Karl Abramson

DC's Flavor Ban Would Harm Public Health, Criminal Justice, Businesses, & District Economy

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Posted by Karl Abramson on Thursday, June 17th, 2021, 2:15 PM PERMALINK

Earlier today, Americans for Tax Reform (ATR) wrote to members of the Council of the District of Columbia, urging them to oppose B24-002, “The Flavored Tobacco Product Prohibition Amendment of 2021” which would introduce a prohibition on flavored cigarettes as well as reduced risk tobacco alternatives. No public hearings have been held on B24-002.  

ATR Director of Consumer Issues Tim Andrews stated: “Policy must be driven by science and evidence, not by ideology. The evidence clearly demonstrates that if enacted, this bill would have a disastrous impact on public health, lead to an increase in smoking rates particularly among high schoolers, cause conflict between minorities and law enforcement with potentially tragic consequences, harm businesses, and reduce District Council Revenue by significantly more than the $3 million annually claimed.” 

Andrews continued: “Reduced risk tobacco alternatives such as e-cigarettes are proven 95% safer than deadly combustible cigarettes, between two and four times more effective than any other form of nicotine replacement therapy, are endorsed by over 50 of the world’s leading medical authorities, and according to Georgetown University Medical Centre have the capacity to save 6.6 million American lives. Studies have repeatedly shown that flavored e-cigarettes are critical to helping adult smokers make the switch to vaping but have no impact on youth initiation. It is beyond belief that DC Council is considering a science-denial bill that will lead to more people smoking and dying as a result." 

Andrews also commented on how B24-002 extends flavor prohibition to conventional tobacco, including menthol cigarettes, something strongly opposed by groups such as the ACLU and civil rights leaders like Rev Al Sharpton. “Banning menthol cigarettes will also significantly increase the policing of minority communities and lead to a rise in negative interactions between law enforcement and minorities, as was seen earlier this week in Ocean City.”   

Andrews concluded, “DC has the experience of other states to learn from. The evidence is incontrovertible: When San Francisco imposed a flavor ban in 2018, the only impact was that youth smoking doubled. When Massachusetts banned menthols, the only result was sales moved interstate or to the black market, with no decrease in the smoking rate, but a loss to the state of $72 million in just the first 7 months. DC Councilors must put science above ideology and reject this truly dangerous bill.” 

The full letter can be read here.

Photo Credit: Ted Eytan

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Heat-Not-Burn Tobacco Products are Saving Lives in Japan

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Posted by Karl Abramson on Wednesday, June 16th, 2021, 1:16 PM PERMALINK

Cigarette sales in Japan have decreased by 43% over the past five years, the greatest decrease in recorded history. This drastic reduction in cigarette use is a direct result of heat-not-burn products, a recent innovation that is already saving lives. 

Switching to a heat-not-burn (HNB) product reduces a cigarette smokers' exposure to harmful chemicals. HNBs produce a vapor by heating the tobacco rather than burning it, like in cigarettes, to create smoke. As there is no combustion, and therefore no smoke, thousands of toxic chemicals found in traditional cigarettes are eliminated, and HNBs are proven to contain significantly less chemicals than combustible tobacco, a claim supported by the U.S. Food and Drug Administration. 

In July 2020, the FDA authorized the marketing of the IQOS Tobacco Heating System with “reduced exposure” information, meaning the product contains a reduced level of a substance. In their authorization, they noted that the heating process “significantly reduces the production of harmful and potentially harmful chemicals compared to cigarette smoke”. Further, the FDA stated that the product “significantly reduces the body’s exposure to 15 specific harmful and potentially harmful chemicals” as well as “potential carcinogens and toxic chemicals”. 

study from January 2021 tested the chemical composition of cigarettes, e-cigarettes, and heat-not-burn products, referred to in the study as heated tobacco products, in addition to their toxicological impacts on respiratory cells. Published in the Journal of Hazardous Materials, the researchers made sure to test each product at the levels a consumer would. As they noted in their article, studies that have claimed to show high levels of chemicals in e-cigarettes and other reduced harm products are often the result of “unrealistic or extreme conditions”, such as extreme levels of consumption, unnaturally high e-cigarette power and temperature, and even the use of broken vapes. 

The key findings from the study can be read below. The full study can be accessed here

Key Findings

  • Heated Tobacco Products (HTP) emitted 87.4% less carbonyl compounds than a conventional cigarette. Carbonyl compounds include formaldehyde, acetaldehyde and acrolein which are incredibly harmful. 

  • Amazingly, the levels of carbonyl compounds found in e-cigarette vapor were “at least 98.5% weaker than in HTP aerosols”.  

