FLAVOR BAN IS WRONG POLICY TO REDUCE HAWAII YOUTH E-CIGARETTE USE

By Lindsey Stroud, Heartland Foundation, March 3, 2020

In 2017, only only 3.5 percent of Hawaiian high school students reported using e-cigarettes daily and only 1.2 percent reported smoking combustible cigarettes daily.

Legislators in the Aloha state are moving forward with several bills that would prohibit the sale of flavored electronic cigarettes, and would ban flavored tobacco products, including cigars and cigarettes.

Senate Bill 2228 would ban the sale of flavored e-cigarettes, as well ban any sale of any tobacco product “other than through retail sales via a direct, in-person exchange.” Senate Bill 2538 would ban the bill of all flavored tobacco products, including cigars, cigarettes, and vapor products. Further, SB 2538 would impose penalties on persons “eighteen to twenty-one years of age who [are] convicted of possession of a tobacco product” or vapor product. House Bill 2457 would also ban the sale of flavored tobacco products and require the Department of Education “to establish a safe harbor program” for minors to dispose of e-cigarettes, as would also require educators in Hawaii to confiscate vapor products. Finally, Senate Bill 2903 would ban the sale of all flavored tobacco products.

Hawaii lawmakers are responding to what they have titled an “epidemic” of tobacco use among Hawaii youth, but flavor bans are ineffective policies to divert youth tobacco use. Further, banning flavors in e-cigarettes will eliminate tobacco harm reduction options for adults who have used vapor products to quit smoking.

The most recent data on Hawaiian youth tobacco use is from the 2017 Youth Risk Behavior Survey. In 2017, only 3.5 percent of Hawaiian high school students reported using e-cigarettes daily. Further, only 1.2 percent reported smoking combustible cigarettes daily, and only 8.9 percent reported smoking a cigarette on at least one day in the 30 days prior to the survey.

It is disingenuous for lawmakers to decry a “youth vaping epidemic,” when so little youth are using such products on a daily basis. More often than not, youth are using vapor products in social settings among peers, similar to youth alcohol use. For example, in 2017, 25.5 percent of Hawaii high school students reported using an e-cigarette on at least one occasion in the 30 days prior to the survey, compared to 24.5 percent who reported drinking alcohol on at least one occasion in the 30 days before the survey.

There is also insufficient evidence that a flavor ban will reduce youth vapor product use. The Heartland Institute analyzed results from the 2017-18 California Youth Tobacco Survey (CYTS) and found that despite flavor restrictions in some localities, youth use of e-cigarettes in those areas increased after the bans went into place.

Santa Clara County, California, banned flavored tobacco product sales to age-restricted stores in 2014. Despite this, youth e-cigarette use increased while the ban was in effect. For example, in the 2015-16 CYTS, 7.5 percent of Santa Clara high school students reported current use of e-cigarettes. In the 2017-18 CYTS, this increased to 10.7 percent

Lawmakers should also understand that youth are not using vapor products because of flavors, but rather because of peer pressure and because their friends and/or family members have used these products. The Heartland Institute recently analyzed several statewide youth vaping surveys to understand the role of flavors in youth e-cigarette use. In an analysis of five states, only 15.6 percent of high school students cited using e-cigarettes because of flavors. A 2019 analysis of the National Youth Tobacco Survey reached similar conclusions, finding only 22.4 percent of middle and high school students said flavors are a reason for e-cigarette use, compared to 55.3 percent citing curiosity and 30.8 percent citing using an e-cigarette because a “friend or family member used them.”

Moreover, lawmakers should refrain from banning flavors tobacco products, including cigars and cigarettes, as such bans won’t reduce use and will create black markets. In a survey of menthol smokers in the journal Addiction, one-fourth of respondents indicated they would find a way to purchase, even illegally, menthol cigarettes should a menthol ban go in place. A 2015 study in Nicotine & Tobacco Research noted that only 28 percent of menthol smokers would give up cigarettes if menthol cigarettes were banned.

Further, there is insufficient evidence to claim that menthol cigarettes attract youth. Analysts at the Reason Foundation examined youth tobacco rates and menthol cigarette sales. The authors of the 2020 report found that states “with more menthol cigarette consumption relative to all cigarettes have lower rates of child smoking.” Indeed, the only “predictive relationship” is between child and adult smoking rates, finding that “states with higher rates of adult use cause higher rates of youth use.”

