WASHINGTON (May 23, 2022) – A new study by R Street Institute Government Affairs Manager Sarah Wall and Harm Reduction Policy Director Mazen Saleh examines the unintended negative consequences of prohibitionist e-cigarette policies that have been enacted throughout the northeastern United States.

Wall and Saleh review how e-cigarette policies that ban flavors, levy disproportionately high excise taxes and limit nicotine levels unintentionally prevent e-cigarettes from being used by adult smokers whose health and life would be greatly improved by switching to this lower-risk alternative to combustible cigarettes. They also stress the importance of implementing proven alternative strategies to reducing youth tobacco use that have been successful in places like the United Kingdom.

“In enacting prohibitionist legislative and regulatory models, policymakers in the Northeast are attempting to stem youth use of e-cigarettes at the cost of the health of 6 million adult smokers in the region,” said Wall. Saleh added, “These models have the unintended consequence of driving former combustible cigarette users back to combustibles, which presents far greater risks than using e-cigarettes.”

Although trying to reduce youth e-cigarette use is an admirable goal, policies such as those mentioned above are often inconsistently applied and have a negative impact on adult cigarette smokers who would benefit from switching to e-cigarettes. E-cigarette users are more likely to quit combustible cigarettes—and stay off them—than those using traditional nicotine replacement therapy. Because e-cigarettes are highly restricted in the northeast, the roughly 6 million smokers in the region suffer the most.

Three key points:

  1. Concerns over youth use drive most e-cigarette policy decisions in northeastern states. However, these policies often negatively affect adult smokers who use them as an alternative to combustible cigarettes. Policymakers should instead focus on enforcing existing age restrictions and increasing youth-based education on nicotine use.
  2. Common e-cigarette restrictions, such as flavor bans, high excise taxes and limits on nicotine concentration unintentionally worsen public health outcomes by increasing the relative appeal of combustible cigarettes.
  3. A harm reduction approach that positions e-cigarettes as a smoking cessation tool has worked in the United Kingdom to bring down rates of smoking while keeping rates of youth vaping low. A similar model in the United States would work far better than our current prohibitionist approach.

Read the full study here.

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