The city council in Kansas City (MO) took the first step this month towards banning flavored smoke-free products, including nicotine pouches and e-cigarettes, that millions of Americans have turned to as a better option than continuing to smoke cigarettes.
Council members are doubtlessly acting with good intentions. The problem is that these bans never work as intended, and often have the exact opposite impact on public health and youth prevention that proponents claim to support.
There are several reasons why those interested in improving public health by reducing smoking should be concerned as the council considers banning these products.
First, contrary to the ban’s intent, it can lead to an uptick in the use of cigarettes among young people. According to a recent study by Abigail Friedman, associate professor in the Department of Public Health and Management at the Yale School of Public Health, bans such as the one proposed by the council raise “potential concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking.” This is the exact opposite of the intended outcome.
Second, removing flavored products eliminates an important harm reduction tool for adults who want to leave cigarettes behind. Fewer than 10 percent of adults who try to do so each year are successful. For the vast majority of adults who smoke and find it difficult or impossible to stop smoking, the next best option is a smoke-free product.
According to a study in Nicotine and Tobacco Research, adults who smoke but switch to a flavored smoke-free product are more likely to stop smoking combustible cigarettes, the most deadly form of tobacco use. Most adults who have made the switch from cigarettes to a safer smoke-free nicotine product use flavors, proving they are an important factor in tobacco harm reduction. This ban would make it more likely that people who used to smoke return to cigarettes.
Third, the ban is unnecessary, as the latest U.S. Centers for Disease Control and Prevention’s (CDC) National Youth Tobacco Survey (NYTS) found that youth e-cigarette use is at a 10-year low, while youth nicotine pouch use is less than two percent, almost unchanged from the year before.
Strong educational campaigns from public health advocates have helped drive down youth e-cigarette use, and despite the increase in popularity with nicotine pouches among adults, youth uptake is almost non-existent.
Finally, given the rise in popularity among nicotine pouches recently, it is important to acknowledge what public health officials have to say regarding their potential for harm reduction. According to Vaughan Rees, a senior lecturer on social and behavioral sciences with Harvard’s T.H. Chan School of Public Health, nicotine pouches present “significantly lower health risks than smoking, because [they do not] contain cancer-causing chemicals and other toxic substances found in cigarette smoke.” Furthermore, Rees concludes that nicotine pouches “offer adult smokers who have not been able to quit smoking a way to reduce their exposure to the toxic chemicals that cause disease, including cancer.”
All of this underscores why council members should rethink their approach to regulating smoke-free nicotine products, especially those that are popular with adults who have moved on from cigarettes. Let’s not pursue a misguided and unnecessary ban on products in the name of public health when there is clear evidence that doing so will not achieve the desired end and instead have unintended consequences.
President and CEO of the Retail Grocers Association Missouri & Kansas
