It is estimated that more than 3 million American children under 18 years of age consume 947 million packs of cigarettes and 26 million containers of smokeless tobacco yearly. These tobacco products account for annual sales of $1.26 billion. Approximately 3% of tobacco industry profits ($221 million in 1988) derive directly from the sale of cigarettes to children, an activity that is illegal in 43 states. Approximately half of the tobacco industry's profits, or $3.35 billion annually, derives from sales to people who became addicted to nicotine as children. Tax revenues to the federal ($152 million) and state ($173 million) governments from cigarette sales to children dwarf governmental expenditures on smoking and health. We describe how dozens of communities have effectively enforced laws that prohibit the distribution of tobacco to children and offer some suggestions for increasing efforts to prevent nicotine addiction.
Death and product defect are two reasons to abolish the sale of cigarettes, but there are others. A third is the financial burden on public and private treasuries, principally from the costs of treating illnesses due to smoking. Cigarette use also results in financial losses from diminished labor productivity, and in many parts of the world makes the poor even poorer.6
Who Benefits From The Sale Of Cigarettes
Cigarettes are also, though, a significant cause of harm to the natural environment. Cigarette manufacturing consumes scarce resources in growing, curing, rolling, flavouring, packaging, transport, advertising and legal defence, but also causes harms from massive pesticide use and deforestation. Many Manhattans of savannah woodlands are lost every year to obtain the charcoal used for flue curing. Cigarette manufacturing also produces non-trivial greenhouse gas emissions, principally from the fossil fuels used for curing and transport, fires from careless disposal of butts, and increased medical costs from maladies caused by smoking5 (China produces 40 percent of the world's cigarettes, for example, and uses mainly coal to cure its tobacco leaf). And cigarette makers have provided substantial funding and institutional support for global climate change deniers, causing further harm.10 Cigarettes are not sustainable in a world of global warming; indeed they are one of its overlooked and easily preventable causes.
While the FTC has collected information on traditional cigarette and smokeless tobacco sales and advertising expenditures for many years, this was the first time it sought information related to e-cigarettes. The orders asked about e-cigarette sales and advertising and promotional activities for 2015 to 2018. The report issued today presents an aggregated and anonymized summary of the information the six companies provided to the Commission.
Almost all adults who smoke cigarettes started in their teens. Public Health Law 13-F, known as the Adolescent Tobacco Use Prevention Act (commonly referred to as ATUPA), regulates the sale of tobacco and vaping products to restrict their access by youth and young adults. ATUPA violations can result in civil penalties or retailer registration suspension or revocation. Recent amendments:
NYS has one of the highest state cigarette taxes in the country. In 2010, NYS's cigarette excise tax increased to $4.35 per pack of 20 cigarettes or little cigars. The tax on moist snuff is $2.00 per ounce, and the tax on cigars and other tobacco products is 75% of wholesale value. Localities may levy additional tobacco taxes with the approval of the state legislature. New York City (NYC) also imposes a local tax on cigarettes at $1.50 per pack, bringing the combined state and local tax to $5.85, the third highest in the nation. As of June 1, 2018, NYC Local Law 145 requires retailers sell cigarettes for a minimum retail price of $13.00 per pack, the highest pack price in the U.S.
Every retail dealer of cigarettes or tobacco products in NYS and every owner or operator of vending machines that sell cigarettes or tobacco products must register with the Department of Taxation and Finance. In 2019, 18,219 tobacco retailers were registered with the NYS Department of Tax and Finance. Cigarette wholesalers, retailers and distributors also must be licensed. Municipalities may establish their own licensing requirements.
Beginning December 1, 2019, every person who intends to sell vapor products in NYS must apply for and receive a certificate of registration from the Department of Taxation and Finance before selling them. Registration certificates are valid for one year and must be displayed. The law gives the State Health Department enforcement oversight to ensure compliance with all tobacco and e-cigarette laws, including adhering to the minimum legal sale age, display of approved signage, restricting the sale of flavored vaping products other than tobacco-flavored, and storing tobacco and vapor products out of consumers' reach. See New York State Tax Law, Article 28-C to learn more.
Enacted in 1985, the Cigarette Marketing Standards Act, Tax Law, Article 20-A, prohibits the sale of cigarettes below cost and makes it illegal for retailers to intentionally avoid the collection or payment of taxes. The law includes fines and penalties for violations.
