From the Heartland Institute:

In a 2017 Policy Study published by the R Street Institute, Associate Fellow Richard B. Belzer examined the potential financial impact to Medicaid costs in a scenario in which varying degrees of Medicaid recipients switch from using combustible tobacco cigarettes to electronic cigarettes or vaping devices.27 Belzer used a sample size of “1% of smokers [within] demographic groups permanently” switching. Using this analysis, Belzer estimated Medicaid savings “will be [in 25 years] approximately $2.8 billion per 1 percent of enrollees” who switch.

Additionally, research by Dr. Edward Anselm, a senior fellow for the R Street Institute and senior fellow and medical director of Health Republic Insurance of New Jersey, concludes the presence of flavorings in e-cigarettes significantly helps smokers quit using traditional tobacco cigarettes.89 Anselm also notes concerns over “flavoring as a tool to recruit children are overblown,” in large part because there is no “evidence that suggests children are drawn to tobacco products specifically because of flavor.”

27 Richard B. Belzer, “Expected Savings to Medicaid From Substituting Electronic for Tobacco Cigarettes,” R Street Institute, December 2017, https://

74 Brad Rodu, “Antidote to NEJM ‘formaldehype’ arrives at last,” R Street Institute, September 19, 2017,

89 Edward Anselm, “The Role of Flavoring in Tobacco Harm Reduction,” Policy Study, R Street Institute, December 2015, https://2o9ub0417chl2lg6m4

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