to result in significant public health and financial benefits for states. For decades, legislators have attempted to reduce the negative health and economic impacts of smoking through taxes, bans, and strong regulations, and recently some legislators have tried to extend these same failed policies to e-cigarettes, even though there’s no evidence e-cigarettes are harmful.
Many opponents of e-cigarette use say the product acts as a “gateway” to cigarettes, especially for younger users. The evidence, however, shows otherwise. A new report released by the Centers for Disease Control and Prevention (CDC) found only 0.4 percent of people who had never smoked tobacco were current vapers, which the report defines as using a vaping device either every day or some days. The CDC report, the first of its kind, estimated e-cigarette use among U.S. adults based on a nationally representative household survey. The report also found only 3.4 of adults who have never smoked have tried an e-cigarette; 12.6 percent of Americans have tried an e-cigarette; and fewer than 4 percent of the U.S. population are regular e-cigarette users.
According to many in the public health community, e-cigarettes are far safer than combustible cigarettes and offer many smokers the best option to quit using tobacco. Several studies have found e-cigarettes to be an effective and viable option for smokers seeking a nicotine replacement therapy. The American Association of Public Health Physicians has concluded e-cigarettes “could save the lives of 4 million of the 8 million current adult American smokers who will otherwise die of a tobacco-related illness over the next 20 years.”
A 2013 clinical trial in New Zealand showed e-cigarettes are as effective as nicotine patches in helping smokers quit. A study by the French Monitoring Centre for Drugs and Drug Addiction found approximately 1 percent of France’s total population had quit smoking using an e-vapor product. In the United States, 47.6 percent of current smokers have tried e-cigarettes, according to CDC, and 55.4 percent of smokers who were able to quit used e-cigarettes.
Beyond improvements in individual health, increased e-cigarette use for smoking cessation could save tax dollars. In a new report from State Budget Solutions, J. Scott Moody writes, “45 states and D.C. stand to gain more from potential Medicaid savings than through lost cigarette tax collections and tobacco settlement payments.” Fifty-one percent of Medicaid recipients smoke, whereas only 21 percent of the general public smokes. Reducing the use of traditional cigarettes among the Medicaid population could save states billions of dollars in health care costs from tobacco smoking-related illnesses.
Moody cites a 2009 study by CDC that claims “the potential savings of e-cig adoption, and the resulting tobacco smoking cessation and harm reduction, could have been up to $48 billion in Fiscal Year (FY) 2012.” The total amount of money the states could have saved is higher than all state cigarette tax collections and tobacco settlement money ($24.4 billion) collected by all the states in that year.
Banning the use of electronic cigarettes in private establishments, in addition to excessive regulation and taxation of these products, is a shortsighted decision that ignores the benefits of e-cigarettes as a nicotine replacement therapy. States can improve their residents’ health and reduce Medicaid costs by avoiding policies that discourage the adoption and use of e-cigarette products as an alternative to smoking.
The following documents provide additional information about electronic cigarettes and efforts to regulate their sale and use.
Electronic Cigarette Use Among Adults: United States, 2014
This report from the Centers for Disease Control and Prevention provides the first estimates of e-cigarette use among U.S. adults from a nationally representative household interview survey, which is organized by selected demographic and cigarette smoking characteristics.
Levels of Selected Carcinogens and Toxicants in Vapor from Electronic Cigarettes
Tobacco Control found e-cigarette vapor contains some toxic substances, but only at levels “9–450 times lower than in cigarette smoke and were, in many cases, comparable with trace amounts found in the reference product.” The study finds replacing tobacco cigarettes with electronic cigarettes could substantially reduce exposure to tobacco-specific toxicants.
E-Cigarettes Poised to Save Medicaid Billions
In a new report from State Budget Solutions, J. Scott Moody finds e-cigarette use could create significant savings for state governments, especially in their Medicaid programs: “As shown in this study, the potential savings to Medicaid significantly exceeds [sic] the state revenue raised from the cigarette excise tax and tobacco settlement payments by 87%. As such, the rational policy decision is to adopt a non-interventionist stance toward the evolution and adoption of the e-cig until hard evidence proves otherwise.”
E-Cigarettes Are Making Tobacco Obsolete. So Why Ban Them?
Matt Ridley reports vaping works better than any other method of giving up smoking, and he examines several studies reaching this conclusion. Ridley asks why cities are banning vaping products given the large amount of evidence present showing their success in helping smokers quit.
Peering Through the Mist: Systematic Review of What the Chemistry of Contaminants in Electronic Cigarettes Tells Us About Health Risks
Electronic cigarettes are generally recognized as a safer alternative to combusted tobacco products, but there are conflicting claims about the degree to which these products warrant concern for the health of the vapers (e-cigarette users). This paper reviews available data on the chemistry of aerosols and liquids of electronic cigarettes and compares modeled exposure of vapers with occupational safety standards.
Secondhand Exposure to Vapors from Electronic Cigarettes
Electronic cigarettes, commonly referred to as e-cigarettes, are designed to generate inhalable nicotine aerosol (vapor). When an e-cigarette user takes a puff, the nicotine solution is heated and the vapor is taken into the lungs. Although no side-stream vapor is generated between puffs, some of the mainstream vapor is exhaled by the e-cigarette user. This study evaluated the secondhand exposure to nicotine and other tobacco-related toxicants from e-cigarettes.
Regulating a Less Unhealthy Cigarette
Michael L. Marlow of the Cato Institute argues the Food and Drug Administration (FDA) jeopardizes public health by not developing an appropriate benefit-cost analysis of a proposed rule. FDA “anticipates,” without quantifying, substantial benefits from reducing harm by regulating e-cigarettes and non-cigarette tobacco products. FDA also does not adequately assess likely costs of its suppression of the e-cigarette market. The evolving literature on e-cigarettes strongly suggests they help smokers quit smoking.
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.
Research & Commentary: Electronic Cigarettes
Heartland Institute Senior Policy Analyst Matthew Glans examines electronic cigarettes, tobacco harm reduction, and various proposals to regulate e-cigarette use. E-cigarettes have become one of the most popular nicotine replacement products and a key building block in tobacco harm reduction strategies.
Studies Show E-Cigarettes Help Smokers Quit
For years, advocates of smoke-free alternatives, such as electronic cigarettes and other e-vapor products, have known these products are effective at helping smokers quit or dramatically reduce their cigarette consumption. Gregory Conley examines several studies showing the value of vapor products in smoking cessation.
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 subject, visit Budget & Tax News at https://heartland.org/publications-resources/newsletters/budget-tax-news, The Heartland Institute’s website at http://heartland.org, and PolicyBot, Heartland’s free online research database at www.policybot.org.
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