Letter to the Utah House Revenue and Taxation Committee on HB 88

Dear Chairman Eliason and members of the House Revenue and Taxation Committee,

I received thoughtful feedback from many of you after I wrote to you last month to share my concerns that H.B. 88 (Electronic Cigarette and Other Nicotine Product Amendments) would harm Utah consumers (especially the most vulnerable), local businesses, and provide no countervailing benefit to the broader public or to the treasury.

I was pleased that some of you shared my view that this attempt to create additional tax revenue does not justify the negative ramifications it will have for your constituents. You understand that any excise tax on lower-risk alternatives to combustible cigarettes would make it harder for your constituents to quit smoking. But this 86% tax proposal is particularly unwise as it would guarantee an expansion of the black market while harming responsible businesses in your community.

Some of you also sought a better understanding about whether e-cigarettes are indeed helping adult smokers quit, and the impact of e-cigarettes on youth, who we all agree should not use any nicotine products, including e-cigarettes.

I wanted to share some recent developments that add to the substantial evidence that suggests that e-cigarettes should be regulated, but with caution, given their potential to help adult smokers quit.

Yesterday, the American Cancer Society, which had been a strident opponent of e-cigarettes, announced an important change in course.  Without dismissing concerns about youth, ACS now recommends “that clinicians support all attempts to quit the use of combustible tobacco and work with smokers to eventually stop using any tobacco product, including e-cigarettes.  Some smokers, despite firm clinician advice, will not attempt to quit smoking cigarettes and will not use FDA approved cessation medications.  These individuals should be encouraged to switch to the least harmful form of tobacco product possible; switching to the exclusive use of e-cigarettes is preferable to continuing to smoke combustible products.”

Additionally, although there are certainly differences between the populations in Utah and the U.K., this month’s Public Health England’s updated comprehensive review is instructive. In describing the analysis, their tobacco control program lead wrote, “Our report found no evidence so far to support the concern that e-cigarettes are a route into smoking among young people. UK surveys show that young people are experimenting with e-cigarettes, but regular use is rare and confined almost entirely to those who already smoke. Meanwhile, smoking rates among young people in the UK continue to decline. 

He added that, There is currently no evidence to suggest that e-cigarettes are encouraging people to continue smoking – the picture in the UK suggests the opposite. The proportion of e-cigarette users who are ex-smokers has been increasing over recent years. Of the 2.9 million adult e-cigarette users in the UK, more than half have completely stopped smoking. A further 770,000 have given up both smoking and vaping. At the same time, quit success rates have been improving and we’re seeing an accelerated drop in smoking rates, currently at a record low of 15.5% in England.

I have faith that the public health community, legislators, and responsible local businesses can work together to prevent youth use of e-cigarettes without unnecessarily harming adult smokers and Utah businesses, so many of whom are diligent in not allowing minors to even enter their premises. It is evident that youth who use e-cigarettes attain them from illicit businesses and other sources. This tax would do nothing to address that problem.


Jeff Stier Senior Fellow, Consumer Choice Center


February 21, 2018


About Jeff Stier

Jeff Stier is a Senior Fellow at the Consumer Choice Center. Mr. Stier has been a frequent guest on CNBC, and has addressed health policy on CNN, Fox News Channel, MSNBC, as well as network newscasts. He is a guest on over 100 radio shows a year, including on NPR and top-rated major market shows in cities including Boston, Philadelphia, and Sacramento, plus syndicated regional broadcasts. Jeff’s op-eds have been published in top outlets including The Wall Street Journal, The Los Angeles Times, The New York Post, Forbes, The Washington Examiner, and National Review Online.

Cryptocurrency Regulations Should Not Stifle the Innovative Potential of Blockchain Technology

By Nur Baysal | 12. February 2018

Recently, the prices of cryptocurrencies like Bitcoin and Ethereum made new headlines: After reaching a staggering all-time-high of $19,783 in December, the price of Bitcoin lost more than half of its value in January and February, dragging the price of other cryptos down alongside it.

During this time, a plethora of news stories tinted cryptocurrencies in a negative light – from Facebook banning ads for cryptocurrencies and ICOs to China restricting access to foreign crypto exchanges for its citizens and lastly, banks banning cryptocurrency purchases on their credit cards.

It is not news that volatility in the crypto markets exceeds that of traditional stock exchanges by a couple of magnitudes. From late 2013 to early 2015, cryptos underwent a draining bear market that came to an end with exponential price explosions in the following bull market.

Shortly following any crash of cryptocurrencies, some people feel validated to voice their prediction of the end of Bitcoin and cryptocurrencies and call for harsher crackdowns of the technology as a whole. In some, this volatility awakens a deeply-entrenched skepticism of a new technology that’s still in its infancy.

But this overly conservative regulatory approach is a danger to the innovative potential of blockchain technology. Instead of focusing on the volatile nature of the crypto market and equating it with manipulation or dismissing it as a sheer gamble, crypto skeptics should learn more about the transformative nature of the technology behind many cryptocurrencies.

Despite their popular label in the media, many of them are not, in fact, primarily currencies.

