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Menthol Limits: Ban Could Close Vaping Escape Hatch for Smokers

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Almost half a million people in our country die from smoking-related illnesses every year. But instead of helping people quit, anti-smoking activists seem to prioritize exacting punishment on cigarette companies.

Maybe that's easier than acknowledging that cigarette companies could, ironically, hold the key to helping millions of people kick the deadly smoking habit — flavored e-cigarettes. And that's why it's concerning that Minneapolis is moving toward a ban on the sale of menthol-flavored tobacco — and e-cigarettes — in convenience stores, adding to an existing city ban on other flavors.

Do-gooder activists and lawmakers may hope that by limiting nicotine-containing products to just "tobacco" flavor, e-cigarettes would prove less appealing to any nonsmokers, including teens and young adults, who might become addicted to nicotine as a result. But this trades one potential, smaller problem for a much bigger problem. Taking away the appetizing flavors would render these much-safer products less appealing to adult smokers, too.

Like it or not, millions of smokers have been able to quit or cut back on smoking by switching to electronic cigarettes. Like cigarettes, vaping liquid (used in electronic cigarettes) most often contains nicotine. But unlike cigarette tobacco, vape liquid is not burned, so it does not produce the ash, tar and other carcinogens that make traditional cigarettes so deadly.

Instead, e-cigarettes deliver nicotine — a substance about as harmful as caffeine — in a way that approximates the smoking experience but with almost none of the adverse health consequences. That could translate to millions of lives saved and the reduction of countless smoking-related illnesses.

Why don't health advocates see it that way? When it comes to other public health endeavors, such as preventing teen pregnancy and reducing disease transmission, health advocates recognize the value in supporting safer alternatives, such as condom distribution, needle-exchange programs and even providing safe injection centers for drug users. For tobacco-harm reduction, however, these same advocates seem unwilling to accept anything other than an "abstinence-only" approach.

The existing evidence about teens and vaping does not justify activists' fears. While it's true that 11.3 percent of high schoolers and 4.3 percent of middle schoolers reported using vapes once in the last month, researchers find that the vast majority of minors who regularly vape are current or former smokers.

A 2016 study published in the American Journal of Preventive Medicine found that fewer than 1 percent of habitual teen vapers could be classified as "never smokers." Put another way, 99 percent of teens who vape would have used much more harmful traditional cigarettes instead of the vastly less harmful e-cigarettes.

The good news for health advocates should be that teen use of cigarettes has plummeted, reaching single-digit levels for the first time ever. This is likely because of e-cigarette availability. As one Cornell study in 2016 demonstrated, when states institute age limits on the sales of e-cigarettes, teen use of traditional tobacco increases.

In other words, e-cigarettes are not a gateway, "luring" teens who would never have smoked into nicotine addiction. Rather, they are giving teens who were already going to smoke a safer alternative.

Furthermore, research indicates that the availability of candy-like vape flavors, such as "gummi bear," does not make them more attractive to nonsmoking teens. One doesn't need a study to understand why nonsmoking teenagers wouldn't be inclined to shell out $25 to $45 (or more) per month for candy-flavored vapes when they can spend far less money on actual candy.

These flavors are, however, appealing to adult smokers who want to quit. A 2014 consumer survey of adult e-cigarette users found that approximately 61 percent cited fruit-, dessert-, candy-, savory- and beverage-flavored liquids as their primary flavor, while just 25 percent cited tobacco or menthol tobacco.

Adult vapers also cite flavor variety as "very important" to their ability to reduce or quit smoking. Half of adult vapers surveyed indicated that restrictions on flavors would increase their cravings for traditional cigarettes and the likelihood they would return to smoking.

Smokers should have the choice to switch to flavored e-cigarettes if they want to. We shouldn't allow public policy to be driven by unsubstantiated fears.

Originally published to Star Tribune.