Are advocates of vaping restrictions the best marketers ever for traditional cigarettes? That's a logical conclusion as Gov. Kate Brown (D-Ore.) signs a bill banning the online sale of nicotine-containing vaping products to state residents—to protect the children, of course. She approved the restrictive law despite convincing evidence that limiting access to e-cigarettes drives users, especially young people, to traditional cigarettes that pose greater health risks than their high-tech counterparts.
Brown signed HB2261, the vaping-restrictions bill, with little fanfare, but last summer she insisted that "as we are facing the spread of a disease that attacks our respiratory systems, it's even more important that we take steps to protect the health and safety of Oregon's youth, who have been using vaping products at increasingly high rates."
"Despite steep declines in the rate of underage cigarette smoking, increasing e-cigarette use among teenagers is threatening years of public health progress," agreed Oregon Attorney General Ellen Rosenblum after lawmakers approved the recent law. "If we want to make real progress in lowering rates of teenage vaping, we need to close this online sales loophole."
But, as politicians eternally pretend to not understand, banning things doesn't mean that people give up on them. Instead, it drives them to legal substitutes that may pose different or greater risks, or else to black market suppliers who offer products of unknown quality and safety.
For example, San Francisco banned the sale of flavored tobacco products in 2018, including both menthol cigarettes and the wide variety of flavored vaping products. According to a 2020 study published in Addictive Behaviors Reports, the ban had little effect on the nicotine consumption of consumers aged 25-34 years old, 92 percent of whom continued their habits after the ban, though with declining use of vaping products.
But the ban had a bigger effect on those in the age 18-24 bracket in multiple ways. While 82 percent of those who used nicotine before the ban on flavored products continued to do so afterwards, the share of those who smoked traditional cigarettes rose from 27 percent to 37 percent of the total.
"[L]ocal bans can still significantly reduce overall e-cigarette use and cigar smoking but may increase cigarette smoking," concluded the researchers.
More disturbingly, found another study from the Yale School of Public Health, "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."
"These findings suggest a need for caution," commented study author Abigail Friedman, an assistant professor of health policy at YSPH. "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."
It's not just San Francisco. Legal-age limits on the purchase of e-cigarettes in general "increased youth smoking participation," according to a 2019 study published in Health Economics.
The conclusion that prodding youthful users from vaping to cigarettes is a bad idea is not controversial.
"Studies suggest nicotine vaping may be less harmful than traditional cigarettes when people who regularly smoke switch to them as a complete replacement," advises the National Institutes of Health, which adds that "nicotine vaping could still damage your health."
"[T]here's almost no doubt that [e-cigarettes] expose you to fewer toxic chemicals than traditional cigarettes," agrees Michael Blaha, director of clinical research at the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease.
So, policies intended to discourage vaping may have some success in doing exactly that but at the expense of shifting users to smoking. And that shift to cigarettes is especially pronounced among the young consumers who are supposed to be protected by the bans. That shouldn't be a surprise given that most teens aren't yet set in their product preferences and are already breaking the law, since the legal age to purchase tobacco products in the United States, including e-cigarettes, is 21. If they want nicotine, youthful users will take it as they can get it, and illegal sources will accommodate them.
Right now, Oregon actually has a relatively small black market in cigarettes—only 4 percent of smokes sold in the state are smuggled, according to the Mackinac Center, because it has a lower tax rate then neighboring Washington and California. But Idaho has a lower rate still, and 27 percent of the cigarettes sold there are illegally peddled out-of-state. About 12 percent of the cigarettes sold in Nevada also make their way to other states. As a result, 40 percent of the cigarettes sold in Washington and 47 percent of those sold in California are smuggled. Even without allowing for increased black-market activity in vaping products, it's a given that youthful nicotine fanciers will have little trouble purchasing cigarettes.
And, while the evidence suggests that young vapers will switch to cigarettes in response to legal restrictions, it's certainly possible that black market e-cigarette vendors could step in. Underground suppliers brought vaping cartridges containing THC to the market years ago. While extremely popular, some of them contained adulterants that caused serious respiratory problems in users. These vendors could easily meet demand after Oregon's restrictions cut off legal sources.
The evidence that black markets step in when restrictions are imposed is so strong that even some regulators acknowledge the facts. "[T]he Task Force expects there will be an increase in smuggling activity and black market sales," the Massachusetts Department of Revenue's Illegal Tobacco Task Force predicted last year of the response to new restrictions on vaping products and flavored tobacco.
Oregon is populated by people much like the residents of Massachusetts and San Francisco, and they all respond to economic forces in the same way. Even as Oregon officials publicly congratulate themselves for protecting kids from the risks of vaping, they must know that they're encouraging illegal activity and prodding young people to switch to more-dangerous cigarettes.
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