Tobacco Prohibitionists Not Letting This Pandemic Go to Waste

Anti-tobacco forces are callously abusing COVID-19-driven anxiety, pain and suffering as they spew their unique brand of science-free propaganda.  A good example is a video interview, titled “The Dangers Of Vaping and Smoking During Coronavirus,” with Matt Myers, head of the Campaign For Tobacco-Free Kids (here).  Following are selected Myers quotes, with my observations (in bold). 

The interview opens with a question on new research suggesting that nicotine might protect smokers from developing COVID-19 illness:

“It is completely false….it is pure and simple bad science.  Last week the World Health Organization convened 29 of the world’s leading scientists, and what they found was two things: First, in fact smoking increases your risk of serious diseases – of serious effects of this disease.  And B, there is no credible evidence that smoking provides any protective effect.  All of the science points that smoking, and potentially vaping, increases your risk of the most serious consequences.”

Myers, a lawyer, is making dogmatic statements on science that legitimate scientists are unwilling to make at this time.  Certainly, a debate about the effects of nicotine and smoking on COVID-19 infection prevalence and illness severity is warranted; here are some articles, pro (here, here, here) and con (here, here).    

“Even if vaping was significantly less hazardous, and we don’t know that for sure, it is still a dangerous product.” 

Even if…?  Extremists are incapable of acknowledging the most incontrovertible facts.  Despite their denials, inhaling vapor has been proven vastly safer than inhaling toxic smoke.  Myers’s denial was a set-up for his major theme – the so-called teen vaping epidemic.

“…in the United States we have over 5 million kids who have become addicted to e-cigarettes.  Many of them would have never smoked in their life…We have a youth e-cigarette epidemic that we need to address…In the last 3 to 4 years we have seen more kids become addicted to e-cigarettes…addicted in a way that’s even more powerful than we’ve seen with cigarettes.”

Myers’ “5 million” is a complete fabrication.  The 2019 National Youth Tobacco Survey, from which the highest estimates are drawn by the CDC, indicates that, at most, 172,000 underage teens might have been addicted to e-cigarettes (evidence here).  There is nothing to suggest that any of these youths have an e-cigarette addiction that is more powerful than cigarettes.

The interviewer asked a leading question about H.R. 2339, a bill approved by the U.S. House of Representatives but languishing in the Senate, that is meant to reverse the youth tobacco epidemic.  “This is one of the most important pieces of legislation Congress could pass.  It would prohibit the sale of all flavored e-cigarettes…it would ban the sale of menthol cigarettes…the tobacco industry has marketed menthol cigarettes to African-American youth and adults with devastating consequences…Eighty-five percent of African-Americans use menthol cigarettes…because the tobacco industry has targeted them.”

Myers wants to ban menthol cigarettes.  Despite a flood of research articles, the FDA has never developed a scientific rationale for such a ban (here and here).   Myers makes a common mistake in claiming menthol is all about race, as a full 68 percent of menthol smokers are not African-American (here).

Tobacco prohibitionists, armed with unfactual talking points, aren’t letting this pandemic go to waste.

The California Crusade Against Tobacco Flavors: From Foolish to Dangerous

Today the California Globe published my oped on the foolish and dangerous legislative effort to ban flavored tobacco products.  Read it here or on the Globe website.

“Crusades typically start out by being admirable, proceed to being foolish, and end by being dangerous.” Russell Baker used these words in a 1994 New York Times column describing the anti-tobacco crusade, noting that the holy war was entering the last stage. Now, 25 years later, California legislators are fighting their own crusade—against the so-called teen vaping “epidemic”—with a proposed ban on flavored tobacco products.

First, let’s examine the “epidemic.” Authorities generously define “current use” of any drug by children as at least once in the past month. The FDA, using this definition in a national survey, reported that vaping among American high school students increased substantially in 2018. The FDA was only telling part of the story; about half of those kids had vaped five or fewer days, the equivalent of trying products at a party. And most frequent e-cigarette users are not virgins with respect to cigarette smoking; most of them have smoked in the past.

Drug use by underage children is a serious matter. That makes it entirely baffling that California legislators ignore higher rates of alcohol and marijuana use among high schoolers, facts that have been known for decades. These behaviors have nothing to do with flavors, but instead demonstrate that kids are attracted to adult behaviors and products.

The FDA promotes the myth that a teen vaping epidemic is caused by unscrupulous manufacturers and retailers. This isn’t true, especially in California, where the violation rate in FDA inspections was only 4% in 2018, one of the lowest in the country (here and here).

Since retailers aren’t the problem in California, a ban on flavored tobacco products isn’t the solution. This is harassment without reason. Even advocates of alcohol prohibition 100 years ago didn’t try to ban flavors.

A flavor ban is supposed to stop kids from using nicotine, but is that a worthwhile objective? Nicotine, while addictive, is not the cause of any diseases associated with smoking. It is as safe to consume as caffeine, another addictive drug used daily by millions of adults and teens.

