Drug use can kill people. Smoking can kill people. But these behaviors don’t have to, and Californians know it.

California—especially the Bay Area—has been a leader in promoting proven methods to reduce death and disease among people who use drugs. When California’s first needle-exchange program opened in 1988 in San Francisco, the operators faced arrest if they were caught. The blossoming of legal needle-exchange programs has resulted in San Francisco now having lower HIV transmission rates than the national average.

California is also leading the charge in recognizing that providing people a safe place to use drugs will reduce disease transmission, bring overdose deaths to zero and restore much needed dignity to people who are the most marginalized in our abstinence-only society. If pending legislation is passed, eight counties in California will have “safe consumption spaces” that allow people who use drugs to have access to clean needles, overdose-prevention health care and treatment referrals.

Among the most sophisticated overdose-prevention programs are those that distribute the drug naloxone (Narcan) to at-risk users. The California Department of Public of Public Health is in the process of providing $3 million in grants to licensed clinics and medical directors to distribute the drug, which can prevent death from opioid use.

But while California long has been on the cutting edge of harm-reduction strategies to help drug users, the state—especially the Bay Area—is leaving smokers vulnerable to tobacco-related diseases that will kill nearly 4,000 Californians this month. Lawmakers who understand the value of harm reduction need to reconsider why they are taking away products that encourage smokers to move away from cigarettes.

It can’t be because flavored vaping products are more dangerous. It is often cited that menthol flavors are more addictive, because menthol chemicals allow nicotine to remain in the bloodstream longer. Those with a background in pharmacology or biological mechanisms of addiction (I am one such person) know that this is a red herring meant to shift blame. In fact, this has almost nothing to do with the addiction potential of cigarettes. However, even when different flavoring chemicals are taken into account, e-cigarettes are at least 95 percent safer than combustible cigarettes.

It also can’t be because flavored vaping products initiate teens to smoke. Rates of teen smoking are at an all-time low and have steadily declined from 15.8 percent in 2011 to 9.3 percent in 2015. Just like cigarettes, it is illegal to sell vaping products to minors. Given that small businesses have a foothold in e-cigarette sales, it is more likely that minors are protected from regular use of e-cigarettes than that of combustible cigarettes; independent “vape shops,” as they are colloquially called, have more to lose if they are caught selling to minors.

Nor can it be because flavored products keep big tobacco in business. Quite the opposite: global revenues of combustible cigarettes, which are not a part of these bans, are valued at approximately $700 billion annually, while the e-cigarette market has global revenues of less than 1 percent of that total. Vape shops (of which San Francisco currently has only eight), rely on flavored e-cigarettes to remain profitable.

Instead, flavor bans are aimed at people who smoke flavored cigarettes, of which menthol is the most prevalent. Taking away the option to have any flavor, other than traditional non-mentholated combustible cigarettes, probably won’t convince anyone to quit smoking.

If reducing the health risks associated with cigarettes is a top priority for California, making e-cigarettes available in a variety of flavors to encourage people to switch to these vastly safer products should also be top priority.

Image by Elizabeth A.Cummings

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