  • PAH (Polycyclic aromatic hydrocarbons) levels were also significantly lower in HTPs and e-cigarettes. A puff of a HTP produced 96.2% less PAHs than a conventional cigarette puff

  • E-cigarettes emitted between 64.9-78.2% less PAHs than HTPs depending on the e-cigarette.

  • While PAHs “generally have a low degree of toxicity”, continued exposure to them, like long-term cigarette smoking, can cause lung, skin, and bladder cancer. 

This study is clear evidence that HNB products are significantly less harmful than traditional cigarettes. Further, it adds to the ever-growing body of evidence in support of electronic nicotine delivery systems as a reduced harm alternative to tobacco.  

While e-cigarettes are growing in popularity in the United States, the UK, and other countries, they are still prohibited in Japan. Therefore, HNBs provide Japanese smokers with an opportunity to continue to use nicotine, which does not cause cancer and is simply addictive, while decreasing the harm they are subject to. Incredibly, the 43% decrease in cigarette sales in Japan has come without any sort of educational campaign from the government. Rather, Japan’s government has largely avoided interfering in the HNB market, allowing the industry to flourish, improving public health. 

South Korea is following Japan’s lead and is seeing similar results. Increases in HNB sales in South Korea has coincided with decreases in cigarette smoking, demonstrating that Japan's success can be replicated in other nations.

This should serve as an example for the United States, where lawmakers and government agencies are constantly waging war on e-cigarettes. This has resulted in an increase in cigarette sales after decades of steady decrease. If Japan and South Korea are any indication, serious improvements in public health are possible when government stays out of the way and allows reduced harm alternatives to be marketed as safer than cigarettes. 

Photo Credit: Abdulla Binmassam

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Fact or Fiction? Debunking Claims About Vaping

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Posted by Karl Abramson on Tuesday, June 15th, 2021, 3:15 PM PERMALINK

Misconceptions about vaping are incredibly common, particularly among the people who vaping would benefit most. For adult smokers, switching from cigarettes to vape products can save their life. In fact, if a majority of American smokers made the switch to vaping, 6.6 million lives would be saved. In the interests of public health, it is critical that myths about vaping are debunked so people can better understand these products. This fact check confronts several of the most widely-spread misconceptions about vaping. 

Myth: Vaping is just as harmful as cigarette smoking. 

Fact: Vaping is estimated to be at least 95% less harmful than cigarette smoking. More than 50 public health organizations and medical bodies have publicly endorsed vaping as safer than smoking. 

Myth: Nicotine causes cancer. 

Fact: No, nicotine does not cause cancer. Nicotine, while addictive, is not classified as a carcinogen and is relatively benign, like caffeine. Cigarette harm comes, not from nicotine, but from tar and thousands of chemicals produced by the combustion process - the "smoke". E-cigarettes do not have a combustion process and produce vapor, not smoke, so these harmful chemicals are absent. 

Myth: Vaping causes “popcorn lung”. 

Fact: No, vaping does not cause bronchiolitis, known as “popcorn lung”. Multiple scientific studies have found no indication that e-liquids cause it and there has never been a recorded case of a vaper developing this condition. 

Myth: E-cigarettes and vaping caused the 2019 outbreak of EVALI (severe lung injury). 

Fact: Nicotine vaping did not cause severe lung disease. The outbreak of EVALI that occurred a few years ago was tied directly to a chemical present in black-market THC vapes, Vitamin E Acetate, that has never been found in nicotine-containing vapes or e-cigarettes. 

Myth: There is a youth vaping “epidemic”. 

Fact: Claims of a youth vaping epidemic lack supporting evidence. Surveys showing high usage among teens have artificially high response rates because they routinely classify someone as a vaper if that person has tried even one puff in a 30-day period. Academic analysis found that National Tobacco Youth Survey data did not support claims of a new epidemic of nicotine addiction. 

Myth: Vaping, like combustible cigarettes, disproportionately harms vulnerable populations. 

Fact: Vaping has tremendously positive effects on disadvantaged populations and helps to reverse the damage that big tobacco companies caused by targeting the impoverished, racial minorities, LGBTQ persons, and those suffering from mental illness and substance abuse. Vaping is critical to helping these vulnerable people quit the deadly habit of smoking and has been found to be more effective than any other nicotine replacement therapy. 

Myth: The reason teenagers vape is the available flavors. 

Fact: Flavors have no effect on youth use. A mere 5% of young vapers reported it was the flavors that attracted them to e-cigarettes and academic studies have found that teenage non-smokers willingness to try plain versus flavored e-cigarettes does not differ. However, flavors are essential for smoking cessation which is why adult access must be preserved. 

 

Photo Credit: Massachusetts General Hospital

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This Sunday Celebrate Millions Of Lives Saved With World Vape Day!

