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Author: Elizabeth Hicks

Limited State Registries Will Negatively Impact Consumers of Nicotine Products 

WASHINGTON, D.C. – In the first few months of 2024, more than a dozen bills have been introduced in US states calling for a state-based Premarket Tobacco Product Application (PMTA) registry for alternative nicotine products such as vaping devices, heaters, and nicotine pouches.

Although this type of legislation has already been passed in Oklahoma, Louisiana, and Alabama, it’s crucial that other states recognize the unintended consequences and course-correct before it is too late.

ELIZABETH HICKS, US Affairs Analyst at Consumer Choice Center, responded, “While the intention behind these bills is to manage consumer access to unregulated nicotine products on the illicit market, the reality is that the FDA is not approving enough new devices and products to create a competitive, regulated marketplace that meets consumer demand.”

While 26 million nicotine alternative products submitted PMTAs to the FDA, only 23 have been approved. Of those 23 approved products, 12 are simply tobacco-flavored e-liquid refills.

“The FDA is hiding the ball here on product approvals and how few new products are actually coming to market. If the goal is to improve public health across the country, then consumers deserve to choose from a variety of different nicotine alternatives,” added Hicks.

“The FDA’s flawed PMTA process needs reform. Instead of restricting consumer access to products that have been demonstrated to be 95 percent less harmful than combustible tobacco, state legislatures should refrain from adding to counterproductive federal policies and advance tobacco harm reduction through a competitive marketplace,” she concluded.

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The CCC represents consumers in over 100 countries across the globe. We closely monitor regulatory trends in Washington, D.C., Ottawa, Brussels, Geneva, and other hotspots of regulation and inform and activate consumers to fight for  Consumer Choice. Learn more at consumerchoicecenter.org

A generational ban on tobacco products is a bad idea

Sweden has found nicotine alternatives are better way to kick smoking

When the city of Brookline passed a generational ban on tobacco products in 2020, it was an extraordinary legal maneuver. The age-gating of goods on an incremental level prevents anyone born after January 1, 2000 from buying any tobacco-related products within city limits. 

It is a policy dreamed up by many in public health who have sought to replicate it elsewhere, including in New Zealand, Malaysia, and, now, the UK.

Now, however, a constitutional challenge in the Massachusetts courts is revisiting whether the health ordinance is legal to enforce. And it’s about time.

Despite already increasing the age limit to purchase tobacco from 19 to 21 and banning flavored tobacco products throughout the state, proponents are claiming that a full generational ban is a sure-fire way to eliminate youth use. But we know it isn’t, as the numbers already show us.

While it shouldn’t need restating, prohibition never works. In 2020, Massachusetts became the first state to ban all flavored tobacco products, again in effort to curb youth use. However, according to the Massachusetts Illegal Tobacco Task Force, the ban resulted in increased interstate smuggling of tobacco products, more tobacco-related police interactions, and a loss in tax revenue for the state. 

Ultimately, the flavor ban did not eliminate consumer use of flavored tobacco products. It just shifted where consumers purchased their goods. Which means the estimated 587,000 adults who smoke in Massachusetts likely had to turn to alternative sources to purchase tobacco products they prefer. 

When a product is banned, then consumers often go to the illicit market to find their desired products. This poses great concern, as the illicit market does not have to abide by product regulations and certainly is not performing age verification on purchases.

California followed in Massachusetts’ footsteps by banning flavored tobacco products in 2022, and further saw an extreme increase in the illicit market where brands known to be trafficked in by Mexican cartels. This suggests that tens of millions of packs are illegally entering California. It’s doubtful that this is the public health “win” tobacco control activists are looking for. 

While Brookline is the first in the US to pass a generational tobacco ban, there are international examples of similar policy. Both New Zealand and Malaysia have attempted to implement a generational tobacco ban, but have since pulled back after backlashes showed up in polling and disagreements over taxation. The Conservative government in the United Kingdom has plans to implement such a ban, but has also faced severe backlash from its more liberty-oriented  grassroots.

Rather than put all our cards on failed generational policies, it would be better to look globally towards policies that have helped reduce smoking prevalence. Sweden is a great example, as the World Health Organization announced that they are likely to become the first smoke-free country. 

