By Carmen Heredia
Rodriguez December 10, 2019
Kathleen
Hambleton once used to spend $100 a week on Marlboro Reds.
The
43-year-old nurse from Saxtons River, Vt., paid a high price for her addiction
to smoking, undergoing multiple throat surgeries. The financial hit was also a
big burden.
After
lozenges, patches and hypnosis failed to help Hambleton quit, she tried vaping.
She is convinced she is healthier now and spends less than $40 per month on her
vaping supplies.
But
Vermont recently passed a 92% wholesale tax on vaping and e-cigarette products.
Hambleton believes the sudden and sharp price hike is prohibitively expensive.
“When
they imposed the 92% tax, I can’t affordably pay that,” she said. “No one can.”
Historically,
taxation has been an effective tool in reducing the number of people who smoke.
The World Health Organization estimates that a 10%
rise in prices causes overall smoking rates to drop about 4% in high-income
countries. Some states are relying on this strategy to work again ― this time
to discourage consumers, especially teenagers and young adults, from using
e-cigarettes and vaping products.
Twenty
states and the District of Columbia have passed those taxes, according to the Campaign for
Tobacco-Free Kids, a nonprofit advocacy group. But whether taxes
would be as effective in combating vaping as they have been with smoking is
unknown, state officials and researchers say.
Early
studies suggest that hiking prices on vapers would have the same effect as on
smokers.
“There
are so many parallels here, and that’s why we’re taxing them like cigarettes,”
said Richard Auxier, a researcher at the Urban-Brookings Tax Policy Center who
specializes in state and local tax policy. “But [vaping] is new, and we should
all just take a minute to know that it all might play out a little
differently.”
The
interest in taxes comes as states grapple with a marked increase in e-cigarette
use among teens. Nearly 28% of high school students reported using e-cigarettes
in 2019, the latest National
Youth Tobacco Survey reported. More than 5 million youth reported using
e-cigarettes that year.
At the
same time, public health officials are investigating an outbreak in serious
lung injuries associated with some vaping products.
Molly
Moilanen, vice president for communications of ClearWay Minnesota, a nonprofit
advocacy and research organization, said increasing the cost of tobacco
products adds muscle to reduction strategies.
“We
know from tobacco prevention that price is king when it comes to inspiring
people to quit, and when it comes to preventing youth from ever starting,” said
Moilanen.
At the
federal level, Congress has introduced several bills that would establish a
nationwide e-cigarette and vaping tax. None have become law.
One
major vaping advocacy organization supports the fiscal move. Tony Abboud,
executive director of the vaping lobbying group Vapor Technology Association,
said that a federal tax could help deter young people from buying these
products and give the Food and Drug Administration more resources “to better
enforce the laws” that regulate them.
States
impose the vaping product taxes in a variety of ways. Among the most common: Retailers
pay the tax as a percentage of the product’s wholesale price or a set price for
each milliliter of nicotine in the vaping liquid.
The
available data shows promise. A 2014 study tracked e-cigarette sales in 52
major U.S. markets using store scanner data and found that a 10% price increase
reduced sales of disposable cigarettes by about 12% and about 19% for reusable
ones. A separate 2018 analysis estimated
that higher prices were linked to a decline in how often middle and high school
students vaped.
However,
Frank Chaloupka, an economist and research professor at the University of
Illinois at Chicago who co-authored these studies, acknowledged the data does
not reflect some important aspects of the e-cigarette market, such as sales
from online vendors or local vape shops. Many vapers purchase their products
from these retailers.
The
studies also did not capture Juul’s impact. The popular device hit the market
in 2015, after the study concluded, and that brand of e-cigarette accounts for more than half of the market share.
Implementing
the taxes can also be complicated. Many e-cigarette products do not go through
the usual distribution chain, so assessing wholesale taxes doesn’t capture all
product sales, Chaloupka said.
On the
other hand, he added, a per-milliliter tax may create a market where products
with little liquid but high levels of addictive nicotine may cost less than
items with a greater volume but lower amounts of nicotine.
“In
some ways, if you’re trying to … reduce the use of products like Juul that are
popular among kids,” Chaloupka said, “that’s not going to do that.”
The
products eligible for the charge also vary by state. Some areas tax only the
nicotine, while others attempt to tax all e-liquids and devices. Pennsylvania revised its rules after
a 2018 court decision that
said separately packaged components like heating coils and batteries could not
be taxed under the state’s tobacco law.
A
bare-bones list of taxable products could undermine state efforts to stop
vaping, Chaloupka said. However, including too many devices and e-liquids might
make it difficult to enforce a tax, he suggested. And even if states do create
a comprehensive list of products, devices on the market are constantly
changing.
“It’s
just very, very hard to define the devices and components that make the taxes
easy to implement,” Chaloupka said.
Vermont’s
tax is assessed on
vaping devices, components specific to vaping and all e-liquids — regardless of
whether they contain nicotine. Although prices can vary by retail outlets and
area, the tax elevates the suggested retail price of a Juul device from about
$35 to a little more than $67 in southeastern Vermont, according to the
Campaign for Tobacco-Free Kids. A pack of Juul menthol pods goes up from about
$16 to $30.70, the group estimated.
The tax
prompted Gaetano Putignano, owner of Hambleton’s preferred vape store, to
shutter two shops and open his business in New Hampshire, which in 2020 will
begin levying an 8% wholesale tax on
e-liquids containing nicotine, and a 30-cent-per-milliliter tax on nicotine in
closed vaping devices like Juul.
Putignano,
49, who is on the Rockingham, Vt., town board,
said he supports age limits for vaping products and restricting the sales of
vaping products to certain establishments. However, he added, Vermont’s high
tax ultimately drives local businesses away and won’t reduce youth use.
“They
say it was to protect the kids,” Putignano said. “It’s already illegal for
kids.”
Collecting
data on whether taxes reduce e-cigarette and vape use has not been easy since
some states don’t report those taxes separate from general tobacco revenue,
said Laura Oliven, the tobacco control manager at the Minnesota Department of
Health.
“The
truth is we really don’t know what the impact” is of the tax, Oliven said,
since state officials have not yet evaluated its effect. However, absent the
tax, she thinks youth e-cigarette use rates would have been much higher.
Even
with the right information on taxes, Wendy Max, a professor of health economics
at the University of California-San Francisco, said data often lags behind
reality.
“For
electronic cigarettes, it’s only in the last couple of years that surveys have
started to ask about them,” Max said. “And if you ask a question, it may be two
or three years before we have the data that allow us to address the question.”
But
time is of the essence. As of Nov. 20, the Centers for Disease Control and
Prevention has identified nearly 2,300
cases of vaping-related illness. Forty-seven people have died, and at least one patient
underwent a double lung transplant.
More
than 80% of patients surveyed reported using products containing THC, the
psychoactive ingredient in marijuana. The CDC has identified vitamin E acetate,
a potentially dangerous additive to vaping products, in 29 patient fluid
samples.
Carmen
Heredia Rodriguez: CarmenH@kff.org,
@ByCHRodriguez
No comments:
Post a Comment