The Dangers of Public Health Zealotry
The latest studies confirm that bans on vaping and flavored tobacco push people back to far more dangerous combustible cigarettes.
SACRAMENTO, Calif. — One of the major public health crusades in recent years has been a push to ban the sale of flavored-tobacco products — something California adopted statewide in 2023. “It will be a point of deep pride and personal privilege as a father of four and as someone who’s had many, many family members die at the hands of the tobacco industry to sign that bill,” said Gov. Gavin Newsom as Senate Bill 793 made its way toward his desk.
The tobacco industry then qualified a referendum in an attempt to overturn the law, but voters sided with the governor and his allies by nearly a two-to-one margin. That initiative campaign delayed the law’s implementation, but didn’t make much headway among the political class or voters. Supporters of the ban mainly targeted e-cigarettes, most of which contain flavors. They also succeeded in banning lower-risk nicotine pouches that contain flavors.
Yet two working papers released this week by the well-respected National Bureau of Economic Research confirm what other studies (and this writer) have long argued: Such bans will undermine rather than improve public health. The reasons aren’t hard to understand. Most smokers and vapers are addicted to nicotine. Every nicotine product in the country is labeled with warnings, including one noting that “nicotine is an addictive substance.”
People who are addicted to substances have a strong craving to obtain them. Therefore, if the state or localities vastly limit the access to nicotine products that are demonstrably safer while still allowing access to the most dangerous products, more nicotine-addicted people will choose the latter — and not worry about the long-term health consequences of doing so. Forgive me for slow-walking this point, but lawmakers routinely rejected this argument.
In the working paper, “Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults,” the researchers came to the following conclusion: “We find evidence that young adults decrease their use of the banned flavored e-cigarettes as well as their overall e-cigarette use by about two percentage points, while increasing cigarette use.” They found little effect of such bans on adult smokers, but “some suggestive evidence of increasing cigarette use” among youth.
The researchers found that “statewide comprehensive flavor bans may have generated an unintended consequence by encouraging substitution towards traditional smoking.” These comprehensive bans were pushed specifically as a means to protect teens from smoking. The approach seemed nonsensical, in that they banned certain adult-only products to limit their use by non-adult populations who already were forbidden from purchasing them. But that was supporters’ main argument, and it appears to be having the opposite effect.
The other study, “The Effect of E-Cigarette Flavor Bans on Tobacco Use,” garnered similar results: “Advocates for sales restrictions on flavored e-cigarettes argue that flavors appeal to young people and lead them down a path to nicotine addiction. … Using data from the State and National Youth Risk Behavior Surveys, we find that the adoption of an ENDS (Electronic Nicotine Delivery Systems) flavor restriction reduces frequent and everyday youth ENDS use by 1.2 to 2.5 percentage points. … However, we also detect evidence of an unintended effect of ENDS flavor restrictions that is especially clear among 18-20-year-olds: inducing substitution to combustible cigarette smoking.”
These may be unintended consequences, but they weren’t unexpected. Before the statewide ban went into place, Yale researchers surveyed the impact of San Francisco’s flavored ban. Per a Yale News report, “After the ban’s implementation, high school students’ odds of smoking conventional cigarettes doubled in San Francisco’s school district relative to trends in districts without the ban, even when adjusting for individual demographics and other tobacco policies.”
The publication quoted that study’s author, who made the obvious point: “While neither smoking cigarettes nor vaping nicotine are safe per se, the bulk of current evidence indicates substantially greater harms from smoking, which is responsible for nearly one in five adult deaths annually. Even if it is well-intentioned, a law that increases youth smoking could pose a threat to public health.” Great Britain’s top health agency, Public Health England, reports that vaping is 95 percent safer than smoking — a point also known long before California approved its law.
These studies should serve as a wakeup call for those public health officials who are seriously interested in improving public health rather than simply waging a crusade against Big Tobacco. Abstinence is always the preferred option, but vaping or the use of pouches with pharmaceutical-grade nicotine are far safer than the main alternative. As I reported for The American Spectator, the Biden administration is sadly echoing California’s policy.
The Biden administration strongly opposed efforts by Congress to limit the Food and Drug Administration’s “ability to protect the nation’s youth from tobacco products by prohibiting FDA from eliminating menthol in cigarettes, flavors in cigars and from setting science-based nicotine standards that reduce the addictive properties of these products.”
Ironically, the administration backed away from its stated health concerns when it feared political consequences. As AP reported, the administration recently announced that it “is indefinitely delaying a long-awaited menthol cigarette ban, a decision that infuriated anti-smoking advocates but could avoid a political backlash from Black voters in November.” Unlike vapes, menthol cigarettes are truly dangerous — but they are the preferred choice among African American smokers.
The evidence increasingly suggests that nicotine users will choose the most dangerous products if they can’t have access to safer ones. Progressive politicians love to yammer about protecting children, yet their own tobacco policies put them at risk. What are the chances California officials and the Biden administration will recognize the latest science?