Interestingly, Sweden is not succeeding using bans and prohibition, but rather through the concept of harm reduction. The Swedish government has recognized that nicotine alternatives, such as vaping, nicotine pouches, and snus, are significantly less harmful than smoking combustible tobacco and have therefore encouraged its citizens to make the switch. As a result, Sweden reduced its smoking rate by 55 percent in the last decade and has the lowest incidence of cancer within the European Union. 

While the desire to reduce youth use of tobacco products and overall smoking prevalence is a noble and important goal, it will be imperative that policymakers understand the serious unintended consequences of prohibition. 

As other countries have shown us, embracing tobacco harm reduction, not prohibition, will be the best strategy to improve public health in Massachusetts. That’s a great idea in any generation.

Originally published here

This Is Not the Time for a Shortage of Healthcare Workers

Winter is a busy time for impromptu hospital visits, whether from slipping on icy sidewalks or throwing out one’s back while shoveling snow. Then there’s the winter crud, which this year is particularly virulent. The CDC has reported that hospitalizations are up for influenza by 51 percent, 200 percent for COVID-19, and a 60 percent jump in RSV infections. Unfortunately, a shortage of nurses and other skilled healthcare workers could mean longer patient wait times.

The healthcare industry nationwide is in the thick of what is now termed the “Great Resignation.” Nearly half of American healthcare workers actively seek alternative employment opportunities, leaving patients with reduced access to healthcare providers and increased costs for services.

Because of this shortage of skilled healthcare workers, patients endure longer wait times in emergency rooms and urgent-care facilities and for crucial services like imaging, labs, exams, and routine or surgical procedures.

Patients deserve prompt access to quality care without delays in matters as critical as health and well-being. No one should have to endure long wait times at a medical facility.

We need more skilled healthcare workers throughout the United States. Still, we can’t sit on our hands and wait for the next generation of students to graduate and enter the workforce. Instead, America needs to tap into a global pool of skilled workers eager to contribute their talents immediately.

Unfortunately, bureaucratic hurdles in the form of visa labor caps exacerbate the labor deficit. Adding to the complexity is retrogression, a process that causes delays in visa processing as the annual visa limit approaches. These barriers make it increasingly difficult to fulfill America’s labor demand, ultimately leaving consumers feeling the pinch.

The crux of the issue lies in the caps and quotas imposed on employment-based visas for international skilled workers. These visa quotas have seen minimal adjustments to accommodate the modern economy, which has more than tripled in size since the quotas were created in 1990. The annual visa cap is set at 140,000, yet the unused employment-based visas reached 65,000 by the end of fiscal year 2021 due to processing capacity constraints. This problem has compounded, with 4.5 million unused employment-based visas since 1922.

The complexity of the system and the financial burdens associated with securing an employment-based visa add immensely to the challenges of entry. The complex application and approval process alone can take up to three years, and capacity constraints at Citizenship and Immigration Services create application backlogs and additional delays.

Countries such as the Philippines, with a significant population of nurses seeking to alleviate the healthcare shortage in the United States, experience lengthy wait times and high costs for their applications.

To address the repercussions patients face from labor shortages, the country must substantially increase the number of visas to at least 420,000 granted to skilled workers willing to help fill the gap. This move would be a boon for the healthcare industry and, most important, patients nationwide.

Unclaimed visas from previous years should be leveraged to bridge the gap quickly, ensuring that future labor shortages do not negatively affect American consumers. This would also help deter retrogression and eliminate unnecessary barriers. Politically, allowing unused visas to be rolled over and used to fill critical gaps could have bipartisan support. Economically, it alleviates labor market shortfalls and rewards migrants seeking to migrate via legal channels.

Patients need the gift of care. Policymakers have the power to give it by initiating visa labor cap reform. This would ensure that Americans spend less time in waiting rooms.

Originally published here

Spectrum Allocation Will Fuel America’s Digital Future

Consumers don’t tend to think of data as a finite resource. Instead, the focus of the average smartphone user or online gamer is on how much they’ve paid their wireless provider per month for 5G and “unlimited data.” 

But data is not actually unlimited. There is only so much available, a function of what is known as spectrum allocation. The economic model of supply and demand might as well not be applied here because the United States is doing very little to meet present or future demand.

