E-cigarette regulations may increase teen smoking (and help Big Tobacco)

As teen smoking rates have declined, teen use of e-cigarettes and other vaping devices have increased. This is a real concern, and it has prompted many states to ban e-cigarette sales to minors. Such regulation sounds like a good idea, but new research suggests it may backfire.

A forthcoming paper in the Journal of Health Economics finds that bans on teen access to e-cigarettes may increase teen smoking rates. Here's how the Yale School of Public Health describes the research:

Using data from the National Survey on Drug Use and Health, the research finds that state bans on e-cigarette sales to minors yield a 0.9 percentage point increase in rates of recent conventional cigarette use by 12 to 17 year olds, relative to states without these bans.

"Conventional cigarette use has been falling somewhat steadily among this age group since the start of the 21st century. This paper shows that bans on e-cigarette sales to minors appear to have slowed this decline by about 70 percent in the states that implemented them," said Abigail Friedman, assistant professor of public health and the study's author. "In other words, as a result of these bans, more teenagers are using conventional cigarettes than otherwise would have done so."

Teen smoking is a serious public health concern, so these results should be alarming. As a father, I don't want my kids to use e-cigarettes - and I certainly don't want them to even consider doing so until they are mature enough to make informed choices - but I don't want them to smoke even more. Nicotine addiction is bad, but nicotine addiction combined with the serious health consequences of smoking are worse. If forced to choose - and I would prefer not to - smoking is clearly the greater evil.

There is increasing reason to believe that, whatever the risks of e-cigarette use, they are a tiny fraction of those presented by conventional cigarettes. There is also good evidence that using e-cigarettes as an alternative source of nicotine can help smokers quit (at least those smokers who want to quit), and they may be as - if not more - effective than alternative smoking cessation methods (at least for some smokers). Again, while e-cigarettes are not risk-free - and there is still much to be learned about their potential long-term health effects - there is an emerging consensus that they are far less dangerous than smoking. Insofar as there is a trade-off between smoking rates and vaping rates, the preference for vaping should be a no-brainer.

That e-cigarettes are a potential substitute for traditional cigarettes is well understood by the tobacco industry - and it has that industry worried. While the big tobacco companies have developed their own e-cigarette brands, they are also supporting the increased regulation of e-cigarettes and other vaping devices. Such regulation is likely to suppress competition to the tobacco companies' benefit, both by restricting the relative availability of e-cigarettes and reducing competition within e-cigarette markets to the advantage of larger firms. I explore this point with Bruce Yandle, Roger Meiners and Andrew Morriss in this Regulation article and this more extensive paper forthcoming in the Yale Journal on Regulation. The bottom line: Not only could poorly conceived e-cigarette regulation undermine public health, it could help tobacco companies as well.

What does this all mean? Well-intentioned public health measures do not always protect public health. Premature or poorly constructed regulation of e-cigarettes may compromise smoking-reduction efforts and (as our research suggests) advance the interests of tobacco companies. I support measures to discourage teen e-cigarette use, and we should all want such measures to be effective. Regulation of new technologies is sometimes justified, but it can also do more harm than good.

DISCLOSURE: In 2014, I co-authored a white paper on the political economy of e-cigarette regulation for which my co-authors and I received compensation from NJOY, an e-cigarette manufacturer. NJOY exercised no control over the conclusions of that white paper, and I have not maintained any relationship, economic or otherwise, with NJOY since completing that work. All of my conclusions about e-cigarette regulation are my own.