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*In late February 2020, the U.S. House of Representatives approved a national e-cigarette tax proportional to the federal cigarette tax (House Bill 2339 2020). The bill specifies a tax rate of $50.33 per 1,810 milligrams of nicotine (or $0.028 per milligram). JUUL pods at the time of writing contain 59 milligrams/ml (at 5% nicotine volume). Assuming this conversion, we simulate that, if this bill were to become law, the tax could raise e-cigarette prices by $2.36 per ml ($0.0278 x 59 x 1.44 using Table 3), would reduce NRSD e-cigarette purchases by 1,784 ml per 100,000 adults , and would increase NRSD cigarette pack purchases by 26,736 packs per 100,000 adults. Our rate of substitution would be halved when compensating for the NRSD capturing roughly twice the share of cigarette sales than e-cigarette sales, which brings us to a substitution rate of one pod = 7.5 packs. | *In late February 2020, the U.S. House of Representatives approved a national e-cigarette tax proportional to the federal cigarette tax (House Bill 2339 2020). The bill specifies a tax rate of $50.33 per 1,810 milligrams of nicotine (or $0.028 per milligram). JUUL pods at the time of writing contain 59 milligrams/ml (at 5% nicotine volume). Assuming this conversion, we simulate that, if this bill were to become law, the tax could raise e-cigarette prices by $2.36 per ml ($0.0278 x 59 x 1.44 using Table 3), would reduce NRSD e-cigarette purchases by 1,784 ml per 100,000 adults , and would increase NRSD cigarette pack purchases by 26,736 packs per 100,000 adults. Our rate of substitution would be halved when compensating for the NRSD capturing roughly twice the share of cigarette sales than e-cigarette sales, which brings us to a substitution rate of one pod = 7.5 packs. | ||
*A limitation of our study is the reliance on e-cigarettes sold through retail stores, so we cannot capture e-cigarettes sold through specialty vape shops and online. However, e-cigarette taxes are collected for both online and vape shop purchases in the same way they are collected in retail stores, so we are unaware of any financial incentive to change shopping venue in response to an e-cigarette tax. | *A limitation of our study is the reliance on e-cigarettes sold through retail stores, so we cannot capture e-cigarettes sold through specialty vape shops and online. However, e-cigarette taxes are collected for both online and vape shop purchases in the same way they are collected in retail stores, so we are unaware of any financial incentive to change shopping venue in response to an e-cigarette tax. | ||
===2020: [https://pubmed.ncbi.nlm.nih.gov/33002156/ The ethics of tobacco harm reduction: An analysis of e-cigarette availability from the perspectives of utilitarianism, bioethics, and public health ethics]=== | |||
*Much evidence suggests e-cigarettes are substantially less harmful than combustible cigarettes. E-Cigarette Availability (ECA) involves making e-cigarettes available to allow smokers to switch to them, and informing smokers of the lower risks of e-cigarettes vis-à-vis smoking. | |||
*First, ECA is supported by a public health ethics framework. ECA is a population-level intervention consistent with respecting individual autonomy by using the least restrictive means to accomplish public health goals, and it supports equity and justice. Second, ECA is supported by four principles that form a biomedical ethics framework. By reducing smokers' health risks and not harming them, ECA fulfills principles of beneficence and non-maleficence. Because ECA allows smokers to make informed health decisions for themselves, it fulfills the principle requiring respect for persons and their autonomy. | |||
*'''E-cigarette availability (ECA) can also advance justice by providing a harm reduction alternative for disadvantaged groups that disproportionately bear the devastating consequences of smoking. Policies of differential taxation of cigarettes and e-cigarettes can facilitate adoption of less harmful alternatives by those economically disadvantaged.''' | |||
*We conclude that public health and biomedical ethics frameworks are mutually reinforcing and supportive of ECA as a tobacco harm reduction strategy. | |||
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