Iowa should tread carefully on e-cigarette rules
by Jeff Stier
Attorney General Tom Miller would like the Iowa Legislature to change the state's "Smokefree Air Act" to include the use of e-cigarettes. This would be a huge mistake.
The law's findings clearly state the purpose of the smoking restriction: A reduction of exposure to environmental tobacco smoke "would improve the public health of Iowans."
Restricting the use of e-cigarettes, known as "vaping" for the vapor they emit, would undermine the very goal of this law.
First, it wouldn't reduce exposure to environmental smoke, better known as second-hand smoke, because there is no smoke. There isn't even any first-hand smoke.
More important, a ban on vaping in public places would damage public health because it would make e-cigarettes a less convenient alternative to cigarette smoking. It would also send the implicit (and incorrect) message that they are also equally dangerous, not only to the user, but to those exposed to the vapor.
An indoor air study conducted in 2011 by New York's Clarkson University found "no significant risk for bystanders for cancer or non-cancer risk for either children or adults as a result of exposure to e-cigarette vapor." Numerous studies since 2011 have confirmed these findings. Further, since 2011, product standards for the vast majority of products have improved exponentially.
It is critical to note that e-cigarettes are attractive alternatives to cigarettes, in part because, like the FDA-approved gum and patch, they provide nicotine. Nicotine, while highly addictive, is not particularly harmful at the levels at which it is consumed.
While nobody should initiate use of any nicotine products, be they pharmaceutical, e-cigarettes or certainly tobacco-burning cigarettes, Iowa legislators and the attorney general should know that it's not the nicotine that makes cigarettes dangerous. It's the burning tobacco that makes traditional cigarettes harmful to users and those exposed to the smoke. E-cigarettes contain no tobacco.
E-cigarettes are a product created by profit-driven private sector innovation that is doing what many hundreds of millions of dollars of government spending, costly litigation, addictive excise taxes, warning labels and punitive regulations have been unable to do: help cigarette smokers quit happily.
It is no wonder the likes of former New York Mayor Michael Bloomberg have smoke coming out of their ears about e-cigarettes. They understand that in order to maintain not only their huge budgets, but their basis for authority to control personal decisions and private businesses, they must demonize, delegitimize and defeat e-cigarettes every step of the way. Treating them as equal to cigarettes would be a dangerous first step.
The attorney general has also asked the Legislature to consider an excise tax, or "sin" tax, on e-cigarettes over and above the state's sales tax. The Legislature should proceed with caution. If Iowa taxes e-cigarettes on par with tobacco cigarettes, the state would be using the tax as an overly-blunt tool to treat products with drastically different risk profiles as if they were the same.
Using taxes to influence behavior is a bad idea. But if the state wanted to think creatively about using taxes to "nudge" behavior and improve public health, it should consider a zero excise tax and reducing the sales tax on e-cigarettes by half to encourage cigarette smokers to quit. Arguments that e-cigarettes should be taxed to discourage youth from purchasing them are bogus. The Legislature should simply ban the sale of e-cigarettes to youth.
Those who oppose e-cigarettes as a tool for harm reduction claim that the products are a "gateway" to smoking. However, preliminary studies, as well as empirical evidence, show that e-cigarettes are a major gateway away from smoking.
A study presented at the American Association for Cancer Research meeting in November looked at 1,300 college students, average age 19. Only 43 of those told researchers their first nicotine product was an e-cigarette, and only one of the 43 later switched to cigarettes. The vast majority of the 43 who tried an e-cigarette weren't using nicotine or tobacco when researchers followed up.
"It didn't seem as though it really proved to be a gateway to anything," said researcher Theodore Wagener, an assistant professor of pediatrics at the University of Oklahoma Health Sciences Center in Oklahoma City.
Critics also rely on the flimsy argument that vaping "normalizes" smoking because people may think vaping is smoking. That's nonsense. Vaping normalizes not smoking.
When thinking about e-cigarette regulations, the Legislature should remember what doctors are taught: First, do no harm.