The pandemic shift toward remote work, at-home learning and online retail shopping has on its own been a huge driver of strain on spectrum network capacity, with nothing to say of the coming needs of AI, self-driving cars, and low-Earth-orbit satellites providing internet. Wireless networks carried more data in 2021 than in the entire seven-year span from 2010 to 2017. 5G home broadband experienced a growth rate 140 times faster than all other home broadband options combined.

If we want greater capacity for our connected devices, 5G on the fly, or even just marginally faster cellular networks, the government will have to massively expand the availability bands for our devices to broadcast and receive.

Earlier this year, Commerce Secretary Gina Raimondo iterated that message, unveiling the beginning of a National Spectrum Strategy, which will aim to define the range of spectrum that becomes available for use, and how it will be doled out.

The National Telecommunications and Information Administration will need to identify 1,500 megahertz of spectrum within the next decade or sooner. It is expected this new radio wave real estate would service autonomous vehicles, smart home devices, and “always-on” internet products powering industry and households alike.

There have been surefire warnings that without additional licensed spectrum, U.S. operators will struggle to meet surging wireless demand, facing a spectrum deficit of 400 MHz within the next five years and 1,400 MHz by 2034.

The 4 GHz (4.4-4.94 GHz) band is pivotal in maximizing 5G potential as this band enables a multitude of advanced 5G use cases, from broadcasting to autonomous vehicles, requiring a mix of coverage and capacity. Moreover, auctioning this band aligns with international harmonization efforts, ensuring that the U.S. remains at the forefront of wireless infrastructure development while delivering lower prices to consumers.

Similarly, the 7/8 GHz band presents an opportunity for further deployment of 5G networks and services. Recent research by NTIA reveals it is nowhere near being fully used by federal incumbents, making it ripe for exploration and auction. In this vein, FCC Chairwoman Jessica Rosenworcel rightly calls for the evaluation of the 7-15 GHz spectrum range to deliver faster speeds and wider coverage. That’s even better.

The higher capacity of the 7 GHz band can enable 5G networks to serve densely populated areas, fostering smart cities and private 5G networks for campuses, manufacturing facilities and other crucial institutions.

Recognizing the early positive benefits of opening up the spectrum will be key to giving entrepreneurs and consumers alike a chance to prosper even further down the road. A National Spectrum Policy should keep all of this in mind while remaining steadfast in empowering consumers and bridging the digital divide.

By prioritizing spectrum allocation for licensed, full-power commercial use, we ensure that consumers have access to reliable, high-speed wireless networks that meet their growing demands. It’s a strategy that fuels economic growth, fosters innovation, and secures America’s position as a global telecommunications leader.

In the age of connectivity, consumers deserve nothing less.

Originally published here

Alabama Ban on Vaping in Cars Worsens Public Health

While the effort to reduce secondhand smoke inhalation from combustible cigarettes is noble, vapor produced from e-cigarettes does not contain the harmful tar and chemicals found in combustible cigarettes. It does not create the same degree of harm.

MONTGOMERY, AL — This spring, Alabama state lawmakers passed a bill (HB3) that is now in effect, prohibiting the use of cigarettes and vaping products in vehicles when a child 14 years of age or younger is present.

Elizabeth Hicks, US Affairs Analyst with the consumer advocacy group Consumer Choice Center, said of HB3, “Legislation like this further demonstrates how regulators view vaping and smoking as the same, when in reality, numerous studies have shown vaping to be 95% less harmful. While the effort to reduce secondhand smoke inhalation from combustible cigarettes is noble, vapor produced from e-cigarettes does not contain the harmful tar and chemicals found in combustible cigarettes. It does not create the same degree of harm.

“Treating vaping like cigarettes hampers public health by deterring smokers from adopting a less harmful nicotine option. With 8,600 annual smoking-related deaths in Alabama, regulators should view vaping as a harm reduction tool rather than regulating it as cigarettes,” added Hicks.

