When former New York City mayor Michael Bloomberg banned smoking in public parks, it made logical sense from a certain autocratic urban-beautification standpoint. Who wants tobacco smoke stinking up their stroll along the Lilac Walk? I grumbled at the time, but the prohibition, which was followed two years later by more anti-smoking measures, at least bore some semblance to reason. The same cannot be said for his successor’s bouquet of punitive policy proposals, which combine a tax on tobacco with a cap on e-cigarette retailers in the five boroughs.
Progressive mayor Bill de Blasio, with these new regulations, would secure for the city of cities a distinction that many assumed it held: the most expensive pack of cigarettes in the nation at $13. But the most important—–and least logical—–of these measures is a a licensing mandate and cap on the number of e-cigarette retailers.
Retailers who sell e-cigs will have a finite time frame in which to apply for a license from the city to keep selling vape products and attendant paraphernalia. These range from cigarette-like “vape pens” with replaceable cartridges that click into place where a filter would be to the more esoteric contraptions that need to be refilled with a nicotine-infused potion. The wide world of vaping spawned its own subculture and grew a new industry. According to public health experts, at least, this trend has been a boon to the developed world’s well-being.
Nicotine addicts who make the switch from combustible cigarettes to vaping are less likely to relapse than smokers who slap on a nicotine patch or go for the gum. And while there’s much more to the e-cigarette—much more to its marketing, certainly—than a saintly plea for smoking cessation, even a smoker who moves to e-cigs spares herself 95 percent of its ill-effects. Or so says the Royal College of Physicians, the British professional body that’s set an international standard in the medical field since the Tudors reigned. (The same Royal College tied tobacco to lung cancer in 1962, two years before our surgeon general.)
Nearly a year ago, a report from the RCP determined e-cigarettes to be a “harm reduction” tool and a “gateway from smoking” rather than the opposite as many have alleged and still do. Their recommendation: “In the interests of public health it is important to promote the use of e-cigarettes, [nicotine replacement therapy] and other non-tobacco nicotine products as widely as possible as a substitute for smoking in the UK.” The same report concluded, “Although it is not possible to precisely quantify the long-term health risks associated with e-cigarettes, the available data suggest that [e-cigarettes] are unlikely to exceed 5% of those associated with smoked tobacco products, and may well be substantially lower than this figure.” In other words, combustible cigarettes are at least 95 percent worse for you than e-cigs.
And yet—in the very same week progressives set aside to celebrate the achievements of objective science—the city’s answer is to cap the number of retailers licensed to sell a medically preferable alternative to combustible tobacco.
New York City’s handling of conventional cigarettes will only encourage the black market to find a way. (Australia’s prohibitively steep tobacco tax hikes, for instance, carved out a new criminal underworld.) E-cig restrictions pretty much guarantee it: “If you begin to chisel away at the number of stores that can legally sell e-cigarettes,” public health advocate Jeff Stier told me, “then you further increase the likelihood that people are going to go to the black market—because you’re making harder for them to quit.”
A recent survey from the Centers for Disease Control found that e-cigarettes are the most popular path away from smoking: Nicotine addicts who switch to e-cigs have a higher cessation rate than than those who choose one of the other nicotine-delivery alternatives. As popular, and demonstrably less deadly, cessation tool e-cigs should be widely available—and according the Royal College of Physicians, they can be prescribed.
With the city government already in the business of telling New Yorkers what to do, “We should really be encouraging more e-cigarette outlets, not fewer,” said Michael Siegel, a professor of public health and medicine at Boston University and tobacco control expert. “Because the more that cigarette smokers have access to these alternatives, the easier it will be for them to quit smoking,” he added, commonsensically.
Common sense hasn’t shaped the city’s tobacco policies, though. When the city scolds, “In 2015, 15.9 percent of New York City high school students were e-cigarette users,” one has to wonder—would anyone rather these kids were smoking Camel straights?
CDC data on high–schoolers shows that vaping has increased at the same time cigarette smoking has plummeted. Dr. Brad Rodu, a professor of oncology at the University of Louisville School of Medicine, who’s made an intensive study of the otherwise overlooked implications of the federal findings, won’t go so far as to say the availability and popularity of e-cigarettes have caused the dramatic decrease in cigarette smoking.
“But when somebody tells me that e-cigarettes are going to raise smoking rates among children, this is evidence that that isn’t happening,” he said. (The Royal College of Physicians reached the same conclusion last year.) Although any real or perceived risk to their overall well-being inspires an instinctual panic, younger generations’ health shouldn’t broadly take precedent over their parents’ and grandparents’—certainly not when it comes to public health policy that ought to help as many people as possible.
Dr. Riccardo Polosa, director of the Institute of Internal Medicine and Clinical Immunology at the University of Catania, takes the causal leap Rodu wouldn’t. “The increasing prevalence of e-cigarette use between 2010 and 2015 has coincided with the sharpest declines in the smoking rate among U.S. youth and young adults on record, while e-cigarette use is already starting to decline,” Dr. Polosa told me via email, adding that, “The surgeon general may in future reports wish to give greater consideration to the possibility that the next generation of young Americans will be decreasingly likely to start smoking tobacco because of, not in spite of, the availability of e-cigarettes.”
And in the meantime, the poorest of the poor—the people likeliest to remain inveterate smokers, and to buy and sell loose, black-market cigarettes (Eric Garner’s crime, incidentally)—bear the brunt. As Dr. Polosa stirringly puts it, “Regulators are targeting the poorest smokers, condemning them, not only to an increased economic burden, but also to lives rampaged by further serious disease, lower quality of life, and premature death.”
A policy package likely to disadvantage the underclasses is pretty sharply inconsistent with the Sandinista mayor’s ideological underpinnings (less so their historical outcomes). The combined effect of taxing conventional cigarettes and restricting the sale of their less harmful modern alternative may help Mayor de Blasio shine on his activistic gleam leading into election season. Otherwise, it’s poised to do more harm than good.
