San Francisco recently banned sales of flavored nicotine-based liquid used in e-cigarettes and flavored tobacco products. Reducing smoking is a laudable goal. However, this ban isn’t the way to do it for three main reasons. Once enacted, it will deprive San Francisco of tens of millions in sales tax revenues and create a black market for tobacco products with all the attendant violence and trauma. Worst of all, it will likely actually erode public health.
1. A ban will create a black market for flavored nicotine products.
Up to half of New York’s smokers buy their cigarettes illegally to avoid the notoriously high taxes, according to the Tax Foundation. Eric Garner was selling illegal loose cigarettes smuggled in from surrounding areas in Staten Island, New York when police accosted him, put him in an illegal chokehold, and ended his life.
High taxes and bans create notoriously violent black markets. “Prohibitions cause a host of problems,” Police Chief John Dixon told Mother Jones when asked about a ban on flavored tobacco in Petersburg, Virginia. A ban “would probably have an adverse effect on the minority community” and create a “burden on law enforcement.”
2. A ban will deprive law-abiding small business owners and the city of revenue.
Flavored tobacco and vape products bring in $50.5 million per year in sales tax revenues, according to the City Economist. Based on how consumers have responded when other nanny cities banned vices such as soda, flavored tobacco, and smokeless tobacco, most consumers will simply buy substitute goods that are equally bad for them or buy the same good in nearby cities or online and have them delivered. That’s $50.5 million going to other jurisdictions.
The ban will outlaw almost half of local convenience store owners’ merchandise. Supervisor Malia Cohen, the bill's sponsor, has promised to make up some of the shortfall by giving small stores tax money to buy food to sell through the Healthy Food Retail program. Last week I asked Cohen’s office via email whether and to what extent fresh fruits and vegetables, available at lower prices and higher margins at nearby grocery stores, can offer margins similar to nicotine products, how long the subsidies will last, and how much it will cost the city on net to get small stores to replace flavored and smokeless tobacco and vape products with fruits and vegetables. I have not yet received a response.
The Arab American Grocers Association and the American Vaping Association support repeal.
3. To the extent it works, a ban will increase cigarette smoking.
Subsidizing electronic cigarettes would reduce smoking by much more than banning them will. In 2016 England’s Royal College of Physicians urged doctors to “promote the use of e-cigarettes, NRT [nicotine replacement therapy] and other non-tobacco nicotine products as widely as possible as a substitute for smoking.” Why? Because vaping helps people quit.
A recent study found that sales of e-cigs are positively correlated with more people quitting smoking. A team led by University of California at San Diego public health professor Shu-Hong Zhu looked at data from a large survey of current and former smokers in the United States and found that e-cigarette users are more likely to try to quit smoking, and more likely to succeed, than smokers who did not vape.
The unintended consequence of banning vaping will be more cigarette smoking. When researchers conducted a cross-sectional study on how teens responded to state bans on selling soda in schools, they found adolescents simply switched to other sugar-sweetened beverages like fruit juices and sports drinks. Which indicates vapers are more likely buy cigarettes than quit nicotine.
According to Public Health England, e-cigs are 95 percent less harmful to your health than cigarettes. This ban will actually harm public health.
And our wallets. Tobacco-related illnesses cost the city $380 million in health care expenses and lost productivity, according to the San Francisco Cancer Initiative. Almost none of that cost can be attributed to flavored nicotine vapor.
"We're focusing on flavored products because they are widely considered to be a starter product for future smokers," Supervisor Malia Cohen, the bill's sponsor, said. “Children will stop picking up a lethal habit if we remove flavored tobacco from the market.” There is zero credible empirical evidence to indicate that vaping leads to smoking. There is, however, a whole lot of peer-reviewed evidence showing that flavored nicotine vapor is much safer than cigarettes and leads to lower rates of cigarette smoking.
I’m with Supervisor Cohen in that the last thing I want is for more people to pick up smoking or vaping, which while safer than smoking, isn’t harmless.
Let’s say the ban works to reduce flavored nicotine vapor use. While a laudable goal, we’ve still created a black market, forfeited ten of millions in sales tax revenues to nearby jurisdictions, and threatened local business owners’ livelihoods. And those are just the likely unintended consequences that we can easily foresee.
Even worse, banning flavored tobacco products probably won’t reduce smoking on net, and outlawing the sales of safer alternatives to cigarettes could even increase it.
We want to reduce smoking because the cost of smoking greatly outweighs the benefit. It’s time we took the same empirical lens to this ban. Looking at the evidence, the conclusion couldn’t be clearer. A ban on flavored tobacco products is bad for the city’s health.
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