Lawmakers should note that a flavor ban would eliminate a million-dollar industry in the Aloha state. According to the Vapor Technology Association, in 2018, the vapor industry provided over $100 million in economic output, with 451 direct vaping-related jobs that generated over $18 million in wages. Further, Hawaii collected over $9 million in state taxes attributable to vaping.

It is disheartening to see Hawaii lawmakers threaten to eliminate a tobacco harm reduction product for many, while dedicated so little of existing tobacco monies to tobacco control programs. For example, in 2019, Hawaii received an estimated $160.3 million in revenue attributed to tobacco taxes and settlement payments. In the same year, the Aloha state dedicated only $4.5 million on tobacco control programs, including education and prevention. To put it in a greater perspective, in 2018, tobacco companies spent $26.1 million marketing tobacco products in Hawaii.

Lawmakers should refrain from prohibitions that will eliminate harm reduction options for adults. Although addressing youth use of age-restricted products is laudable, flavor bans are ineffective measures to reduce youth e-cigarette and tobacco use. Rather than pushing forward with draconian bans, lawmakers should dedicate more of the existing tobacco monies towards education and prevention programs.

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The following documents provide more information on e-cigarettes and tobacco harm reduction.

Tobacco Harm Reduction 101: Hawaii

Heartland State Government Relations Manager Lindsey Stroud provides an analysis of the vaping industry in Hawaii, including economic data, state health department findings on vaping-related lung illnesses, youth e-cigarette use, tobacco retail compliance checks, and state funding dedicated to tobacco control programs.

Policy Tip Sheet: Tobacco Harm Reduction 101: Flavor Bans

Heartland State Government Relations Manager Lindsey Stroud provides an analysis on the role of flavors in vapor products. In the research, Heartland found that in examination of five states, only 15.6 percent of high school students reported using e-cigarettes because of flavors, compared to a survey of 70,000 American adult vapers, in which 83.2 percent and 72.3 percent reported vaping fruit and dessert flavors, respectively. With nearly 80 percent of 2016 sales of e-liquids being flavored, a ban on flavored vapor products would cripple an industry that created more than $24 billion in total economic impact in 2018.

Policy Tip Sheet: Tobacco Harm Reduction 101: Menthol Bans

Heartland State Government Relations Manager Lindsey Stroud provides an analysis on the role of menthol in tobacco products. In this Policy Tip Sheet, Stroud notes that a menthol ban would eliminate more than $130 billion in revenue over the next 10 years and such bans would lead to larger black markets.

Tobacco Harm Reduction 101: A Guidebook for Policymakers

This booklet from The Heartland Institute aims to inform key stakeholders on the much-needed information on the benefits of electronic cigarettes and vaping devices. Tobacco Harm Reduction 101details the history of e-cigarettes, including regulatory actions on these products. The booklet also explains the role of nicotine, addresses tax policy and debunks many of the myths associated with e-cigarettes, including assertions about “popcorn lung,” formaldehyde, and the so-called youth vaping epidemic.

Research & Commentary: Largest Vaping Survey Finds Flavors Play Important Role in Tobacco Harm Reduction 

In this Research & Commentary, Heartland State Government Relations Manager Lindsey Stroud examines a survey of nearly 70,000 adult vapers in the United States. The survey was completed in response to the U.S. Food and Drug Administration’s recent Advanced Notice of Proposed Rulemaking seeking comment on the role of flavors in tobacco products. The authors found nearly 95 percent of survey respondents were at one time smokers and the majority reported using flavors at the point of e-cigarette initiation. Stroud compares this to other surveys. She concludes, “eliminating flavors will force [vapers] to vape only tobacco-flavored e-cigarettes, which would likely cause them to return to combustible cigarettes.” Stroud also found research has found e-cigarettes are a key tobacco harm reduction product and could help alleviate state budgets by mitigating health care costs.

Podcast Series: Voices of Vapers 

In this weekly podcast series, State Government Relations Manager Lindsey Stroud talks with researchers, advocates, and policymakers about tobacco harm reduction and electronic cigarettes. The series provides important information about the thousands of entrepreneurs who have started small businesses thanks to THRs and the millions of adults that have used electronic cigarettes and vaping devices to quit smoking tobacco cigarettes.