In the late 1960s, I worked at Grant Hospital as an inhalation therapist, fascinated that some of those I treated for breathing ailments would stub out a cigarette right before treatment and light up again as I packed up the gear. What I learned was how very difficult it is for many to give up smoking and just how many bodily conditions smoking can affect.

Though a half-million Americans die yearly from smoking-related illness, roughly 17 percent of U.S. adults continue to smoke. New options have come to the market for those who find they just can’t quit the habit. Electronic cigarettes and other vapor devices deliver nicotine without the negative effects of tar and carcinogens. While vaping isn’t completely safe, the best evidence suggests it’s about 95 percent safer than smoking cigarettes.

But state and local governments, along with the U.S. Food and Drug Administration, haven’t always been so welcoming to e-cigarettes. A new report from the R Street Institute examines taxes, regulations and public information campaigns in 52 of the largest U.S. cities, assigning letter grades that assess whether local rules encourage tobacco harm reduction.

In that respect, Columbus performed admirably, earning a grade of A-minus. The city saw few deductions, which were given for things like onerous licensing, bans on e-cigarette shops, punitive taxes on vaping products and misleading public information campaigns. Columbus’ propensity to engage stakeholders, study an issue at length and avoid frustrating emerging industries has served us well.

An overview of the scores finds some interesting trends. For example, nine of the 52 cities levy an excise tax on vaping products. That figure could rise, particularly as local governments seek to replace the cigarette-tax revenue they’ve become hooked on.

The cities scoring lowest – including Boston, Philadelphia, Chicago and all of the California cities studied – tended to treat cigarettes and vaping products as equivalent, or even banned vaping in venues designed for e-cigarette use. Dead last was Minneapolis, whose local tax structure inexplicably favors cigarettes over vapor products.

The top score went to Virginia Beach, aided by a 2010 court decision that held the commonwealth’s smoking ban did not apply to e-cigarettes. A number of cities in Arizona and New Mexico also were recognized for policies conducive to tobacco harm reduction.

Policymakers understandably have concerns about e-cigarettes, including whether vaping will attract new customers who are not smokers. To date, research here and in Europe suggests this is rare. Meta-analysis of studies with populations of millions of vapers show less than a 1 percent recruitment rate of nonsmokers.

This is crucial, as smoking-cessation products on the market combine to produce about a 7 percent success rate – which is to say a 93 percent failure rate. Meanwhile, millions of vapers use e-cigarettes to cease or significantly curtail their smoking. Public policy should recognize this reality and, at the very least, do no harm.

Image by NeydtStock

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