Because nicotine is so safe, prohibitionists fabricate hazards. One frequent claim is that nicotine can harm teenage brains. That may be a legitimate argument – for laboratory mice. If it was true for humans, then 40 million current smokers – and even more former smokers – who started as teens and smoked for decades would have demonstrable brain damage. There is no scientific evidence of such injury, nor to support the claim of youth brain risk. If California legislators want to protect children’s brains, they should ban football, as there is unequivocal evidence linking concussion-producing sports activities to chronic traumatic encephalopathy (here, for example).

A flavor ban will not affect vapers who make their own vaping liquids. This segment of the market is already large and growing; a few examples can be found here, here and here. A ban might cause the current retail market to fracture in two: one segment selling concentrated, unflavored nicotine liquids, and another selling flavors. A high-tax jurisdiction like Chicago, where a prohibitively high per-milliliter tax is imposed on nicotine liquids, demonstrates what happens when the market is bifurcated.  Vape shops there sell 30 ml bottles of zero-nicotine e-liquids (no tax) and small concentrated bottles of high-strength nicotine that are taxed.  Flavor bans will simply encourage consumers to purchase flavorless e-liquids, and then buy flavoring that is widely available in grocery stores and online, such as here and here.

Unintended Consequences

A flavor ban would create unintended consequences. Flavors would no longer be supplied by legitimate companies. Instead, do-it-yourselfers would be adding flavors with unknown chemistry to concentrated nicotine solutions. It is worth noting that the only known death attributable to vapor products in the U.S. resulted from a young child accidentally ingesting pure nicotine.

Politicians routinely ignore another basic economic fact: bans drive black markets. Economists and legal scholars use the terms “bootleggers” (black market retailers) and “Baptists” (legislators and other misguided do-gooders), calling them “unlikely allies from the tobacco wars [who] try to fight off a game-changer [e-cigarettes].”

Two years ago, California was already the sixth biggest cigarette black-market state. Legislators should not create a bootlegger paradise for flavored tobacco, when they haven’t even solved the bootleg marijuana problem. The legislature legalized cannabis in 2016, but retained high taxes; the black market is now worth $3.7 billion, four times the legal market. The same rush to stigmatize vaping will doubtlessly create a black market in this category, as well.

The California crusade to ban flavors isn’t just foolish, it’s dangerous. With the exception of menthol, the ban will have the least impact on sales of cigarettes, the deadliest tobacco products. But it will remove from retail shelves many more smoke-free products – including e-cigarette liquids, dip, chew and snus. These products are vastly less hazardous than cigarettes. Imagine if alcohol opponents had only banned flavors during Prohibition. Beer, wine and other flavored spirits would have been eliminated, leaving only pure alcohol on retail shelves. That policy would have been an abject failure, as would any similar ban on flavored tobacco products.

Association of Youth E-Cigarette Bans with Increased Smoking Confirmed

There is fresh evidence indicating that attempts to prohibit youth access to e-cigarettes increase youth smoking rates.

Last November, I discussed a Yale research finding that smoking increased significantly among teens aged 12-17 in states that banned e-cigarette sales to minors compared with states with no bans (here).  Now this from researchers at Cornell University: “We document a concerning trend of cigarette smoking among adolescents increasing when [e-cigarettes] become more difficult to purchase.”

Michael Pesko and colleagues at the Cornell medical school compared adolescent smoking in states that implemented e-cigarette purchasing restrictions during the period 2007 to 2013, compared with states that had no restrictions.  Using federal Youth Risk Behavior Surveillance System surveys, they examined smoking rates over the past 30 days: recent (smoked at least 1 day), casual (1-19 days), regular (20+ days) and heavy (all 30 days).  They also accounted for state differences in cigarette taxes and indoor use laws, and they included a fixed effects variable to account for additional unmeasured differences in states’ smoking norms and anti-smoking sentiments.  The study was published in Preventive Medicine (abstract here).

Pesko et al. found “…that [e-cigarette] age purchasing restrictions are associated with a 3.1 percentage point (17.9% of the mean) increase in adolescent cigarette use (p < 0.05) in the period of implementation.  Most of this effect is accounted for within casual cigarette using adolescents… Our results suggest that adolescents are willing to substitute [e-cigarettes] for cigarettes depending on legal purchasing opportunities of [e-cigarettes].”

The researchers’ finding that e-cigs had no effect on use of cigars, smokeless tobacco or marijuana provides confidence about the specificity of the e-cig effect.    

While the Cornell researchers do not claim that the restrictions caused smoking to increase, they note that their results are consistent with those of the Yale study, and they add: “All policymaking bodies should be aware of a potential increase in cigarette use following [e-cigarette] age purchasing restrictions.”  They recommend raising cigarette excise taxes and they endorse the Yale researchers’ support for setting the e-cig sales age lower than the cigarette age in order to take advantage of the substitution effect.

This is Pesko’s second notable paper this year.  Earlier, he published an experimental study (abstract here) concluding that: “Increased taxes, a proposed US Food and Drug Administration warning label for [e-cigarettes] and a more severe warning label may discourage adult smokers from switching to [e-cigarettes].  Reducing the availability of flavours may reduce [e-cigarette] use by young adult smokers.”

It is important to note that none of these studies were funded by the National Institutes of Health.  The NIH predominantly funds researchers who endorse the federal government’s vision of a tobacco-free society.