San Francisco supervisors’ e-cigarette ban, recently enacted, packs a symbolic punch because Juul, a “tech startup” whose product has become the market-dominating maker of vaping devices, is headquartered in the city.
Officials not only banned e-cigarette sales, they also decreed that their makers cannot manufacture the devices on municipal property. Juul is unaffected by this action because it is not retroactive, and the company says it does not make its product in its offices, space that is leased from the city on Pier 70.
The Bay Area metropolis joined tony Beverly Hills in targeting health-harming products. The wealthy Los Angeles suburb recently banned stores and gas stations from selling e-cigarettes, tobacco burning cigarettes, and chewing tobacco. The many and often pricey hotels in the city may purvey the products in their room service, and officials carved out an exemption to the municipal ban on smoking in public to permit cigar lounges to keep operating.
Juul officials criticized the San Francisco actions, saying it, too, wants and works to keep vaping devices out of the hands of young people. But the company and e-cigarette advocates suggested the net effect of the product crackdown will lead more adults to tobacco cigarette smoking, a proven cause of different types of cancer, heart disease, and other significant health harms. Some officials have pushed e-cigarettes as a less harmful way for adults to reduce the damage caused by toxins generated when tobacco is burned. But critics have noted that the devices expose users to addictive nicotine in equal or greater amounts, with that chemical’s negative effects known and greater for young and developing minds and bodies.
The federal Food and Drug Administration under the Obama Administration had fought to regulate vaping and e-cigarettes in rigorous fashion — a move disastrously postponed by the Trump Administration and former Commissioner Scott Gottlieb. He wanted more study of the devices and vaping, as part of a different oversight of tobacco focused on nicotine reduction. During the time the FDA wrung its hands about vaping, Juul exploded as a hip and trendy device for the young, many of them teens in high school. The company promoted its product aggressively through social media and attractive young models and those who influence peer behavior. The FDA was caught snoring, as vaping and e-cigarette use reached what critics called epidemic levels, with the likelihood that a generation of consumers had been hooked on nicotine and potentially were on a path to cancer-causing tobacco smoking.
In my practice, I see the harms that patients suffer while seeking medical services, and experience and decades of rigorous research affirm that an important way for them to avoid injury in the health care system is to stay healthy and away from it. One of the major advances in Americans’ wellness and longevity occurred when, after long struggles, health advocates beat down Big Tobacco. That meant that access to its products were curtailed and consumers learned in explicit ways their cancer-causing potential. Cancers, heart disease, stroke, and other illnesses killed fewer Americans and people globally.
Big Tobacco, however, is metastasizing before regulators’ eyes, investing heavily in e-cigarettes and makers like Juul, as well as in marijuana. Elected leaders in San Francisco and Beverly Hills deserve credit for bucking themselves up and taking on powerful special interests to take a stab at corralling the health damages of vaping and e-cigarettes. Their actions, of course, stop at the cities’ lines. The FDA has jawed at e-cigarette makers and imposed tougher regulations on them while still not stopping vaping’s growing popularity. The agency needs to do more. Congress and the administration also could act with greater urgency and impact. Americans may need to be wary, however, of Mitch McConnell, the Senate majority leader and Republican from Kentucky. He and others are pushing a measure aimed at restricting tobacco and e-cigarette use to consumers 21 and older. The fine print on that and other similar measures must be read with extreme care to ensure Big Tobacco shills don’t push through an industry-beneficial regulatory Trojan horse.