Read the full text here

Harm reduction, not policing, will boost public health in Alabama

By: Elizabeth Hicks & Stephen Kent

In a landmark move earlier this year, Alabama state lawmakers passed first-of-its-kind legislation effectively outlawing the use of cigarettes and vaping products in vehicles when a child 14 years of age or younger is present. That law is now in effect statewide. While the intent behind this legislation is undoubtedly noble, the treatment of vaping and smoking as equals is going to cause real harm in Alabama. This will not go the way lawmakers think. 

The idea of the new law is simple. Adults should not be subjecting young children to cigarette smoke and adversely impacting their health when the kids have no say in the matter. Smoking, after all, is a choice that adult consumers make for themselves. 

Older folks who grew up in the heyday of cigarette smoking often share some memories of being in smokey cars with the windows rolled up, toughing it out at a time when smokers weren’t widely aware of the hazard posed by second-hand smoke to their passengers. That time is past. 

Acknowledging this fact, we have to all ask ourselves what protection is owed to young passengers in the car with smokers, and also what kind of laws will reduce harm for both children and their parent/guardian in the driver’s seat. Alabama Representative Rolanda Hollis made an effort to address this in HB3, but the law’s failure to make distinctions between cigarettes and vape products which have been shown to be 95% less harmful than traditional cigarettes, is not going to be a net benefit to public health. 

Alabama is a state that sees a staggering number of smoking-related fatalities, close to 8,600 deaths annually, along with nearly $309 million in Medicaid costs incurred by the state. Reducing these harms is important, and it should start with incentivizing cigarette smokers to switch. Passing laws that insinuate the two products are equally harmful reads to a smoker as an excuse to keep on with the product they’re accustomed to. Switching can be hard, but the potential for small social benefits like not being kicked to the curb every time you want to smoke is one of those things that makes the switch to vaping easier. The same goes for smokers behind the steering wheel. 

Harm reduction strategies work. There is little evidence, however, to show that punitive measures like $100 fines for smoking in the car whilst parenting is going to be a boon to public health in states like Alabama. 

As is well known, cigarettes contain a harmful cocktail of chemicals and tar, which contribute to respiratory diseases and cancer. These components are not present in the vapor produced by e-cigarettes.  Toxicologist Igor Burstyn of Drexel University noted that the contents of e-cig vapor “justifies surveillance,” but that exhaled vapor contains so little contamination that the risk to bystanders is insignificant. This has been supported by Public Health England’s updated review of evidence in 2018. 

Tacking financial penalties to vaping in the car, even with the windows down and fresh air flowing in, smacks of the early days of COVID-19 alarmism when police were arresting people for being outside at public beaches or doing watersports. When it comes to vaping, the level of risk and the effort that will be required to police the activity, just don’t line up. 

Yes, nicotine fuels both products in question, and there’s no getting away from its addictive qualities for the smoker. If the Heart of Dixie wants to lead the way in protecting public health, it is never too late to embrace harm reduction strategies when it comes to smoking. 

Elizabeth Hicks is the U.S. Affairs Analyst and Stephen Kent is the Media Director for the Consumer Choice Center

Organization warns vaping laws may eventually hurt taxpayers

Illinois now has a law that bans the use of electronic cigarettes in indoor public spaces, but a consumer advocacy group warns such laws could backfire.

Gov. J.B. Pritzker signed into law a measure that adds electronic smoking devices to the 2008 Smoke-Free Illinois Act, which banned smoking in most public spaces in the state.

“Illinoisans deserve to enjoy public spaces without being exposed unwillingly to secondhand vapor and other electronic cigarette byproducts,” said Pritzker in a statement.

The Illinois Department of Public Health noted that e-cigarettes can cause lung damage and addiction to nicotine.

Illinois also passed a law to raise the age to buy tobacco products from 18 to 21 in 2019, and limited the advertising of e-cigarette products in 2022.

“We have made great progress, but the surge of use of e-cigarettes has threatened that progress and lured more people toward a deadly addiction,” said the bill’s sponsor, state Sen. Julie Morrison, D-Lake Forest.

But Elizabeth Hicks with the Consumer Choice Center said vaping should not be compared with smoking regular cigarettes.

“We know that smoking combustible tobacco is harmful to health, however, vaping studies have shown that it is 95% less harmful than smoking,” said Hicks to The Center Square.

