When it comes to battling teen pregnancy, our nation’s health officials have for two decades put aside moralism and focused on “harm reduction.” For example, instead of continuing a failed $1 billion policy to promote abstinence, the Department of Health and Human Services shifted focus to promote “safe sex”—and teen pregnancy rates fell to record lows. It seems to have been a wise change of course, from a public-health standpoint.

Indeed, the harm-reduction blueprint is used globally, from needle-exchange programs to combat HIV to opioid replacement therapy to designated-driver advocacy. But there is one vice toward which American politicians seldom apply harm-reduction methods: tobacco. With anything smoking or nicotine-related, health officials can be counted on to be as moralistic as a Woman’s Christian Temperance Union activist in the heat of the Prohibition fight.

Smoking contributes to the deaths of nearly a half-million Americans annually, yet 17% of adults persist in puffing away. Faced with similar problems, medical practitioners in England recently took the unique step of urging traditional smokers to switch to electronic cigarettes, which deliver nicotine without the negative effects of tar and carcinogens. These physicians noticed a growing body of research demonstrating the efficacy of e-cigarettes as harm-reduction tools. Vaping isn’t entirely safe, but it is about 95% safer than smoking cigarettes. That’s a massive gain.

But the U.S. public-health establishment, by contrast, is committed almost entirely to abstinence. Instead of promoting the healthful policy of tobacco harm reduction, our political leaders continue to pursue complex regulatory schemes designed to cripple—and ultimately eliminate—access to e-cigarettes. With increasingly prohibitive access to harm-reduction alternatives, smokers are cut off from the one proven alternative to the Sisyphean undertaking of smoking abstention.

In new research published this month, the R Street Institute developed an interactive website that maps and codes the legal and regulatory climates for e-cigarettes and other nicotine-vapor devices across 52 major U.S. cities, assigning letter grades based on different criteria. The report examines whether each city’s vaping regulations—including excise taxes, excessive licensing requirements and environmental restrictions—are consistent with the goal of tobacco harm reduction.

For instance, in New York, there is mounting pressure to circumscribe drastically the areas in which vapers may congregate, to increase the age of purchase for e-cigarettes to 21 from 18, to prohibit the sale of discounted e-cigarettes and to define the use of e-cigarettes as smoking, a rhetorical slight-of-hand that may later allow the government to get rid of e-cigarettes altogether. As a result, New York received a D+ in the report.

This low grade will come as no surprise to the numerous small-business owners who suffer because of Albany’s misguided crusade; nor will it surprise the medical community, whose righteous crusade against tobacco-caused cancer embraces tobacco harm reduction. But it will surprise, and should shock, New Yorkers of every stripe who care about the well-being of their neighbors and the health of the community.

Of the 52 cities in our sample, the average Vapescore was C+ and the median score a B+, with 13 cities receiving failing grades. Since few cities address the distinction between vapor and traditional cigarettes in terms of tax policy, predicting trends is somewhat difficult.

New York officials need to rethink their approach and ask themselves a simple question: Are they putting the health concerns of the state’s residents first, or are they jeopardizing them because of a moralistic disdain for nicotine products?

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