E-cigarettes and other electronic nicotine delivery systems (ENDS) continue to prove beneficial as tobacco harm reduction products. Recently, Health Scotland issued a statement in which the agency pointed to conclusions made by more than 20 organizations about the benefits of using ENDS, especially for those struggling to break their addiction to traditional combustible cigarettes. “There is now agreement based on the current evidence that vaping e-cigarettes is definitely less harmful than smoking tobacco. … Thus, it would be a good thing if smokers used them instead of tobacco,” stated Health Scotland.
Other U.K. health organizations have reached similar conclusions on the safety of vaping products. Earlier in 2017, researchers at University College London reported e-cigarette use has been one of the primary factors in helping the United Kingdom attain higher smoking-cessation rates. It also determined e-cigarettes are a safe alternative to traditional smoking.
In 2015, Public Health England, a national health education agency, found evidence showing e-cigarette use is correlated with reduced rates of smoking and smoking-related diseases, does not lead to nicotine poisoning, and is 95 percent safer than smoking.
In Vaping, E-Cigarettes, and Public Policy Toward Alternatives to Smoking, Heartland Senior Fellow Dr. Brad Rodu describes the many U.S. policies that unfairly target ENDS. In many states, Rodu writes, high “sin taxes” are levied on vaping products, just as they are on gambling, smoking, and alcohol, with the goal being to discourage consumption of these “vices.” For example, in 2016, Pennsylvania lawmakers passed a 40 percent wholesale tax on all vaping products sold in state, which resulted in the closing of more than 100 businesses and the loss of several hundred jobs.
Other burdensome and punitive policies include indoor and outdoor bans on the use of vaping products, which do not emit the “secondhand” toxins and smoke that cigarettes do, and Food and Drug Administration mandates requiring ENDS manufactures to submit lengthy and costly pre-market tobacco applications.
Heartland Government Relations Manager Lindsey Stroud wrote in a new Research & Commentary, “In 2010, 8.7 percent of U.S. health care spending, about $170 billion per year, was attributable to tobacco cigarettes. ENDS could help offset health care costs, an argument J. Scott Moody, chief executive officer and chief economist at State Budget Solutions, made in a 2015 Policy Analysis.”
Medicaid is one of the largest expenditures in states’ budgets. Conventional cigarette smokers constitute a higher percentage of Medicaid enrollees (51 percent) than of the general public (21 percent). Moody estimated a switch from cigarettes to ENDS could have resulted in a savings of up to $48 billion in fiscal year 2012.
Smoking is the leading cause of preventable death in the United States, causing as many as 480,000 premature deaths every year. If policymakers wish to lower health care costs and government spending, they should be pushing for policies consistent with the latest research, which shows clearly ENDS are a less harmful alternative to combustible cigarettes.
Stroud concludes, “Rather than demonize ENDS, state officials should welcome their use and refrain from imposing unnecessary regulations on them and from treating them as though they are similar to combustible cigarettes.”
What We’re Working On
Research & Commentary: ESA Program Passes Constitutional Muster in New Hampshire
In this Research & Commentary, Policy Analyst Tim Benson writes about a new legal review from the Josiah Bartlett Center for Public Policy and the Institute for Justice that claims an education savings account (ESA) program would be legal under New Hampshire’s constitution. The authors of the review state that given precedent and advisory opinions, there is “no doubt” ESAs would pass muster constitutionally in the Granite State.
Energy & Environment
North Carolina, Texas Limit Attractiveness of New Wind Farm Developments
In this article published by Environment & Climate News, Managing Editor and Heartland Research Fellow H. Sterling Burnett writes that because military effectiveness and readiness at military bases are being compromised by the growing number of wind turbines erected near bases, North Carolina and Texas are taking measures to rein in wind farm develop near military installations. Texas has eliminated tax exemptions property owners could previously have claimed if they allowed wind farms to be erected on land within 30 miles of the borders of a military installation. North Carolina has placed an 18-month moratorium on the construction of new wind farms.
Budget & Tax
Research & Commentary: Florida Considers Supermajority Requirement for Tax Changes
In this Research & Commentary, Senior Policy Analyst Matthew Glans examines a proposal in Florida to require a supermajority vote in the state’s legislature to approve tax increases. “Supermajority requirements are a solid first step toward reining in out-of-control state budgets. States must learn to live within their means and also adopt reforms that limit spending. Controlling spending would force the government to more closely monitor and limit state spending, thereby properly balancing the budget while limiting the need for future tax hikes,” Glans wrote.
Research & Commentary: Political Donations May Allow Health Care Providers to Game Certificate of Need Laws
In this Research & Commentary, Senior Policy Analyst Matthew Glans examines a new study that considers how health care providers can influence the certificate of need (CON) approval process through targeted donations to the elected officials responsible for assembling the CON boards making the decisions. “The health care market in the United States has grown as a result of the presence of free-market competition and innovation, not government regulation. All states still imposing CON laws should consider reforming or repealing them, thereby ending these burdensome regulations across the country. Allowing CON laws to continue to exist increases the cost of health care, limits access, benefits those with political connections,” Glans wrote.
From Our Free-Market Friends
How to Clarify and Expand the ACA’s State Innovation Waivers
In this Manhattan Institute paper, Senior Fellow Paul Howard and Adjunct Fellow Yevgeniy Feyman encourage Congress to aid in the waiver process for states looking for flexibility and savings in their health care markets. They suggest Congress enact waiver legislation clarifying the availability of federal subsidies and instructing the Department of Health and Human Services to create standardized waivers. In the meantime, Howard and Feyman say states should establish high-risk pools, modify Obamacare’s individual mandate penalty, and offer high-deductible health insurance plans that are accompanied by health savings accounts.