Over 375 US localities and 7 states have adopted permanent restrictions on sales of flavored electronic nicotine delivery systems (“ENDS”). These policies’ effects on combustible cigarette use (“smoking”), a more lethal habit, remain unclear. Matching new flavor policy data to retail sales data, we find a tradeoff of 15 additional cigarettes for every 1 less 0.7 mL ENDS pod sold due to ENDS flavor restrictions. Further, cigarette sales increase even among brands disproportionately used by underage youth. Thus, any public health benefits of reducing ENDS use via flavor restrictions may be offset by public health costs from increased cigarette sales.

Philip Morris International (PMI) has registered new lobbyists in at least 19 US states this year, and plans to add some in four more in the next two weeks, according to a review of public records and information provided by the company. The world’s biggest cigarette maker by market value is expanding its lobbying firepower as it prepares to launch its flagship IQOS heated tobacco device in a long-awaited entry to the US, where vaping already is an established alternative to smoking.

Lawmakers in the Bay State recently heard testimony on proposals in both the Massachusetts House and Senate which seek to address youth nicotine addiction by increasing the state excise taxes on cigars and cigarettes. While protecting youth from all age-restricted products is laudable, Massachusetts youth are reporting record lows in cigarette and cigar use. Rather than imposing draconian taxes that will disproportionately impact lower-income persons, and stoke fears of a youth vaping epidemic that doesn’t exist, lawmakers should utilize existing tobacco monies on programs to address youth use of tobacco and vapor products.

According to the UN health agency, the tobacco industry’s approach has resulted in increased use of e-cigarettes, with nine out of 10 smokers starting before the age of 18 - and some as early as 11. “Considering that children spend nearly one-third of their waking hours in school, and much of the peer pressure they encounter occurs within these educational environments, schools play a pivotal role,” WHO said. Schools are in “a uniquely powerful position to play a major role in reducing the serious problem of smoking and other tobacco and nicotine use by kids”.

How often have you seen a health body talk about smoking alternative products and then hand-wave them away because we don’t have enough long-term research to say they are safe? I’ve personally lost count. The frustrating thing about these arguments is that novel products will never come with 20 years of clinical research behind them. Instead, health experts will sit on their hands and let people smoke combustible cigarettes instead of recommending alternative harm-reduction products. Deaths and smoking-related illnesses pile up because many medical professionals are afraid to stick their necks out.

This is a contribution to a consultation and parliamentary deliberation held in Brazil in September 2023. I make five brief points in three minutes.

Vaping could lead to narrowing or blocking of blood-vessels, heart disease and premature ageing, a leading oncologist and specialist in lung cancer has warned. Ken O’Byrne [...] said “we all have to have concerns” about the explosion in vaping in recent years. “It is still nicotine and is addictive. Nicotine itself may be cancerous, the way it works in the cell. But, also, it may encourage cigarette smoking later on. So, we all have to have concerns about that. Certainly, in my own view, there needs to be much more strict legislation and control of the fashion of vaping.