With its proposed ordinance to menthol and fruit flavors for tobacco and tobacco-related products, the St. Paul City Council is going down a dangerous road that will do nothing to stem the 5,000 deaths that occur from smoking each year in Minnesota.
On its face, the proposed ban—which is cosponsored by six of the seven council members—might seem like a good way to tamp down the allure of these harmful products. Unfortunately, the proposal fails to recognize that the vast majority of smokers still gravitate primarily to regular tobacco products, which would remain untouched by the ordinance.
But more troublingly, the ban would also cover vapor products. This essentially marks the council as rejecting the evidence that electronic cigarettes are a much safer alternative to combustible cigarettes. While current smokers who transition to vapor products generally start with tobacco-flavored liquid, fruit flavors are preferred by those who transition completely away from combustible cigarettes.
E-cigarettes are intended by both manufacturers and vendors to serve as cigarette substitutes for current smokers who need or simply desire self-administered nicotine, without the deadly tar and other products of combustion found in tobacco cigarettes. E-cigarettes are not totally safe or healthful, but they are far less harmful than combustible cigarettes. Furthermore, most e-cigarette users are, in fact, current or former smokers. Less than 1 percent of users transition from never smoking to e-cigarettes to smoking, putting the idea that e-cigarettes are a gateway to using combustible cigarettes to rest
The facts about e-cigarettes are more readily acknowledged by public health and anti-smoking experts across the Atlantic. Earlier this month, ASH UK, ASH Scotland, ASH Wales, Cancer Research UK, the New Nicotine Alliance, the Royal College of Physicians and the U.K. Centre for Tobacco and Alcohol Studies all announced their support for allowing positive health claims in e-cigarette advertisements and encouraging U.K. physicians to endorse e-cigarettes to current smokers. (ASH is Action on Smoking and Health, a public health charity established by Royal College of Physicians in 1971 to fight for a smoke-free world).
Public Health England estimates that e-cigarettes pose no more than 5 percent of the risk of combustible cigarettes. Indeed, both Public Health England and the U.S. Office of the Surgeon General report that e-cigarettes have a similar risk profile to other nicotine replacements, such as the patch and nicotine gum. More impressive is that e-cigarettes have a better long-term success rate for quitting combustibles than all nicotine replacements combined.
Flavors like those that St. Paul proposes to ban play a big part in that. Limitations on flavor choices negatively impact user experience. Research shows that about 40 percent of former and current adult smokers say removing their ability to choose flavors would make them less likely to remain abstinent or attempt to quit. For this reason, it’s imperative that e-cigarettes remain available in a variety of flavors. Smokers need incentives to use them and never-smokers need to remain that way.
A ban on menthol, wintergreen, mint and fruit-flavored tobacco products will have minimal impact on initiation or prevalence of smoking in Minnesota. Only about a quarter of Minnesota smokers primarily use menthol cigarettes, leaving the other 75 percent unaffected by this ban. A better, more appropriate way to curb smoking-related illnesses and deaths is to focus on the bigger picture of cigarette use in Minnesota. Providing a safer range of products that are attractive to smokers, rather than limiting them through ill-conceived flavor bans, is what will prevent the incidence of the 14 smoking-related cancers and other lung diseases that are caused by combustion.
With 480,000 deaths a year from combustible cigarettes, it is crucially important we recognize the potential of e-cigarettes to mitigate the risks associated with smoking. This means encouraging, rather than discouraging, people to switch to these less-harmful products.
Dr. Carrie Wade is a senior fellow with the R Street Institute