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Posted by Karl Abramson on Saturday, May 29th, 2021, 9:45 AM PERMALINK

This Sunday, millions of ex-smokers from all over the world will come together with public health experts to celebrate World Vape Day. In pursuit of a smoke-free future, these people have much to celebrate, even as lawmakers and misguided public health officials seek to prohibit adult access to these life-saving products. This World Vape Day, it is up to all of us to stand with the millions of former cigarette smokers who have had vaping change their lives for the better. 

This year marks 20 years since the world’s first e-cigarette was created by Hon Lik, a heavy cigarette smoker who had recently lost his father to lung cancer and was determined to quit the deadly habit . Lik invented a vaporization system that combined non-toxic aerosol with nicotine concentrate, creating a device that mimics the habitual nature of cigarette smoking while removing the thousands of chemicals and tar that cause cancer and other severe illnesses. Lik’s invention has transformed millions of lives. 

Today, e-cigarettes are widely regarded as at least 95% less harmful than traditional cigarettes and are by far the most effective method of smoking cessation. In the US rates smoking rates are at record lows, with only 2.3% of young Americans smoking. In Japan, heat-not-burn technology is attributed with a 43% decrease in cigarette smoking over the past ten years. Unfortunately, well funded anti-science activists continue to push restrictions on these life saving products. In Minnesota, an exorbitant e-cigarette tax prevented at least 32,400 smokers from quitting. In Massachusetts, a 2019 prohibition on flavored vaping products starkly increased cigarette consumption while costing the state over $10 million a month in tax revenue. Recently, a study found that San Francisco’s 2018 flavor ban caused youth smoking to double. 

However, this World Vape Day let us take the opportunity to consider how we can transform our country into a place where cigarettes, and the destruction caused by them, are a product of the past. Let us remember those around the world who lost their lives to tobacco and honor their memory by ensuring a smoke-free future for all. 

In the United States, if a majority of cigarette smokers switched to vaping, 6.6 million lives would be saved according to a large-scale analysis from Georgetown University Medical Center. That same analysis states that 86.7 million years of life would be preserved, an invaluable gift for smokers and their families. This would mean 86.7 million more years that grandparents get to spend with their children and grandchildren. Many who lose loved ones too soon say that they would give anything just for one more moment with the departed. Vaping can, and will, save millions of lives and offer extra, irreplaceable time with loved ones. 

E-cigarettes are also a critical tool for confronting inequalities that exist in health. A study from the University of Glasgow revealed that vaping is particularly helpful for disadvantaged people and vaping products are shown to improve attitudes among people with mental health problems and help them quit smoking, even when they lacked interest in quitting. Considering that mentally ill individuals smoke at rates three to four times the national average, e-cigarettes have the proven ability to better the prospects of the 51.9 million American adults who suffer from a mental illness. 

This Sunday, take time to imagine what a smoke-free future looks like and consider what you can do to make that dream a reality. It is up to all of us, not just vapers, to demand that our politicians follow the science on e-cigarettes and stop the assault on these lifesaving products. Millions of lives are at stake. We must act now. 

Photo Credit: INNCO

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STUDY: San Francisco’s Ban on Flavored Tobacco More than Doubled Youth Smoking

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Posted by Karl Abramson on Wednesday, May 26th, 2021, 4:17 PM PERMALINK

In June of 2018, San Francisco became the first city in the United States to enact a complete ban on all flavored tobacco products. Included in the ban were reduced harm alternatives like e-cigarettes, vapes, and smokeless tobacco. The ban was the result of a ballot referendum, Proposition E, that 68% of voters supported. Nearly three years later, startling new evidence is emerging that demonstrates San Francisco’s flavor ban has had serious consequences for public health and should serve as a clear and urgent warning to other states that are considering similar measures. 

Dr. Abigail Friedman, a public health policy expert and researcher at Yale University, published a new study this week in the peer-reviewed Journal of the American Medical Association. Dr. Friedman’s study utilized data from the Youth Risk Behavior Survey, a biennial survey of students, to examine if changes in San Francisco’s smoking rates were associated with the flavored tobacco ban. She looked at data from previous surveys in San Francisco’s schools, as well as other large school districts like Broward County, Florida; Los Angeles, California; New York City, New York; and Philadelphia, Pennsylvania. 