Read the full text here

The Real Consequences the Proposed Vaping Flavor Ban in Columbus

Columbus is considering putting an end to the sales of menthol cigarettes and flavored vapes. Although official legislation hasn’t been formally introduced, tobacco-control advocates who are drafting the proposal are claiming a ban would help decrease smoking rates amongst Black people, other groups of color, women, and LGBTQ populations.

Sadly, over 20,000 Ohioans lose their lives to cigarette smoking-related illnesses every year. Considering that studies have shown vaping to be 95% less harmful than smoking and that adults who used flavored vaping products were 2.3 times more likely to quit smoking cigarettes, ensuring that adult consumers in Columbus have access to the vaping products they prefer will ultimately lead to fewer cigarette smoking-related deaths in Ohio. 

It’s estimated that more than 5% of Ohio’s adult population uses vaping products, accounting for over 634,000 Ohioans who have switched to a healthier alternative to combustible tobacco. Banning flavored vaping products will encourage these former smokers to switch back to smoking cigarettes, and will ultimately lead to increases in smoking-related healthcare costs, which are already costing Ohioan taxpayers $1.85 billion annually.

Advocates for the ban claim that it wouldn’t outlaw flavored vaping products or menthol cigarettes within Columbus, just the sale of said products and that consumers wouldn’t be punished for buying products elsewhere and bringing them into the city. Not only would this plan greatly harm small businesses who sell vaping products, but it would also effectively set up a dangerous illicit market within Columbus where bad actors could easily take advantage of consumers by selling them unregulated faulty products which could cause serious health concerns. 

Additionally, although the flavor ban intends to help minority groups of color, the reality of setting up an illicit market is that it will further exacerbate interactions between law enforcement and consumers of these products. One of the most infamous examples of this is the tragic death of Eric Garner, who was killed by police in New York after being approached on suspicion of selling untaxed individual cigarettes. 

Implementing a ban on flavored vaping products and menthol cigarettes within Columbus will have serious unintended consequences. Instead of a ban, more tobacco harm reduction efforts must first be explored such as increasing educational outreach to specific communities as well as encouraging vapes and smoke-free tobacco products as a tool for cessation. 

Elizabeth Hicks is the U.S. Affairs Analyst and David Clement is the North American Affairs Manager with the Consumer Choice Center. 

Court battle continues over the legal use of vaping products

As the legal use of vaping products continues to be argued in court, a debate also continues on whether a ban would send vapors back to regular cigarettes.  

Juul can continue to sell its electronic cigarettes after a federal appeals court in June blocked an FDA ban. 

To stay on the market, companies must show that their e-cigarettes benefit public health. Essentially, that means proving that adult smokers who use vapes are likely to quit or reduce their smoking, while teenagers are unlikely to become hooked on them.   

This week for a third time in four decisions, a federal appeals court has denied an Illinois-based vaping manufacturer’s petition for review of an FDA marketing denial order. A three judge panel of the Seventh Circuit Court of Appeals ruled for the FDA, denying the appeal by Gripum LLC, which makes bottled e-liquid under several names. 

In Illinois, there’s talk of placing a ban on all flavored tobacco and vapes in the state, but legislation has yet to move out of committee. 

Elizabeth Hicks, U.S. Affairs analyst with the Consumer Choice Center, warned that enacting a flavor ban for vaping and tobacco products would push consumers to switch back to smoking combustible tobacco.

Read the full text here

Michigan law makes fight for municipal broadband an uphill battle

For more than a decade, municipalities around the United States have been starting their own government-run broadband networks to bring high-speed internet to their residents. 

They might do so for a variety of reasons: to provide residents faster service at a lower cost, to encourage economic development, to provide high-speed internet to areas that private Internet Service Providers aren’t interested in serving, or to bring more economical connections to urban areas where residents can’t afford the service provided by private ISPs.

But due to laws on the books in Michigan, cities can face significant obstacles in starting their own network.

Michigan is one of 18 states that put restrictions on municipal broadband programs. Under the Metropolitan Extension Telecommunications Rights-of-Way Oversight Act of 2002, public entities can provide telecommunications services only if they have first requested bids for the services and received fewer than three qualified bids. They also must subject themselves to the same terms as those specified in their Request for Proposal.

Read the full text here

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