How should state policymakers approach e-cigarettes?
One of the questions of economics teaches you to ask is ‘compared to what?’ Someone might tell you that a job paying $10 an hour is bad, but any reasonable economist would have to ask: ‘bad compared to what?’ If the alternative to a job paying $10 an hour is no job at all, it might be the preferable option.
We should ask the same question about e-cigarettes. The Economist reports:
In 2019 America’s surgeon-general called vaping an epidemic among young people, criticising in particular products with “kid-friendly” flavours, such as cinnamon and vanilla. Later that year more than 450 people in America suffered from a mysterious and severe lung illness that was linked to vaping, and was probably caused by black-market cartridges containing cannabis extracts and harmful substances such as vitamin E oil. Other countries, including Brazil, India and Singapore, have already banned e-cigarettes. So what goes into them, and how bad are they really?
The answer is ‘Not great’: you would probably be better off not using them:
The devices use an electric charge to vaporise a dose of nicotine (accompanied, often, by various flavouring chemicals). The composition of the vapour varies between brands. Its main ingredients—propylene glycol and glycerol—are thought to be mostly harmless when inhaled. But that is not certain. Nitrosamines, a carcinogenic family of chemicals, have been found in e-cigarette vapour, albeit at levels low enough to be deemed insignificant. Metallic particles from the device’s heating element, such as nickel and cadmium, are also a concern. High exposure to these can increase the risk of cancer. And some studies have found that the vapour can contain high levels of unambiguously nasty chemicals such as formaldehyde, acetaldehyde and acrolein, all derived from other ingredients that have been exposed to high temperatures. It also contains free radicals, highly oxidising substances that can damage tissue or DNA, and which are thought to come mostly from flavourings. Then there is nicotine. Besides being addictive, it is known to have an adverse affect all around the body. The main concern is its effects on children. Work in animals suggests that exposure to nicotine at an early age could make users more susceptible to other addictive substances later in life.
But remember, if we say that e-cigarettes are bad, the economist is trained to ask ‘compared to what?’ The Economist goes on:
This sounds worrying, but e-cigarettes are nowhere near as nasty as their combustible cousins. Cigarette smoke contains about 70 carcinogens, as well as carbon monoxide (a poison), particulates, toxic heavy metals such as cadmium and arsenic, oxidising chemicals and assorted other organic compounds. Instead of the thousands of different compounds in cigarette smoke, e-cigarette vapour probably contains merely hundreds. And cigarettes may be more addictive than some e-cigarettes because they deliver other chemicals along with nicotine. For example tobacco smoke amplifies the addictive nature of nicotine by inhibiting monoamine oxidase, an enzyme that helps to break down the dopamine (a pleasure hormone) that nicotine releases in the brain.
In many cases, it is not a question of comparing the use of e-cigarettes to the use of nothing at all but of comparing the use of e-cigarettes to the use of actual cigarettes. While we might prefer people to use nothing compared to using either, we must also prefer people using e-cigarettes to actual cigarettes.
E-cigarettes are substitutes for actual cigarettes and are less harmful. If policymakers are serious about reducing smoking, they need to stop treating e-cigarettes as though they are as harmful as actual cigarettes: They ought to be taxed and regulated differently.