Dr. Friedman’s study compared differences-to-differences, meaning she looked at how different San Francisco’s data was from other comparable districts to determine the impact of the 2018 flavor ban. Her findings are remarkable and should serve as a warning to the many other states and localities seeking to implement similar measures. The main findings of Dr. Friedman’s study can be found below, while the full study can be read here

Key Findings: 

  • San Francisco’s ban on flavored tobacco product sales was associated with increased smoking among minor high school students relative to other school districts”.
  • The city’s flavored tobacco ban “was associated with more than doubled odds of recent smoking among underage high school students”, compared to similar school districts without a flavor ban. 
  • From 2012 to 2016, San Francisco’s youth cigarette smoking rates were below the average rates in comparable districts. In 2017, there was not a statistically significant difference between cigarette smoking rates in San Francisco and comparable districts. 
  • In 2019, youth cigarette smoking rates in San Francisco had risen to 6.2%. In comparable districts, the rate had continued its decade-long downward trend and had fallen to 2.8%, an all-time low. 
     

Scientific evidence shows that e-cigarettes are 95% less harmful than traditional cigarettes and are at least twice as effective at helping smokers quit than nicotine replacement therapies like patches or gum. Youth vaping has significantly decreased since it was declared an “epidemic” in 2018, although there is still work to be done. However, any proposal that would decrease e-cigarette use at the expense of increased cigarette smoking among teenagers or adults would cause much more harm than youth vaping ever could. 

The prohibition of flavored vaping products lacks justifying evidence, while there are numerous evidence-based reasons to allow flavors in vapes. Primarily, adult cigarette smokers like flavored vapes and find them more helpful for smoking cessation. A recent study found that smokers who use flavored vapes to quit are 43% more likely to succeed than someone using an unflavored or tobacco-flavored vape. Further, data shows that teenagers are not drawn to vapes because of flavors, with only 5% of underage vapers saying that it was flavors that made them start vaping. Additionally, academic studies have found that teenage non-smokers “willingness to try plain versus flavored varieties did not differ”. 

Dr. Friedman’s study is a vital contribution to the scientific field of tobacco control and harm reduction and shows a proposal that is popular across the country has unintended, grave consequences for public health. So far this year, at least thirteen states have considered prohibitions on flavored tobacco products and e-cigarettes that, if enacted, would likely drive-up youth smoking rates across the country. The work of Dr. Friedman should be widely publicized in order to best educate voters and lawmakers on the impacts that these policies have. The evidence is clear; flavor bans do more harm than good and must not be implemented in the interests of public health.

Graph from A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California by Dr. Abigail S. Friedman

Pictured above is a graph from "A Difference-In-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco in San Francisco, California" by Dr. Abigail S. Friedman, depicting Youth Risk Behavior survey results from 2011-2019 in San Francisco and similar school districts. The original graph can be accessed here.

Photo Credit: karosieben

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Oklahoma Governor Kevin Stitt Signs Bill to Cut Taxes, Improve Public Health

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Posted by Karl Abramson on Wednesday, May 26th, 2021, 12:37 PM PERMALINK

On May 24, 2021 Oklahoma Governor Kevin Stitt signed into law Senate Bill 1078, modifying the definition of tobacco and nicotine-containing products, and exempting certain products from taxation. The new law incentivizes users of highly harmful tobacco products, like cigarettes, to transition to less harmful alternatives. With evidence demonstrating that some nicotine products expose users to significantly less harm than others, SB (Senate Bill) 1078 is a welcome reform to Oklahoma’s tax laws that will improve public health. 

Cigarette smoking is the leading cause of preventable death in the United States and the smoking rate in Oklahoma is the 9th highest in the country, according to CDC estimates. Such high rates of cigarette use demonstrated to Governor Stitt and the Oklahoma legislature the necessity of following the science on reduced harm alternatives and enacting this legislation. Increased adult access to these products will decrease cigarette smoking in Oklahoma and save lives. 

The state’s previous tobacco tax placed products like nicotine pouches and lozenges, which contain no tobacco, in the same category as tobacco-containing products. By placing safer products in the same category as harmful ones, Oklahoma’s legislature had signaled to consumers that there was no distinguishable difference, while scientific evidence shows otherwise. 

According to a harm analysis from the world’s leading researchers on tobacco control, cancer prevention, and public health, cigarettes are the most harmful of all nicotine-containing products. The products exempted from Oklahoma’s tobacco tax, nicotine pouches, lozenges, and gums, are the least harmful of all nicotine-containing products and expose users to 3% or less of the harm cigarettes cause. 

E-cigarettes, which the harm analysis estimated to be only 4% as harmful as cigarettes, are already exempt from the Oklahoma’s tobacco tax. SB 1078 ensured that they remain exempt, even amidst pressure to tax vaping from anti-vaping activists and misinformed public health officials. It should be noted that e-cigarettes would save at least 92,000 lives in Oklahoma if a majority of cigarette smokers in the state switched to vaping. 

