Connecticut’s HB 6450 Would Put 91,000 Lives At Risk

March 1, 2021 

 

To: Members of the Connecticut Joint Committee on Public Health   
From: Americans for Tax Reform 

Dear Member, 

On behalf of Americans for Tax Reform (ATR), a non-profit organization which advocates in the interests of taxpayers and consumers throughout the United States, I urge you to reject HB 6450, misguided legislation which seeks to restrict access to life-saving reduced risk tobacco alternatives such as electronic cigarettes through flavor bans proven critical to the process of helping adults quit smoking. The evidence clearly demonstrates that if enacted, this bill would have a disastrous impact upon not only businesses, but public health throughout the State, and lead to a clear increase in tobacco-related deaths. 

Traditional combustible tobacco products remain one of the leading preventable causes of death in Connecticut. It is noted, however, that the negative health effects of smoking combustible tobacco come not from the nicotine, a relatively benign, yet highly addictive substance much like caffeine, but rather the chemicals produced during the combustion process – “people smoke for the nicotine but die from the tar”. For this reason, nicotine replacement therapies such as nicotine patches and gums have been used to help smokers quit for decades.  

In more recent years, technology has developed to allow for the creation of more effective alternative nicotine delivery systems, colloquially known as e-cigarettes or personal vaporizers. Through delivering nicotine through water vaper, these mimic the habitual nature of smoking, however, the absence of “smoke” leads to the absence of the carcinogens created through the combustion of tobacco. As a result, these have been overwhelmingly proven to be 95% safer  than combustible cigarettes, while least  twice as effective  as more traditional nicotine replacement therapies. Just last week a new analysis by Public Health England offered more evidence in favor of vapor products as an indispensable tool to help smokers quit, and noted how in 2017, over 50,000 British smokers stopped smoking with a vaping product who would have continued smoking otherwise. For this reason, over 30 of the world’s leading public health organizations have endorsed nicotine vaping as safer than smoking and an effective way to help smokers quit. This list includes Cancer Research UK; the British Medical Association; the British Lung Foundation; the New Zealand Minister of Health; the US National Academies of Sciences, Engineering, and Medicine; the American Association of Public Health Physicians; the Royal Australian College of Physicians; the French National Academy of Pharmacy; and the German Federal Institute for Risk Assessment. 

It is further noted that studies have repeatedly shown that flavors, which this bill seeks to ban, are critical to helping adult smokers make the switch to vaping, and that adults who used flavored e-cigarette products have been found to be more than twice as likely to quit smoking combustible cigarettes than adults using non-flavored vaping products. Multiple studies have shown that banning all flavors in e-cigarettes (except tobacco flavor) would result in a decline in the use of e-cigarettes and an increase in the smoking of deadly combustible cigarettes. This deadly shift would occur because flavors “contribute to both perceived pleasure and the effort to reduce cigarette consumption or quit smoking.”  One such study found a simple ban on all flavors but tobacco in e-cigarettes would increase smoking by 8.3 percent. Furthermore, a recent study performed by researchers at the University of Glasgow has shown that e-cigarettes particularly help disadvantaged persons quit smoking. The impacts of this on health inequalities would be monumental, however measures like HB 6450 would widen even further these socioeconomic disparities in health. 

We would also like to draw the Committee’s attention to the fact that in the UK, Public Health England canvassed a number of vaper surveys and found that “banning flavored liquids would deter them [vapers] from using vaping products to help them quit or reduce their smoking. It could also push current vapers towards illicit products.” Public Health England therefore concluded that, a “ban on flavored liquids could have adverse effects and unintended consequences for smokers using vaping products to quit.” One nationwide British survey from 2019 found that if a vaping flavor ban were enacted, then 25 percent of vapers would still try to get flavors through the black market. Nearly 10 percent who use flavored liquids said they would stop vaping, and 20 percent said that they would either smoke more tobacco or return to smoking tobacco entirely.  

While flavors in vaping products are critical in helping adults quit smoking, the evidence also demonstrates that they play no role in youth uptake of vaping.  A 2015 survey of nonsmoking teens aged 13-17 found interest levels in flavored e-cigarettes at 0.4 out of a possible score of 10. Additionally, fewer than a third of high school students self-report to care about flavors. Academic studies have found that teenage non-smokers’ “willingness to try plain versus flavored varieties did not differ” and a mere 5 percent of vapers aged 14-23 reported it was the different flavors that attracted them to e-cigarettes. It is also worth noting that, despite media reports to the contrary, data from the National Youth Tobacco Surveys demonstrates that youth dependence on nicotine in US high school students has not increased since the introduction of these products to the market.   

In fact, available evidence demonstrates that banning flavored vapor products has a significantly worse impact upon the health of high school students. In San Francisco, a city-wide ban on flavored e-cigarettes and vapor products, as proposed in HB 6450, had no effect on usage among youths. To the contrary, after nearly a decade of steady decline in youth use of combustible cigarettes, there has been an increase in cigarette smoking among youths in San Francisco since the flavor ban was enacted. In cities that have maintained looser regulations regarding reduced harm tobacco products, youth combustible cigarette use has continued to decline. 

Extrapolating from a large-scale analysis by the US’s leading cancer researchers and coordinated by Georgetown University Medical Centre, vapor products would save over 91,000 lives if a majority of Connecticut smokers made the switch to vaping. This bill places lives in jeopardy by reducing access to these life-saving products.  

ATR further submits that in addition to the public health disaster that reducing access to reduced risk tobacco alternatives will unleash, these proposals would also have devastating consequences on businesses, at a time when they can afford it least. At a time of great hardship due to the Covid-19 pandemic, this bill would effectively outlaw sections of the Connecticut economy. It would kill thousands of jobs and would cost business owners their livelihood. Its total economic cost would be devastating. 

For the reasons outlined above, in the interests of public health and protecting the Connecticut economy, we call upon the Committee to accept the science and vote against HB 6450. Tens of thousands of lives quite literally depend upon it.  

Sincerely, 

Tim Andrews 
Director of Consumer Issues 
Americans for Tax Reform