Push to ban flavored tobacco products undermines public health


On November 9, the Portland City Council’s Safety Committee voted to approve a sweeping ban on the sale of all flavored tobacco products. The full City Council is expected to take up the measure in the coming weeks. If adopted, Portland’s ordinance would make it the latest in a string of Maine jurisdictions — including Bangor and Washington County — that have launched misguided crackdowns on the vaping industry.

In a presentation before the Safety Committee, Kristen Goodrich, Portland’s Tobacco Prevention Coordinator, asserted that 85% of young people are using cigarettes and that “flavor bans have been proven to be effective public health strategy.” Ms. Goodrich’s facts are wrong.

In 2019, 30.2 percent of Maine high school students used electronic vapor products on at least one day in the past 30 days — a concerning figure, to be sure, but nowhere near the level Ms. Goodrich claimed. Moreover, a growing body of evidence indicates that banning flavored e-cigarettes will do more harm than good.

The goal of the flavors ban is to discourage tobacco use — and a worthy objective it is. About 2,400 Mainers succumb to smoking-related illnesses each year, according to the CDC. What the ban ignores, however, are the gradations of harm within the broad class of “tobacco products.”

While e-cigarettes are not risk-free, public health authorities around the world — including the CDC, Johns Hopkins Medical School, and the National Academies of Sciences, Engineering, and Medicine — agree that they are far safer than combustible cigarettes. An exhaustive review of the scientific literature by Public Health England in 2015 concluded: “In a nutshell, best estimates show e-cigarettes are 95% less harmful to your health than normal cigarettes, and when supported by a smoking cessation service, help most smokers to quit tobacco altogether.”

Tragically, a flavors ban would steer some Portlanders away from low-risk e-cigarettes and toward lethal combustible cigarettes. A 2017 study led by researchers at Yale University surveyed a nationally representative sample of 2,031 adult smokers and recent quitters and found that a ban on all flavored tobacco products would cause e-cigarette use to decline by 7.9 percent, combustible cigarette use to increase by 2.7 percent, and non-smoking to increase by 5.2 percent.

Another recent study found that a flavor ban would cause 17.1 percent of adult e-cigarette users to stop vaping and smoke instead. This implies the policy would drive some Portlanders back to the pack. In other words, when denied their first choice of flavored e-cigarettes, consumers split between choosing combustible cigarettes and kicking the habit entirely.

If e-cigarettes and combustible cigarettes were equally harmful, then the tradeoff would make sense. But they’re not. As noted above, prominent scientific bodies estimate that combustible cigarettes are 20 times more dangerous.

So, while a flavors ban may deliver small health benefits to e-cigarette users who abandon tobacco products entirely, this gain is vastly outweighed by the harms to e-cigarette users who switch to combustible cigarettes.

And for the 1-in-15 high school students and 1-in-6 adults in Maine who currently smoke combustible cigarettes, restricting e-cigarette flavors will reduce the appeal of a potentially life-saving alternative. Research has found that adults who vaped flavored e-cigarettes were significantly more likely to quit smoking combustible cigarettes than those who vaped tobacco-flavored e-cigarettes.

According to a 2018 study, adults in the U.S. who have completely switched from smoking cigarettes to using e-cigarettes are increasingly likely to have initiated e-cigarette use with non-tobacco flavors. “Restricting access to…e-cigarette flavors may discourage smokers from attempting to switch to e-cigarettes,” the authors conclude.

In making its decision on whether to move forward with the flavors ban, the City Council should heed this evidence, which was ignored during the Safety Committee’s deliberations. Lives are at stake.


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