ATR (Americans for Tax Reform) commends the Oklahoma Legislature for passing SB 1078 and thanks Governor Stitt for signing this crucial bill. ATR would also like to extend gratitude to Representative Dustin Roberts who sponsored this bill in the House. Representative Roberts is a signer of ATR’s Taxpayer Protection Pledge and is a reliable and productive defender of taxpayers across the state of Oklahoma. His work on SB 1078 will undoubtedly save lives and this massive success could not have been achieved without his support. 

Photo Credit: Trump White House Archives

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Lawmakers Use Taxpayer-Funded Junk Science to Justify Tax Hikes

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Posted by Karl Abramson on Wednesday, May 19th, 2021, 3:36 PM PERMALINK

Junk science is more prevalent than ever. A bogus study from 1998 claiming that vaccine’s cause autism in young children has been debunked countless times and determined to be a “complete fraud” of a study. And yet a recent Gallup poll showed that 10% of Americans believe that vaccines cause autism. That same poll showed that more respondents were unsure if vaccines cause autism than didn’t believe the claim. 

While it is concerning that 10% of Americans believe this conspiracy, it is even more worrisome that a plurality is undecided. This illustrates the damage that junk science can do to society by sowing doubt among the population, even after the blatantly false “studies” have been publicly disproven. 

Unfortunately, these pseudoscientists and their followers are quite prevalent in the field of e-cigarettes and vaping. The claims put out by these “scientists” are weaponized by anti-vaping advocates to push, and in many cases implement, policies such as tax hikes and flavor bans that have zero basis in actual evidence or data.  

Recognizing the importance of exposing these lies and misleading claims for what they are, tobacco harm reduction advocate and prominent researcher Carl Phillips released a comprehensive systemic review of popular scientific journal papers claiming to show negatives associated with vaping in April 2021. These journal papers are easily refutable, yet there are numerous cases in which anti-vaping propaganda has been paraded as “scientific evidence”.  

One such example is the infamous 2019 article from Stanton Glantz and Dharma Bhatta that sought to examine the effect of e-cigarettes on heart attacks. Glantz and Bhatta intentionally mislead readers by failing to disclose that most of the heart attacks analyzed and mentioned in their article had occurred before the subjects had started vaping. This article was so erroneous that it was retracted by the publisher, but not before a months-long effort, described by Phillips as “enormous”, to get the paper retracted despite a clear and irredeemable error. 

Instances like that illustrated to Phillips the necessity of an in-depth review of papers pushing an anti-vaping narrative. Working alongside Dr. Cother Hajat, Professor Riccardo Polosa, and numerous other academics and researchers, Phillips’ review determined that nearly all of the 24 papers the researchers examined were “fatally flawed”. 

Phillips’ and his team looked at the 24 most popular journal papers that “addressed questions of vaping causing smoking cessation, vaping affecting smoking initiation, as well as a few papers on health outcomes”. The researchers analyzed the papers to assess the validity of the research methods used, as well as if it was apparent the authors were trying to be “intentionally alarmist”.  

The scientific literature that Phillips and his colleagues evaluated produced “substantial negative information value”, with “only a few exceptions”. More crucial takeaways can be read below, while the full review can be accessed here

Key Findings: 

  • Of the 24 papers examined, Phillips’ research team was “unable to point to a single example of someone using suitable methods.” 

  • As a whole, the analyzed studies “reflected a literature that is not based on basic scientific thinking.” 

  • The largest problem that spanned across nearly all of the papers was that the authors “ignored the obvious alternative causal pathways”, meaning that the studies did not explore other variables that could affect data. 

  • Phillips and the other researchers were able to determine that “none of the papers actually proposed a specific hypothesis, identified potential causal pathways, identified what observed associations would distinguish between it and competing hypotheses, and performed the relevant tests”. 

Their findings are concerning for many reasons, particularly because these papers and the anti-vaping body of “research” is so often weaponized to justify anti-science restrictions on adult e-cigarette use. Through flavor bans and high vaping taxes, state legislatures and localities across the country are waging a full-out war on vaping, with disastrous consequences for public health. 

In Minnesota, a vaping tax prevented more than 32,000 adult smokers from quitting. Without these scientific papers and studies, shown by Phillips and his team to be bogus, Minnesota very well may have avoided enacting the tax, a policy that has undoubtedly cost lives.  

Perhaps most disturbing of all is that “a large portion” of the papers that Phillips, Dr. Hajat, and the other researchers analyzed came from research funded by the U.S. Government, paid for with taxpayer dollars. It should infuriate everyone who cares about public health or fiscal responsibility that the federal government is using the tax dollars of hard-working Americans to fund sham research.  

Those funds would be better spent educating adult cigarette smokers about the benefits of switching to a reduced harm tobacco alternative like e-cigarettes and other vaping products. In fact, according to a large-scale analysis coordinated by Georgetown University Medical Center, 6.6 million premature deaths would be avoided in the U.S. if a majority of cigarette smokers switched to e-cigarettes.  