The use cases of distributed ledger technology span from delivering aid efficiently to refugees, using blockchain to build a digital identityenabling scientists to use your safely stored genomic data and a myriad of other fields of application.

Many crypto skeptics refuse to inform themselves on the multitude of use cases of blockchain technology across several industries. Solely focusing on the volatile price does not leave enough room to ponder upon the many ways this newly emergent technology might change our lives in the near future.

During the recent Senate hearing on cryptocurrency regulations, the chairman of the United States Commodity Futures Trading Commission (CFTC) J. Christopher Giancarlo had some encouraging words for the primarily younger generation interested in blockchain technology.

Talking about his niece’s interest in Bitcoin, Giancarlo stressed that any future regulations should not be dismissive, but rather respectful of the younger generation’s fascination with blockchain technology:

“It strikes me that we owe it to this generation to respect their enthusiasm about virtual currencies with a thoughtful and balanced response, not a dismissive one,” said Giancarlo.

Elaborating further, Giancarlo stressed that regulators should have a positive outlook on the future of this technology. While doing so, he seemed quite knowledgeable, even going as far as explaining the meaning of crypto-related terms like ‘HODL’ and ‘kimchi premium’.

For Giancarlo, regulating cryptocurrencies should have the aim of cracking down on fraudsters and fight market manipulation, not to stifle the flourishment of a new technology whose many advantages he acknowledged.

In this way, consumers should be given the opportunity to educate themselves on the different use cases of blockchain technology and have the liberty to invest in projects they deem promising.

Instead of stifling innovation and consumer choice, such a regulatory framework that provides enough space for creative exploration would ensure that future advancements in the cryptosphere are acknowledged as such and gradually find themselves changing traditional banks, corporations, and government operations.


About Nur Baysal

Nur Baysal is a Technology and Disruption Fellow at the Consumer Choice Center and Research Associate at the Competitive Enterprise Institute. A philosophy major, she is especially interested in the intersection between creativity and technological innovation.

Dental Therapists: A new dental category may not be the answer

Because so much of the U.S. healthcare system is focused on medical expenses, benefits, and insurance programs, it’s an unfortunate fact that dental care is often neglected.

An estimated 35.6 percent of U.S. adults didn’t visit a dentist last year, along with 55.3 percent of Medicaid-eligible children.

Is it mostly because people cannot find enough dentists or because costs are too high?

For consumers, it seems the single biggest reason for not visiting a dentist is cost. Knowing these facts, what can we do in order to help reduce costs for dental patients around the country? It’s a serious question which invites a good amount of discussion and recommendations.

In Florida, legislators and dental professionals have called for the state to improve the dental workforce by establishing a special loan program for dentists who practice in high-need areas.

That would at least increase the number of dentists and ease the burden for dental students who face an average amount of $287,331 in debt once they leave school.

In states like New Mexico, Arizona, and Florida, there is a movement afoot to introduce a new professional category in the field of dental care, known as dental therapists.

Dental therapists, unlike dentists, require less training and education, and could presumably offer their services at a lower cost, albeit while not fully capable of performing more complex procedures.

Such programs have already been implemented in states such as Maine, Vermont, and Minnesota, and in countries like New Zealand and Canada, but the results haven’t been clear.

New Zealand first implemented dental therapy programs early in the 20th century, and they formalized their degree program in 1999.

In the last two decades, however, the rate of child tooth decay has increased wildly, forcing thousands of children to face hospitalization or emergy surgeries. The number of children hospitalized for dental issues has skyrocketed from 4500 to 7500 in the past 15 years. So that result doesn’t seem positive.

One researcher at the School of Public Health at the University of Minnesota studying this issue is very skeptical it will work in that state.

However, the reality is that this hasn’t truly addressed the problem of that growing disparity between rural and urban oral health. As of December 2016, there were only 63 licensed dental therapists, half of whom were practicing in the Twin Cities metropolitan area.

It seems that dental therapy school graduates, once able to practice, are flocking to major cities in order to pay off their debts as well.

Organizations such as Pew Charitable Trust have crafted multi-state campaigns in order to advocate for the midlevel dental position, advocating for legislation which would allow dental therapists to become legal professions and be eligible for accepting Medicaid funding.

And that last distinction is important to note.

If we look at the state of Arizona, for example, there are 1,921,145 Arizonians on the Medicaid program, according to the  Arizona Health Care Cost Containment System. That’s 27 percent of the population eligible to have dental treatments covered as part of their public plans paid by taxpayers.

If dental therapists become a category of dental professionals and are able to perform dental services, they will also be eligible to accept Medicaid funding.

Would consumers benefit from such a scenario? Would patients be able to afford better care and have access to higher quality dental services?

That much is unclear, but the numbers from states and countries which have implemented dental therapy programs give us pause on whether they have been effective.


About Yaël Ossowski

Yaël Ossowski is a journalist and informational entrepreneur. He's currently deputy director at the Consumer Choice Center, and senior development officer for Students For Liberty. He was previously a national investigative reporter at Watchdog.org. He is currently seeking a Master’s Degree in Philosophy, Politics, Economics (PPE) at the CEVRO Institute in Prague. Born in Québec and raised in the southern United States, he currently lives in Vienna, Austria.