When it comes to drugs, Portland, Oregon, is one of the most liberal cities in the United States. Weed shops abound since the state legalized cannabis in 2015. The state decriminalized possession of nearly all drugs in 2020. Come January, Oregon will be the first state to allow therapeutic use of psilocybin. Even the liquor laws have been recently liberalized, with the state permanently legalizing the sale of to-go cocktails in June of 2021.
But even Portland must draw the line somewhere, and it draws it at flavored tobacco and nicotine products. Next week, the Multnomah County Board of Commissioners will vote on an ordinance that will make it illegal to sell any tobacco or nicotine products with a characterizing flavor other than tobacco. This includes e-cigarettes, oral tobacco, and shisha. The sale of conventional cigarettes, the extremely addictive and highly lethal kind that kills more than 400,000 Americans every year and around 7 million people worldwide, will remain completely legal in Multnomah County so long as they do not commit the sin of bearing flavor.
The illogic of this ordinance is almost too obvious to be worth explaining, but here it goes anyway: Regulating products solely by their flavor and with zero regard for their capacity for harm is a terrible way to legislate public health. It leaves the deadliest products widely available on the shelves of every convenience store while banning far safer alternatives that do substantially less harm to users and have a proven record of helping smokers quit.
Multnomah County follows the state of California, where voters approved a ban on flavored tobacco in November. But unlike the California law, which specifically exempted the flavored shisha sold in hookah lounges, the Multnomah County ordinance makes no exceptions. That will likely drive Portland's handful of operating hookah lounges out of business.
"It feels kind of like alcohol prohibition from the 1920s," says Marysa Lattiak, night manager and "hookah barista" at King's Hookah Lounge in Portland. I visited the lounge last night hoping to speak with the owner, Raed Dear, about the looming ban. When I arrived, he greeted me with a smile and held up a handwritten note: "I cannot hear." Dear is deaf, so he gestured to a menu of flavors like mint, strawberry, and jasmine to indicate that I should order a hookah by pointing. I went with rose (it's the Rose City, so why not?) and settled into a chair with my hookah and some coconut water.
The vibe inside was very much like that of a neighborhood bar. Regulars chatted about the Portland Trail Blazers, a couple curled up on a date, others sat quietly glued to their phones. Unlike the typical bars in that Portland neighborhood, no one was getting intoxicated and the patrons weren't mostly white.
Dear was happy to discuss the ban, but because he is deaf and speaks English imperfectly, he preferred that I talk to Lattiak. She joined the lounge in 2016 when Raed offered her a job on the spot. With previous hookah experience and some fluency in sign language thanks to growing up with deaf relatives, she was an obvious fit for the role. "Everybody here is so nice, and we treat each other like family," she told Reason.
From Lattiak I learned that Dear was born in Jordan in a family of 10 children, immigrating to Los Angeles in the 1990s. There, he worked as a chef and mechanic until he shattered his knee, which ended his days of heavy lifting. Eventually, he made his way to Portland where he opened King's Hookah Lounge.
Oregon banned the licensing of new hookah lounges in 2011. Only seven remain in the entire state, down from 10 before the pandemic, according to Willamette Week. The Multnomah County flavor ban would likely mark the end for the three remaining in Portland. I ventured to guess that more than 90 percent of the shisha they sell at King's Hookah Lounge is flavored. Lattiak laughed. "More like 98 percent," she said. She mentioned non-nicotine CBD hookah as a potential pivot, but it's not very convincing. It's hard for a business to survive when the government bans 98 percent of what it sells.
The Multnomah County commissioners are aware that their ordinance will wipe out these minority-owned businesses. Commissioner Lori Stegmann proposed an amendment to exempt them. "I support minority-owned businesses. I support the existence of culturally specific spaces and the preservation of them," she said. Her colleagues disagreed, voting down the amendment 4–1.
One might have hoped that Portland, which was central to protests for racial justice throughout 2020, would express more tolerance for the hookah lounges that provide social spaces for residents from Africa and the Middle East. At a public hearing in November, diverse owners of hookah lounges, vape shops, and convenience stores showed up to voice their opposition to the ban. Testimony in favor came, with a few exceptions, from mostly white activists and health professionals.
