The Leaflet: What Lawmakers Should Know About Tobacco Harm Reduction

Published April 18, 2018

E-cigarettes’ health benefits outweigh their risks according to a March 2018 study in Nicotine & Tobacco Research. Tobacco harm reduction (THR) products such as e-cigarettes have been touted as viable alternatives to combustible cigarettes particularly because of their efficacy in smoking cessation.

Despite THR product’s benefits, states are decreasing THR products availability while increasing their costs. In recent years, policy makers have instituted several draconian measures on THR products, such as: outright bans, onerous taxes, and minimum purchase ages between 18 and 21. These policies are not based on research and actually undermine the public health gains THR products provide to millions of smokers.

The March report comes on the heels of a previous study that found “a majority of adults erroneously link nicotine to cancer,” indicating most Americans incorrectly believe nicotine causes cancers and other health risks. Such false notions undermine nicotine’s presence in THR products. Ironically, despite Americans misperceptions, many smokers are choosing THR products instead of combustible cigarettes to avoid major health risks.

Electronic cigarettes and vaping devices are significantly less harmful than combustible cigarettes. In fact, the use of e-cigarettes “is around 95% safer than smoking,” Public Health England declared in 2015. And health risks associated with e-cigarette use were “unlikely to exceed 5% of the harm from smoking,” the Tobacco Advisory Group of the Royal College of Physicians found in 2015.

Furthermore, e-cigarette use resulted in “reduced short-term adverse health outcomes in several organs,” the National Academies of Sciences, Engineering and Medicine reported in January 2018. Even the American Cancer Society noted the “currently available evidence, using current generation e-cigarettes is less harmful than smoking.”

Electronic cigarettes replacing combustible cigarettes also help state budgets. In 2010, 8.7 percent of U.S. health care spending, about $170 billion per year, was attributable to tobacco cigarettes. If only 1% of smokers permanently switched to e-cigarettes, Medicaid programs could save about $2.8 billion annually, with median states’ “savings exceeding $32 million per year.”

Though THR products are effective tools for smoking cessation, state and local policy makers treat these products more and more like combustible cigarettes. Thirteen states and more than 700 municipalities classify electronic cigarettes and vaping devices as prohibited products in smoke free laws. All states have “at least some tax on non-cigarette tobacco products.” Such policies perpetuate THR demonization, even though these products are effective alternatives to smoking combustible cigarettes.

In addition to e-cigarettes, other THR products such as smokeless tobacco and heat-not-burn devices allow nicotine consumption with significantly less health risks than combustible cigarettes. Policy makers should promote, or at the very least not discourage, potentially life-saving THR products.


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