Anecdotes and gut-feelings aren’t evidence. Sometimes you need an expert to confirm what seems glaringly obvious. This is the case with the San Francisco E-Cig ban. In a city famous for humane harm reduction policies, e-Cigs have been banned but combustible cigarettes are still available.
As Reason.com reported earlier this week, San Francisco’s chief economist Ted Egan told the city's board of supervisors that more people will smoke as a result of the city's vape ban. Back in May, he concluded that the city would not end up losing out economically because of this spike in cigarette sales.
Somewhere in a city that distributes millions of needles and is pushing for safe injection sites for IV drug users, there must be an official who realizes that the e-cig ban is nearly analogous to banning NARCAN, methadone and buprenorphine while doing nothing to hinder the illicit sale of fentanyl, heroin and opiate pain killers.
Does this example sound too extreme? A study authored by Dr. David Levy and published in Tobacco Control, found that 6.6 million premature deaths could be prevented in just a decade if US smokers switched to e-cigarettes. In 2017, the US opioid epidemic resulted in 70,000 overdose deaths. Of course, smoking is not currently illegal for adults and millions use prescribed opiates responsibly. But legality does not confer a blanket immunity from health consequences.
This is not to say that US regulatory bodies and medical authorities view vaping in the same light as pharmaceutical addiction and maintenance interventions, but countries such as New Zealand promote vaping over smoking.
Former FDA commissioner Scott Gottlieb, who is not exactly a shill for the vaping industry, has said it would be a net benefit if all smokers switched to vaping. The most well-known example is the UK. Their National Health Service hosts a website dedicated to using e-cigs to quit stop smoking.
Adults who lack the financial wherewithal, mobility or time to seek vaping supplies outside of San Francisco city limits will be funneled back onto conventional cigarettes. This disproportionate impact demonstrates how marginalized groups will be punished by the San Francisco e-cig ban.
Economic Impact of Vape Ban
It does not take much imagination to envision independent vape shops being shuttered and employees left without a job. Shamann Walton, one of the primary archetects of the vape ban, downplayed the economic impact in an interview with the San Francisco chronicle.
“E-cigarettes haven’t been around forever. A lot of these stores were thriving before e-cigarettes. If we work together, they’ll continue to thrive. But it’s more important to keep our young people safe.”Shamann Walton, San Francisco Board of Supervisors
Read another way, increased cigarette sales will cover the loss of vaping tax revenue, and the hardship inflicted on vape company employees and potential harm inflicted on marginalized adults who vape is a worthwhile trade-off. The fight against teen vaping has heated up in San Francisco. It is unclear why strict age verification and education, the strategies used to drive down the smoking rate, are not enough in this case.
San Francisco Vape Ban a Bridge Too Far?
The only possible positive consequence of the San Francisco vape ban is that it has unmasked anti-vaping zealots and their radical nicotine abstinence agenda. Could the San Francisco vape ban end up saving vaping in the US?
Nicotine replacement therapy was destroyed by vaping in a New England Journal of Medicine Study (NEJM), and the only complaint levied by anti-vapers was that a high percentage of e-cig users who had ceased smoking entirely were still vaping. The much smaller percentage of nicotine replacement therapy users who successfully quit were more likely to be entirely nicotine free.
With this evidence in hand, the humane and rational approach would be to develop a science based “Road to Zero Nicotine” to help vapers taper off their habit. Our goal at Vapor4Life is to provide an authentic alternative to cigarettes, and for vapers to eventually reduce their nicotine level to zero, with goal being to cease vaping as well.
San Francisco Out of Touch With Vaping Technology
San Francisco would have been more justified in looking at the higher nicotine levels found in prefilled vape pods. This tact would dovetail nicely with San Francisco's aggressive crusade against Juul, and the thousands of jobs that the vaping giant has brought to the Bay area. But targeting a style of vaping technology would have required a deeper understanding of vaping technology and trends.