Trumping all other considerations was youth vaping. The hearing brought to mind Helen Lovejoy, The Simpsons character (aptly named after a street in Portland) who memorably cried, "Won't somebody please think of the children?" in an episode about Springfield's own foray into alcohol prohibition. The line has become synonymous with moral panic, capturing the way concern for minors allows politicians and activists to portray themselves as virtuous even when pursuing ultimately destructive policies.
Never mind that youth vaping rates have plummeted since their peak around 2019 or that youth smoking, a much more worrying habit, has fallen to its lowest level in modern history since the advent of vaping. And while the popularity of youth vaping is a valid concern, it should be balanced by the potential for safer nicotine products to reduce the harms of tobacco use.
Neither the board nor its health advisers appeared to make any serious efforts to grapple with these tradeoffs. Multnomah County Public Health Officer Jennifer Vines dismissed the potential benefits of vaping for adult smokers, advising that they should instead try other cessation products. This ignores mounting evidence that e-cigarettes are more effective than nicotine replacement therapies at helping smokers quit; an updated Cochrane review published in November, drawing on 78 studies, concluded that there is now "high certainty evidence" that smokers are more likely to quit with vapes than with patches or gums. If the ordinance passes, adult smokers in Multnomah County will be deprived of most of these options, even if the Food and Drug Administration authorizes some flavored e-cigarettes as appropriate for the protection of public health.
This disregard for adult smokers has become endemic in tobacco control. A recent paper co-authored by fifteen past presidents of the Society for Research on Nicotine and Tobacco warns that the benefits of harm reduction for adult smokers are tragically obscured by the exclusive focus on youth vaping. "The need to pay attention to adult smokers is particularly important from a social justice perspective," they write, noting that African-American and LGBT populations could particularly benefit from policies that encourage switching to safer sources of nicotine.
Whatever one thinks of these tradeoffs, they are virtually irrelevant to the ban on flavored hookah smoking. Hookah smoking is rare among teenagers, with only 1.1 percent of youth reporting using one in the most recent National Youth Tobacco Survey. For obvious reasons, hookahs are impractical for high schoolers; it's much easier to hide a vape in one's backpack than to conceal a water pipe that's 2 feet tall. And with only three lounges remaining in Portland, their impact on public health is negligible. Business owners like Dear are simply caught in the crossfire, their livelihoods threatened by a crackdown on vaping that has nothing to do with them.
From a public health perspective, the banning of safer products like flavored e-cigarettes and nicotine pouches is certainly the worst aspect of the proposed ban in Multnomah County, depriving adult smokers of low-risk options that could save their lives. The same can't be said for hookahs, which are a form of combustible tobacco. Yet after puffing on my rose shisha last night, and getting to know Lattiak and Dear, the impact on hookah lounges is now what angers me the most. In a city where I can smoke cigars with a glass of scotch on the side, get blitzed on flaming tiki drinks, and get stoned on literal candy, the pointless destruction of these businesses stands out as grossly unfair.
We should think of the children, of course, but we should think of adults too. Consenting adults should be allowed to go to places like King's Hookah Lounge, where I.D.s are checked at the door and no one is unwillingly exposed to tobacco smoke. "Let the adults make their own decisions just like anybody else," Lattiak said. "The idea America was essentially founded on was supposed to be freedom."
If progressives in Portland really believe in "my body, my choice," that principle should extend to smoking hookah. And if they want to be welcoming to immigrants not merely in word but also in deed, they should not strip livelihoods away from people like Raed.
The board's deliberations evince an embarrassing lack of knowledge about tobacco harm reduction, a shameful lack of care for current smokers, and a blatant contempt for the adults who gather in the county's last three hookah lounges. The ordinance will perpetuate the harms of smoking, ban the safest sources of nicotine while keeping cigarettes on the market, and drive minority-owned social spaces out of business.