Misinformation about vaping prevents smokers from making the lifesaving switch. The misleading, and downright false, claims presented in scientific journals and funded by taxpayer dollars are not only irresponsible; they are deadly. 

Photo Credit: Trank

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STUDY: Misinformation about E-Cigarettes and EVALI Increased Cigarette Consumption Nationwide

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Posted by Karl Abramson on Tuesday, May 11th, 2021, 4:08 PM PERMALINK

A new study from researchers at Boston University has indicated that misinformation stemming from outbreaks of vaping-related illnesses in the fall of 2019 has led to an increase in cigarette consumption across the country. Cases of EVALI, which misleadingly stands for e-cigarette or vaping-use associated lung injury, sharply increased in August 2019 before peaking a month later in September. During this time, public health officials offered little explanation for the outbreak, simply attributing it to “vaping”. 

Cases had subsided by November, when the Center for Disease Control finally put out a statement acknowledging what by then was common knowledge and identified in Vitamin E Acetate, a compound found exclusively in some illicit, black-market tetrahydrocannabinol (THC) vapes, as responsible for the outbreak. Vapes that contain THC, a psychoactive compound found in marijuana, are completely unrelated from e-cigarettes and other nicotine-containing vapes, and the chemical composition of e-cigarettes is such that it is physically impossible for them to be laced with products such as Vitamin E Acetate in the manner that THC products can be. Unfortunately, by the time the CDC put out a statement, public perception had been considerably altered beyond repair.  

The media, public health officials, and lawmakers aggregated legal reduced risk smoking alternatives like nicotine e-cigarettes with black market illegal THC-containing products under the umbrella of “vaping”, despite the overwhelming difference between the two. This decision did extraordinary damage to the reputation of e-cigarettes, which have been proven 95% safer than traditional combustible tobacco, and the most effective quit-smoking tool on the market, and this misinformation has now been proven to have caused serious harm to public health. Published in the Harm Reduction Journal, this recent study from researchers at BU examined the impacts of the EVALI outbreak on e-cigarette and combustible cigarette sales.  

In addition, the study looked at Massachusetts’ ban on all vaping products that implemented in September 2019 until December 2019. The prohibition completely lacked any scientific or evidence-based reasoning and forced the closure of numerous small vape shops, costing hundreds of jobs. While a majority of shops returned to businesses after the prohibition was lifted, many shops never reopened. The crucial takeaways from the study are discussed below and the full study can be read here

Key Findings:  

  • Many governments and health organizations used the EVALI outbreak as a reason to restrict e-cigarette use.  

  • Messaging that questioned the safety of nicotine-containing e-cigarettes, “led to an increase in combustible cigarette use”. 

  • Before the EVALI outbreak and resulting e-cigarette bans, cigarette sales in the US were decreasing significantly. In Massachusetts, cigarette sales were decreasing significantly greater than in the rest of the country.  

  • After the EVALI outbreak and resulting e-cigarette bans, “e-cigarette purchases decreased significantly while cigarette purchases increased” in the US and Massachusetts. 

  • There is a "need for health authorities to reconsider how they communicate the relative risks of smoking and vaping”. 

  • Even after the CDC identified THC-containing vapes as the cause of EVALI and Massachusetts' vape ban was lifted cigarette sales stayed steady, illustrating the damage done to public opinion. 

Massachusetts’ response to the EVALI outbreak should serve as a warning to reactionary lawmakers who seek to implement policies without any basis in scientific evidence. Governor Charlie Baker and the Massachusetts Legislature ought to have taken the time to understand the science behind e-cigarettes and harm reduction. If they had done so, they very likely would have come to a different solution, one that would have avoided doing irreversible harm to public health. 

E-cigarettes are proven to be 95% less harmful than traditional cigarettes and have been endorsed by dozens of the world’s leading public health organizations as safer than smoking an effective way to help smokers quit. There is a plethora of evidence available that policy makers can access demonstrating the importance of maintaining access to e-cigarettes for adults. According to a study from the Georgetown University Medical Centre, 6.6 million premature deaths would be avoided over the next ten years if a majority of cigarette smokers made the switch to vaping.  

E-cigarette bans and fear-driven hysteria confuse consumers about the safety of these products, preventing them from making evidence-based decisions about their health. Encouraging smokers to make the switch to vaping will save lives and transform futures. Poor messaging and misinformed legislation will only keep people smoking, and dying from, combustible cigarettes.  

The EVALI outbreak resulted in the deaths of 68 people across the United States. The anti-science response to the outbreak, and the resulting increase in cigarette consumption across the country, will undoubtedly kill many, many more. 

