Do new Bay Area tobacco bans promote health or erode harm reduction?

by Steven Greenhut | May 2, 2017 2:18 pm

Restrictive new anti-tobacco ordinances are spreading across the San Francisco Bay Area like a cigarette-sparked wildfire. Northern California cities already have some of the toughest anti-smoking laws in the nation, but a raft of new laws and proposals take aim at “flavored”[1] tobacco products such as menthol cigarettes and fruity mini-cigars.

Health officials argue that these flavored products are particularly appealing to teens[2], and that their bans are designed to keep young people from picking up an unquestionably dangerous habit. They also argue that the purveyors of menthol cigarettes, for example, target minority communities, and lead to ongoing health problems there.

The ordinances, however, share one trait that has advocates for tobacco “harm reduction” concerned. They make no distinction between combustible tobacco products – i.e., cigarettes, cigarillos, pipe tobacco and cigars – and smokeless products such as e-cigarettes and snus[3] (Swedish-style spit-less tobacco that one places on one’s upper lip).

Tobacco “harm reduction” is a public health strategy designed to reduce the harmful effects of cigarette smoking by encouraging smokers to switch to far-less dangerous – not safe, but less dangerous – types of tobacco-related products. For instance, Public Health England[4], the United Kingdom’s main public-health agency, argues that vaping is 95 percent safer than cigarette smoking and therefore is a potentially beneficial alternative to smoking.

“About 40 percent of former and current adult smokers predict that removing their ability to choose flavors would make them less likely to remain abstinent or attempt to quit,” wrote Carrie Wade, the R Street Institute’s director of harm-reduction policy, in a recent Washington Examiner column[5]. “While the vast majority of quit attempts are of the ‘cold turkey’ variety, e-cigarettes beat out both nicotine replacement therapies like the patch or nicotine gum and prescribed drugs like Chantix and Zyban.”

Vape liquids are not actually tobacco but mostly contain nicotine. They almost always are flavored. Many adult e-cigarette users prefer vaping with flavored liquids than vaping with those that have a tobacco flavor. These local bans on flavors, by the way, follow a recent statewide law that taxes vaping liquids at the same rate as cigarettes. The California Board of Equalization[6] is currently working out the details of that taxation edict.

Wade described the essence of tobacco harm-reduction policy: make it easier for smokers to switch to smoking alternatives that cause fewer health-related problems. It might be ideal, health-wise if every smoker simply went “cold turkey,” but that’s not likely to happen, so harm-reduction[7] advocates see vaping as a reasonable alternative. They see efforts to limit access to liquids and to boost taxes on them as policies that work against this harm-reduction approach.

Even California’s official Tobacco Education and Research Oversight Committee[8] explained, in a public meeting earlier this year, that insufficient numbers of smokers participate in medically approved nicotine-replacement therapies. The committee, however, made no effort to distinguish between degrees of harm, and one member depicted vaping as just another form of smoking. In Bay Area cities and elsewhere, public-health officials argue that vaping is still dangerous – and they argue (despite contrary evidence) that it serves as a gateway for teens to actual smoking.

As a result of the new rules, it will become increasingly difficult for nicotine-addicted northern Californians to purchase and use vaping products. That’s particularly true as neighboring counties and cities embrace similar bans[9]. Supporters of these bans admit that it is one of their goals to have such ordinances spread from one community to another, thus making it more difficult for people to simply go to a neighboring city to grab some vape juice.

Some proposals have become law, such as one in the Marin County city of Novato. Others are under consideration. The Contra Costa County Board of Supervisors is now considering a ban after one of its committees recently approved a new proposal. Likewise, officials in San Francisco[10] and Oakland have also introduced flavor bans.

San Francisco Supervisor Malia Cohen’s public statements focus on the sale of mentholated tobacco products. She explains that 80 percent of African-American smokers use menthol products. Nevertheless, her proposal[11] includes all flavored tobacco, which includes vaping liquids. Oakland Councilmember Annie Campbell Washington, who led a 2016 campaign to increase soda taxes in the city, has introduced a similar measure that includes vapor products in the flavoring ban.

Novato’s ordinance[12], which goes into effect January 2018, requires that all residential leases in the city include a clause calling it a “material breach of the agreement for tenant or any other person subject to the control of the tenant … to violate any law regulating smoking while anywhere on the property.” In other words, tenants can be evicted from their apartments not only if caught smoking – but if they or their guests are caught vaping.

The Contra Costa County health department[13] justifies its proposal by stating that e-cigarettes contain nicotine, which is addictive, and includes various chemicals known to cause cancer and lung problems. But harm-reduction advocates don’t claim that vaping is totally safe, only that it is far safer than cigarette smoking.

Given the political bent of Bay Area cities and counties[14], it seems likely that most if not all of these proposals will eventually become law. The question remains whether in their zeal to improve the public’s health, these officials are embracing policies that will make actual smoking-related health improvements that much harder to attain.

Steven Greenhut is Western region director for the R Street Institute. Write to him at [email protected].

Source URL: https://calwatchdog.com/2017/05/02/new-bay-area-tobacco-bans-promote-health-erode-harm-reduction/

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