By Raymond March, Ph.D.
A recent editorial by the Grand Forks Herald urged North Dakota lawmakers to “recognize e-cigarettes as the tobacco products they are.” Noting recent actions by the FDA to limit e-cigarette availability to young smokers, the piece calls for similar efforts to “crack down” on vaping at the local level.
As a health economist, I find the Herald's desire to help younger generations avoid addiction praiseworthy. It is also misinformed and misguided.
Although e-cigarette use has become increasingly popular among young smokers, likening it to an “epidemic” is farfetched.
According to the 2017 National Youth Tobacco Survey, the number of middle and high school students using tobacco products decreased 20 percent from 2011 to 2017. E-cigarettes entered the U.S. market in 2006. It is difficult to blame e-cigarettes for enticing younger generations to smoke when their smoking rates are decreasing.
Even if recent survey data is correct and there has been a recent and swift increase in e-cigarette use among high-school age smokers, overall trends over the last half dozen years indicate significantly less smoking. I think this hardly constitutes an “epidemic.”
Similarly, while it is true that lifelong smoking habits typically begin in high school, the 2014 National Survey on Drug and Health finds this trend long predates the invention of e-cigarettes. Younger generations have consistently found ways to access tobacco products despite government restrictions. An article published in the American Journal of Public Health found that numerous U.S. laws banning the sale of tobacco products to young adults did little to reduce smoking rates between the 1920s and mid-1960s.
Calling for increased regulation for young smokers is nothing new, and history indicates such calls to action are unlikely to succeed.
The editorial specifically calls for e-cigarettes to “fall under the tobacco tax umbrella” in hopes that higher prices will decrease product use. I disagree. The prospects of taxing away e-cigarettes’ popularity are slim. According to a National Bureau of Economic Research paper, reducing cigarette smoking rates by 5 percent would require at least a 100 percent tax rate increase, dwarfing any current tobacco-related tax in North Dakota.
Further, taxing goods does not guarantee better health outcomes. On the contrary, efforts to regulate vices often result in more harm than good.
For example, soda taxes universally fail to reduce obesity; taxing fast-food leads to overconsumption of fatty-foods at home; and restrictions on opioid prescriptions often motivate patients to seek illicit alternative drugs, even heroin, to cope with their addiction.
Perhaps most importantly, smoking rates in the United States have been decreasing steadily for 50 years. However, the FDA only started regulating nicotine in 2009, meaning little of these rate reductions were the result of government policy.
E-cigarettes, on the other hand, provide a comparatively healthier alternative to many tobacco products and have helped millions of smokers quit. One research paper considers them part of an “endgame for cigarette smoking,” saving potentially 6.6 million preventable deaths in just 10 years.
Like many, I am deeply concerned about the health of those who smoke e-cigarettes. However, based on considerable evidence, I am extremely hesitant to look to government to solve pressing public health issues. Smoking is dangerous. Vaping is too. However, despite good intentions, regulation can make them more dangerous.
This op-ed appeared in the Grand Forks Herald.
The views and opinions expressed in this article belong to the author and do not reflect the official policy or position of any agencies he/she is employed by or affiliated with.