It is unclear if the authors of the San Francisco vape ban even know what nic salt is. A layman does not need to know vaping terms of art, but leaders who are banning an entire class of product should not be ill-informed fountains of misinformation. Zombie vaping myths will never die if individuals in positions of leadership continue to spout such undiluted nonsense as fact.
The FDA is gradually acknowledging changes in vaping technology, hinting at a vape pod ban, but developing a thorough understanding of vaping trends and habits requires killing too many sacred cows.
For instance, retro e-juice flavors that mimic popular candies and cereals from the Reagan-era are actually targeting adults who grew up during the Reagan-era. Juul Mint, a menthol derivative, is the most popular flavor with minors. Big tobacco would benefit greatly from a flavor ban, the IQOS has been approved by the FDA and wiping out the competition would give them a virtually monopoly. It is not a coincidence that Altria supports a flavor ban.
San Francisco chose the simple and damaging expedient of pulling all e-cigs from the market and pushing vapers back onto combustible cigarettes. This is not the first time lawmakers have rewarded big tobacco with their vaping legislation. The Reversing Youth Tobacco Epidemic Act 2019 would wipe out the independent vaping industry with a stroke of the pen.
Experts Blast San Francisco Ban
NBC News quoted a health expert who declared the ban “ludicrous”. Unless you believe there will now be nicotine abstinence or that smokers will choose to embrace the nicotine replacement therapies that were demolished by vaping in the NEJM study, it is impossible to ignore that the inevitable result of this ban will be vapers transitioning back to cigarettes.
Dr. Michael Siegel, a professor in the Department of Community Health Sciences at the Boston University School of Public Health, pulled no punches when describing the San Francisco law:
“This has to be one of the most insane public health proposals I have ever seen. This legislation basically says: “We care so much about the health of our kids that we can’t allow e-cigarettes to remain on the market until they have a complete safety review. However, we are perfectly happy allowing cigarettes—which have had extensive safety reviews and been found to be killing hundreds of thousands of Americans each year—to remain on the market.
This is an easy political victory because they know the vaping industry is not organized or centralized enough to fight it successfully.Dr. Michael Siegel, Boston University School of Public Health
Marginalized Groups Punished By San Francisco Vape Ban
The International Journal of Environmental Research and Public Health conducted a study into racial and ethnic differences among e-cigarette users. They discovered that African Americans were more likely to embrace e-cigarettes as a cessation aid than Whites and Hispanics. They enjoyed even less success with nicotine replacement therapy, and were statistically more inclined to avoid the dual use of cigarettes and e-cigarettes.
The CDC found that 20.3 percent of adults identifying as lesbian, gay or bisexual smoke cigarettes, versus an overall rate of 14 percent. Bisexual women are over twice as likely to smoke as heterosexual women. As a whole, the LGBT population in the US is three times more likely to use electronic cigarettes: 7.5 percent versus 2.6 percent. This is the highest rate for any group surveyed.
Smoking rates among the transgendered have been estimated at over 80 percent. Studies have tied this to massive number to structural discrimination. As a whole, the smoking kills over 30,000 members of the LGBTQ+ community annually and leads to significant health disparities. San Francisco is apparently willing to abdicate their role as a bastion of LGBTQ+ rights in pursuit of e-cig prohibition and nicotine abstinence. Would "total abstinence" for adults be viewed as a solution for high risk teen behaviors in any other area?
Outside of the San Francisco metro area, rural Americans suffer disproportionately from cigarette related illnesses. This is why Iowa AG Thomas Miller blasted the new FDA e-cig regulations last fall.
On the flip side of the coin, the wealthy and most educated have largely quit smoking and drink more frequently than any other group. The CDC reports alcohol kills 4,300 minors annually and sends over 100,000 to the emergency room. It may be a scourge, but it is no danger of being banned.
Compare how moderate drinkers are treated in comparison to vapers. They are not shamed into using ineffectual cessation aids or mocked for not adhering to a program of total abstinence.
All of this is being done in response to an uptick in teen vaping, which now poses an existential threat to the vaping industry.