Over the last several decades, Americans have been smoking less. In 1954, 45% of Americans reported smoking cigarettes at least once in the past week. Today, that figure is a record low 11%. This massive reduction in usage is no accident of history – it was the result of a deliberate, inter-generational public health campaign informing smokers (and smokers-to-be) of the potentially deadly effects of traditional cigarette use.

Importantly, this campaign was grounded in good science. In 1964, U.S. Surgeon General Luther L. Terry released a landmark report linking tobacco use to lung cancer and heart disease. Since then, federal agencies, state governments, and nonprofits have invested in new research to confirm these findings, as well as in public health campaigns to stigmatize tobacco use. Smoking on airplanes, for instance, seems ridiculous to our modern sensibilities – it wasn’t that long ago that the federal government banned this practice in the United States in 2000.

A transition toward smoking cessation products like vape has also accelerated our societal shift away from combustible cigarettes. Consumers want to enjoy the pleasures of smoking and nicotine inhalation without the documented harmful side effects of tobacco use. Vaping products, alongside other innovative smoking cessation products, have filled that void. Unfortunately, legislative efforts guided by a lack of long-term peer-reviewed studies and driven by popular misconceptions seek to snuff out Arizona’s thriving local and regional brick-and-mortar vapor product businesses that generate over $81M in annual tax revenue. 

During the previous legislative session, small businesses involved in the vapor product industry faced the imposition of a “Vapor Registry” measure. The rationale behind this proposal proved unsubstantiated, and it presumed the existence of a functional and effective regulatory framework established by the Food and Drug Administration, which, in reality, is not in place. 

The implementation of any government regulation in Arizona necessitates the demonstration of proven harm before any legislative reform can be considered for any industry.

As a legislator and a nurse, it is essential to approach public health and safety matters with good intentions and be fully informed about the issue, if there is one to begin with. A report by R Street, a think tank based in Washington, D.C., criticizes recent efforts to over-regulate the market for these products. The report suggests supporting innovation and conducting more comprehensive research on the side effects of vaping to reduce harm to smokers instead of harming an industry based on conjecture.

Should we not make every effort to support smoking cessation and ensure the utilization of the safest available option in the market?

Jeffrey Smith, the author of the report, found that research on smoking cessation products is lackluster, stating that “…many of the studies lacked basic components of sound scientific research, such as clear hypotheses, appropriate design, and pre-identified intended outcomes. Additionally, many of the studies contained inaccurate statements of findings and lacked appropriate controls.”

Until better research is funded and conducted, regulators and innovators will not have a clear idea of which products reduce harm most. Besides the lack of research, our federal tobacco control policies are counter-productively decelerating the introduction of new and innovative harm-reduction products to the market.

Fifteen years ago, lawmakers established the Center for Tobacco Products (CTP), a federal entity charged with regulating tobacco products. Smith says that at the time of its passage, lawmakers “could not have predicted the immense growth of the reduced-risk marketplace, the diversity of products that would enter the market, or the challenges of reviewing, approving, and regulating these products. Because such products were not specifically anticipated or mentioned in the TCA, the CTP extended its oversight to include them.”

The CTP has received no specific legislative guidance on how to regulate and approve new products entering the reduced-risk marketplace, so it has taken it upon itself to establish its own rules and processes. Unfortunately, these regulations are opaque and lead to very few products receiving approval. Those who are rejected are often not told exactly why they were rejected, leading to decreased innovation and an expansion of illicit sales (which are, of course, completely unregulated).

So, what comes next?

First, governments, nonprofits, and industry partners should work together to invest in thorough, peer-reviewed research on the side effects of various smoking cessation products.

Next, federal policymakers should modernize the tobacco control regime, allowing for further innovation in the space instead of erecting unnecessary barriers to market entry. We should be encouraging innovation in this space, not stigmatizing it.

Lastly, leaders in the public and private sectors should coalesce around the noble goal of harm reduction. We should inform them about the safest alternatives to tobacco use and allow them to purchase these products.

Despite the negative press and a relentless anti-innovation regulatory environment, it bears saying that smoking cessation products are saving lives. Elected officials like Attorney Generals and policymakers within state legislatures should proceed with causation and base any legislative reform on evidence and data to advance public health and safety measures.