Enacted in 2000 and implemented in 2004, the Cigarette Fire Safety Act, Executive Law Article 6-C Section 156-C, established fire safety standards for cigarettes sold in NYS. The act requires manufacturers to certify that all cigarettes they offer for sale in NYS meet a specific ignition propensity standard to prevent fires caused by burning cigarettes left unattended and particularly those held by smokers who fall asleep during use. NYS was the first jurisdiction in the world to establish such a requirement. Cigarette-caused fires and deaths have declined since the implementation of the law.
However, because the youth e-cigarette epidemic in the United States and the youth appeal of flavored e-cigarettes go hand in hand, Truth Initiative strongly supports removing all flavored e-cigarettes from the market, regardless of device type. At a minimum, an e-cigarette manufacturer must show that the flavor itself is safe, helps smokers switch completely from combustible cigarettes, and does not attract youth before a product is allowed to go to market. In addition to flavor restrictions, Truth Initiative supports strong regulations to keep all tobacco products, including e-cigarettes, away from youth.
After a smoker switches completely to e-cigarettes, they should also stop using e-cigarettes to achieve the maximum health benefit. Many youth and young adult e-cigarette users, many of whom never previously used tobacco, are also in need of support to quit (see sidebar This is Quitting). Evidence from multiple sources indicate that both youth and young adult e-cigarette users want to quit and have made a quit attempt. Nearly two-thirds of adult e-cigarette users plan to quit vaping and almost a quarter of adolescents attempted to quit vaping in the past year. Here is what we know about reasons for quitting vaping:
E-cigarettes contain nicotine, sometimes at levels near or exceeding those found in combustible cigarettes. Nicotine is harmful to developing brains: younger users are more likely to become addicted, have more difficulty quitting and may be at higher risk for addiction to other substances in the future. While new products may be beneficial to smokers who completely switch from combustible tobacco, they still pose health risks and nonsmokers should never use them.
Although there is no doubt that smokers switching to electronic cigarettes (EC) substantially reduce the risk to their health, some tobacco control activists and health organisations discourage smokers from using EC and lobby policy makers to reduce EC use by draconian regulation.
The hostility to EC may be related to a moral belief that nicotine use should be eradicated rather than allowed to morph into a relatively harmless activity. If EC are allowed to compete with cigarettes and develop further, smoking is likely to all but disappear. Discouraging smokers from making the switch and reducing EC competitiveness with cigarettes by unwarranted regulation will delay this opportunity or squander it altogether.
Electronic cigarettes (EC) are a consumer product appealing to smokers looking for a safer way to obtain what they want from their cigarettes. From what we know about EC ingredients, toxicology and the chemical and physical processes involved, they can be expected, outside pregnancy, to be at least 95% less harmful than cigarettes [1]. There is now a sufficient body of evidence available on several aspects and effects of EC for recent reviews to conclude that health care professionals and public health bodies should encourage smokers who cannot stop smoking using available treatments, or do not want to do so, to switch to EC [2],[3].
Yet at the same time, the World Health Organisation (WHO) have labelled EC a threat to public health, issued a strong advice to smokers not to use them [4], and urges policy makers to limit their use by prohibition or strict regulation [5]. This and other negative campaigns are starting to have an alarming effect of persuading smokers that EC are as harmful as cigarettes [6] and discouraging them from making the switch [7],[8].
This commentary argues that EC have a potential to generate substantial public health benefits and that discouraging smokers from using them and regulating EC as severely as cigarettes, or even more severely, is detrimental to public health.
EC are a disruptive technology, threatening sales of tobacco products as well as sales of stop smoking medications and so commercially motivated opposition can be expected. The hostility to EC from some tobacco control activists, however, is puzzling. Future textbooks are likely to discuss this phenomenon at length. Here is one hypothesis.
Emerging trends are as expected. In the UK where EC are available and taken up by sufficient numbers of smokers, quit rates are increasing and decline in smoking, especially among young people, is accelerating [19]-[21]. The same is happening in the US [12]. In France and Italy the decline in cigarette sales has been accelerating [22],[23]. Such data, of course, cannot determine the cause of these trends. The sales of EC have so far been too low compared to sales of cigarettes for their impact to be clearly visible. More comprehensive studies of the relationship between sales of cigarettes and sales of EC are currently the number one research priority. Comparisons are needed of time trends in sales of cigarettes in countries that allow and that prohibit EC sales, and sales of cigarettes need to be plotted against sales of EC over time. This is needed urgently, before the drastic regulation of EC advocated by the tobacco and pharmaceutical industries and misguided medical organisations stops the effects of EC sales on cigarette sales unfolding and hard data emerging which could provide a rational guidance to policy. 2ff7e9595c
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