Photo Credit: E-Cig Click

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Rep. Krishnamoorthi’s E-Cigarette Nicotine Cap Proposal Will Increase Youth Cigarette Smoking, Ravage Business

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Posted by Karl Abramson on Monday, May 10th, 2021, 5:05 PM PERMALINK

Earlier this month, U.S. Representative Raja Krishnamoorthi (D-Illinois) introduced H.R. 3051 which seeks to implement a cap on nicotine concentration in e-cigarettes at 20 milligrams per milliliter. The proposed bill, titled the END ENDS Act (Ending Nicotine Dependency from Electronic Nicotine Delivery Systems), is aimed at “making e-cigarettes less addictive and appealing to youth”. While well-intentioned, Rep. Krishnamoorthi’s proposal would increase youth smoking, prevent adult cigarette smokers from quitting, and devastate countless small businesses across the country. 

In a press release, Rep. Krishnamoorthi stated that the intent of H.R. 3051 is to, “successfully replicate international efforts to prevent youth from using e-cigarettes". Citing the United Kingdom and European Union as examples, Rep. Krishnamoorthi correctly claims that imposed caps on nicotine levels have led to lower rates of youth vaping in those countries. However, he chooses to ignore the overwhelming evidence that nicotine caps have led to increases in youth cigarette smoking. 

Comparing youth nicotine use in the United States, Canada, and the United Kingdom, the overall rate of nicotine use is nearly identical. In the US, the rate of those aged 16-19 who reported vaping or smoking in the last 30 days was 21.3% as of 2019. The rate of prevalence was 21.6% in Canada and 21.0% in the UK.  

However, when looking at the data more closely, the situation is significantly worse in the UK than the US or Canada. 8.4% of youth between the ages of 16 and 19 smoked only cigarettes in the past 30 days in the UK, while a mere 2.8% of youth in the US smoked only cigarettes. In Canada, 3.8% of youth reported smoking only cigarettes in the past 30 days.  

The United Kingdom has a 20 mg/ml cap on nicotine concentration, identical to the proposal of Rep. Krishnamoorthi. If youth smoking rates are any indication, this policy has not been successful at improving public health. E-cigarettes are proven to be 95% less harmful than combustible cigarettes and have been endorsed by dozens of the world’s leading public health organizations as safer than smoking. Decreasing youth vaping use is critical and should be addressed, but policies that would lower e-cigarette prevalence at the expense of increased cigarette smoking among teenagers would harm the health of our youth more than e-cigarettes ever could. 

It is also vital to acknowledge that nicotine caps hurt adult cigarette smokers seeking to quit. E-cigarettes are the most effective method of smoking cessation, more than twice as effective as nicotine patches or gum. Capping the amount of nicotine allowed in e-cigarettes makes it much more difficult for vapes to compete with cigarettes, protecting cigarette companies and their sales at the expense of public health. E-cigarettes must be able to deliver sufficient nicotine to quell the cravings of those addicted to nicotine and lowering the amount of nicotine removes their ability to do so. Data shows this, as a study of adult smokers demonstrated that higher levels of nicotine “significantly reduced craving and withdrawal”, compared to lower strength nicotine. 

There is also noteworthy evidence revealing that nicotine caps make it harder for adults to quit smoking. The rates of cigarette smokers switching to e-cigarettes is 40% lower in the UK, where a 20 mg/ml limit exists, then in the United States and Canada where no such limit is yet in place nationwide. 

In addition to helping smokers quit, high strength e-cigarettes are immensely valuable for members of disadvantaged groups, like those struggling with schizophrenia and other mental-health related illnesses. A study authored by Dr. Richard Polosa and published by the Oxford University Press found that, among a sample of schizophrenic cigarette smokers, 40% had completely quit cigarette use after twelve weeks of vaping high strength nicotine products and 92.5% of participants had reduced their cigarette consumption by 50% or more. By the end of the study, 61.9% of participants reported feeling more awake, less irritable, and had a greater ability to concentrate.  

With data showing that people with mental health issues smoke at three to four times the national average, it is unsurprising that a study from researchers at the University of Glasgow determined that e-cigarettes are particularly helpful for members of disadvantaged communities. Imposing a nicotine cap, which would prohibit products like the one used by Dr. Polosa in his study, would exacerbate existing socioeconomic inequalities in health and fail to address such disparities. 

In the Canadian province of Nova Scotia, a 20 mg/ml nicotine cap was implemented in April of 2020 along with a ban on flavored vape products. This policy caused the closure of 50% of all specialty vape shops in the province, destroying businesses and livelihoods. Additionally, cigarette sales increased by 25%, further evidence that nicotine caps drive vapers back to higher risk, combustible cigarettes. 

