When it comes to public health, we should follow the facts and science, as opposed to political posturing.
If history has taught us anything, it’s that prohibition is rarely the answer when addressing a public health problem.
Outright bans of products tend to produce the opposite result of their intent, spurring more product consumption and fueling unregulated black markets. Unfortunately, this is the approach the Food and Drug Administration (FDA) is taking when it comes to adults over 21 consuming tobacco products.
Just look at the early 1920s, when the average annual per capita consumption of hard liquor shot up 11.64 percent during the national prohibition of alcohol. Not only were people consuming more, but the product they were consuming was more potent. It’s estimated that the potency of Prohibition-era products distributed by underground markets was more than 150 percent of the potency of products produced either before or after Prohibition.
So, when President Biden recently announced a plan to publish a proposed rule in May 2023 that could eliminate nearly 98 percent of the nicotine found in cigarettes, it’s difficult not to see this as a 21st-century “Prohibition.” We know it didn’t work for alcohol, so why does this administration think banning nicotine in cigarettes will be different?
No one wants kids smoking, but the most recent National Youth Tobacco Survey by the FDA and Centers for Disease Control and Prevention (CDC) shows combustion cigarette use among adolescents is trending even further downward, with only 1.5 percent of students now reporting consumption of traditional cigarettes since Congress passed a law raising the smoking age to 21 in 2019. Instead of addressing the core concern of youth e-cigarette use, this proposed rule only stands to pull the rug out from under more than 30 million adults, forcing them to essentially quit smoking cold turkey or — much like during Prohibition — get their fix through illicit markets.
In response to cigarette tax hikes in New York City alone, over half the cigarettes smoked are now smuggled. Can you imagine the impact Biden’s federal proposal would have nationwide? Surging black-market sales lead to more funding for organized crime and less for “mom-and-pop” corner stores. In addition, the illicit tobacco market has been found to fund terrorist organizations overseas — so it wouldn’t be surprising to see a cigarette ban directly correlated to more funding for terrorist groups such as Hamas and Hezbollah.
Instead of pushing for prohibition, the administration should implement harm-reduction tactics for cigarettes, similar to how they’ve addressed marijuana and opioid use. Harm reduction is proven to work. For example, when it comes to combating the HIV crisis, cities that have needle and syringe programs have an average annual decrease in HIV prevalence of 18.6 percent, compared with an annual average increase of 8.1 percent in cities without these programs.
The Biden administration could use the $712 million annually given to the Center for Tobacco Products to educate adults on alternatives to cigarettes. Countries such as Japan, Britain and Sweden have done so and have seen significant drops in cigarette consumption as adults have transitioned. Or, if Biden wants to really get serious about reducing nicotine usage, he should encourage the FDA to exercise the authority given to it by Congress to better regulate synthetic nicotine, the main ingredient in e-cigarette products such as youth-favorite Puff Bar.
Prohibition will not lead to smoking cessation, but it could spur more illicit cigarette consumption and even raise national security concerns. It’s time to enforce the laws we have on the books and apply harm reduction approaches universally.
Richard Marianos, an adjunct professor at Georgetown University, is a senior law enforcement consultant, having served more than 27 years with the U.S. Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). He was assistant director in the Office of Public and Governmental Affairs and Special Agent in Charge of ATF’s Washington Field Division. Since his retirement, he has consulted for clients on tobacco industry issues, including RJ Reynolds and Altria.
Richard Marianos – The Hill – 2023-01-05.