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Commentary By Charles Hughes

Adverse Health Effects of Vaping Bans

Economics Regulatory Policy

In an article at The Atlantic this week, Grover Norquist suggests vaping might have swung the 2016 election. Ten million e-cigarettes users oppose further regulations on vaping, and this opposition makes them skeptical of the administrative state. In addition to possible electoral effects, research shows that some e-cigarette restrictions have had harmful results, particularly on young people.

The regulatory push has focused on Minimum Legal Sale Age laws (MLSAs) that prohibit the sale of e-cigarettes to young people. In most instances the MLSA threshold is 18, but some states have raised it to 21.

A new working paper published by the National Bureau of Economic Research finds that these MLSA laws increase conventional cigarette smoking for affected youths.  Earlier research from the U.K.'s Royal College of Physicians suggests that e-cigarette use was only five percent as harmful as cigarette smoking. Regulations that shift young people from vaping to conventional cigarette use have significant adverse health outcomes.

E-cigarettes have been growing in popularity, particularly among younger people. From 2011 to 2015, the share of high school students reporting use of e-cigarettes increased from 2 percent to 16 percent. E-cigarettes have surpassed cigarettes as the most common nicotine delivery product among young people.

But regulators and advocacy groups are wary of this surge in use. They fear that increased e-cigarette use could lead to higher use of other tobacco products and their related problems.

These fears spurred a wave of MLSA laws at the state level. Only two states did not have such laws in place when the Food and Drug Administration ruled it had the authority to regulate “any product made or derived from tobacco, including any component, part, or accessory of a tobacco product.”

As explained in more detail in an E21 paper on e-cigarettes by Jared Meyer, the regulations deemed any e-cigarette as subject to these rules, even those that were nicotine-free or not derived from tobacco in any way, because they could still be considered components and parts. As a result, all e-cigarettes are subject to the minimum age of 18, nationwide. 

Source: Dave, Feng, and Pesko (2017).

MLSA laws reduce the relative cost of traditional cigarettes. Cigarettes are often easier for affected young people to find than e-cigarettes. The relative ease of acquisition might lead some young people to shift from e-cigarettes to conventional ones.

MLSA laws increase youth smoking of conventional cigarettes by 0.7 to 1.4 percentage points, an increase of 8 to 12 percent compared to the baseline. Young people who had not smoked conventional cigarettes before but started to due to MLSA laws “may have contributed to about half of the increase in smoking participation,” according to the paperThe other half of the increase is from conventional smokers continuing instead of using e-cigarettes as a cessation aid.

MLSA laws both make it harder for young people to quit smoking, and cause more of them to take up conventional cigarettes. If the aim of these regulations is to reduce the exposure and risk of harmful substances to young people, they seem to have failed miserably.

This new study is the latest in a recent string analyzing the effect of e-cigarette MLSA laws, with two finding an increase in youth smoking and one finding a decline. The debate over the effect of the legislation is ongoing and far from a consensus, but the regulatory framework has operated as if the effect of the regulation is unambiguously good and effective.

Just because a minimum age of 18 is in effect throughout the country does not mean the issue of e-cigarette MLSA laws is over. Some jurisdictions have pushed their minimum age even higher. By the end of 2016, four states had a minimum age of 19 and three others had increased the age to 21.

Increases in conventional cigarette smoking for young people raise the rate of related health problems that they will deal with over their lives. States and the federal government will also have to bear the burden of the costs of smoking-related illnesses such as lung cancer, asthma, and heart disease.

Most evidence suggests that MLSA laws do more harm than good when it comes to youth smoking. Electoral effects aside, states and cities should hold off on additional limits—and reverse the ones they have implemented.

Charles Hughes is a policy analyst at the Manhattan Institute. Follow him on twitter @CharlesHHughes

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