While these harmful effects were in part a result of the flavor ban, which is not included in H.R. 3051, Rep. Krishnamoorthi signed on to a letter earlier this year that called for the removal of all flavored e-cigarettes. Nicotine caps are a part, but not all, of the anti-vaping agenda being pushed by advocates on both sides of the aisle. Flavor bans are another aspect of this agenda and at least 13 states have introduced proposals to ban flavors in e-cigarettes. If implemented, these policies will increase smoking rates among youths and adults, prevent adult cigarette smokers from making the life-saving switch to vaping, and ravage businesses all over the US, costing thousands of jobs. In the interests of public health and protecting the American economy at a time when it is most vulnerable, H.R. 3051 must be rejected.  

Photo Credit: Anthony T. Pope

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Tennessee’s Fiscal Responsibility Sets Nashville Music Scene Apart From New York, Los Angeles

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Posted by Karl Abramson on Thursday, May 6th, 2021, 2:04 PM PERMALINK

The vibrant music scene in Nashville, Tennessee has earned the area a well-deserved nickname: “The Music City”. While the origins of the moniker are unknown, it is believed that the first person to call Nashville “Music City” was Queen Victoria when she remarked that the Fisk Jubilee Singers, an African American choral ensemble from Fisk University in Nashville, had such beautiful voices they must have come from “Music City”.  

Perhaps a more fitting nickname, however, would be “The City of Music and Low Taxes”, as the incredible success of Nashville’s music industry is aided by Tennessee’s zero personal income tax and low regulations that have allowed Nashville’s music scene to be the fastest growing in the country by a landslide. 

The total economic impact of the music industry in the United States has increased by 9.2% since 2013, totaling more than $500 billion dollars a year. However, this growth is dwarfed by the massive success of Nashville’s music industry which has grown since 2013 by a staggering 43%. 

The music industry in Nashville contributes 80% more today to the Tennessee’s gross domestic product (GDP) than it did in 2013. This has given Nashville the opportunity to improve its already strong quality of life as tens millions of dollars each year in music-related tax revenue goes toward funding public works programs, community safety initiatives, and wage hikes for K-12 teachers. 

Compared to the ten largest cities for music-related jobs in the U.S., Nashville ranks first for net job growth as well as overall growth rate. In 2012, Nashville’s music industry employed 27,000 people. As of 2019, it had swelled to 41,000. Further, these jobs are incredibly well-paying. The median annual earnings for music and entertainment industry jobs in Tennessee is over three times the annual median earnings nationwide for all employment. 

Even though New York and Los Angeles employ more total people, Nashville’s per capita music industry employment is over three times that of Los Angeles’ and nearly four times higher than New York’s. More striking, however, is the disparity in job growth. Between 2009 and 2019, jobs in Nashville’s music industry have increased 31%. In Los Angeles, industry job growth is 2%. In New York, there has been a paltry net increase of ten total jobs over the ten-year period.  

The Recording Industry Association of America published a report on Nashville’s music industry, attributing its success to “the entrepreneurial drive that has characterized Nashville’s music industry from the start”, adding that it, “continues to be the core of this unique industry cluster.” This is largely due to Tennessee’s fiscally responsible economic policies that promote innovation and entrepreneurship through low taxes and reasonable regulations. 

In addition, Tennessee’s cost of living is the second lowest in the country, an attractive feature for young singers, songwriters, and producers looking to make a living in music or entertainment. Meanwhile, New York’s cost of living is third highest in the nation, just barely beating out California, which ranks second. The tax burden in Tennessee is also the second lowest in the country. Sales and property taxes are minimal, and the state’s personal income tax rate is zero.  

The Tennessee Entertainment Commission advertises the advantages of moving a music or entertainment company to Nashville. One of those advantages is free use of state-owned property for shooting music videos or feature films. As maintenance of this property is paid for by taxpayers, this is a simple, common sense policy that helps set Tennessee apart from its competition. Another noted advantage is Tennessee's status as a right-to-work state. Unionized and non-unionized workers are guaranteed equal treatment under the law, ensuring freedom of choice for workers considering unionization. 

Tennessee has prioritized fiscal responsibility, allowing Nashville’s music industry to grow in unprecedented numbers. Even though the Covid-19 pandemic has done considerable damage to many small businesses across the U.S., with the music industry being no exception, experts predict this downturn will be short-lived. While revenues are understandably down in 2020, the industry is poised for, and expected to have, a robust comeback.

The Music City has been an integral part of the American music and cultural experience for over a century. With the assistance of sound fiscal policies that make Tennessee one of the most economically competitive states in the nation, Nashville’s music industry will certainly continue to be a hub for musical innovation for decades to come. 

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