Balancing & Mitigating Trade-offs: Can E-cigarette Regulation Be Optimized?

32 Pages Posted: 1 Nov 2023

Date Written: March 1, 2022

Abstract

Context: E-cigarettes are vastly safer than smoking, and research suggests that they are an effective cessation aid for smokers. Nonetheless, vaping is not without risks and vaping by those with no history of tobacco use should be discouraged. Regulators are therefore faced with a dual imperative: make e-cigarettes more attractive to smokers while discouraging use among non-smokers and youthful experimenters.

To date, e-cigarette regulations have failed to balance these goals. When e-cigarettes first came to market, a lack of regulatory oversight meant that the available devices and liquids were largely untested. Further, marketing practices often went unchecked. Advertising messages, product descriptions and characteristics were designed with an appeal to youth. As vaping became popular with teenagers, regulators rushed to impose outright bans or to treat e-cigarettes the same as combustible tobacco. Unfortunately, this approach undermines e-cigarettes’ utility as a cessation aid and leads to other unintended consequences including continued combustible tobacco use among smokers and, in some cases, nudging some young e-cigarette users towards more harmful combustible cigarettes.

The discourse on e-cigarettes has become intensely polarized upon ideological grounds which hinders good policymaking. Too often, each side fails to acknowledge the concerns of the other and mischaracterizations of the balance of harms are common. The literature frequently, if implicitly, suggests that e-cigarette regulation requires choosing between protecting youth or helping smokers quit. However, these goals are not mutually exclusive; optimal regulation is not always a zero-sum game.

Like most policy matters, e-cigarette regulation requires a degree of compromise, which should be driven by data about use patterns and medical fact. Identifying nuances within policy options offers regulators a means with which to differentiate between combustibles and e-cigarettes based on their associated harms. Adjusting these differentials could play an important role in advancing each of the identified goals without sacrificing the other.

Methods: This paper pulls together findings from the public health, econometric, and policy analytic literature to explore options with which e-cigarette regulation could be designed to simultaneously encourage substitutions that support smoking cessation and protect against uptake by youth and never/former smokers, thus mitigating the unintended consequences associated with black and white regulatory stances.

Findings: Current and proposed restrictions on combustible tobacco include taxation, flavor bans, smoke-free laws, marketing restrictions and nicotine limits, all of which provide opportunities to differentiate between combustible tobacco and e-cigarettes. Sufficiently nuanced regulations could both encourage substitution by current smokers, while also being sufficiently stringent so as to discourage uptake among the uninitiated.

Conclusions: While some trade-offs are unavoidable, there are opportunities to balance the dual goals of e-cigarette regulation. Treating the goals as mutually exclusive undermines public health.

Note:

Funding Information: This report was funded with a grant from the Foundation for a Smoke-Free World, a U.S. nonprofit 501(c)(3) private foundation with a mission to end smoking in this generation.

Conflict of Interests: FSFW had no role in the planning or execution of this survey/report/study, data analysis, or publication of results. FSFW’s mission is to end smoking in this generation. FSFW accepts charitable gifts from PMI Global Services Inc. (PMI); under FSFW’s Bylaws and Pledge Agreement with PMI, FSFW is independent from PMI and the tobacco industry.

Suggested Citation

Hampsher-Monk, Samuel, Balancing & Mitigating Trade-offs: Can E-cigarette Regulation Be Optimized? (March 1, 2022). Available at SSRN: https://ssrn.com/abstract=4590492 or http://dx.doi.org/10.2139/ssrn.4590492

Samuel Hampsher-Monk (Contact Author)

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