The WasteWatcher: The Staff Blog of Citizens Against Government Waste

Tobacco Harm-Reduction: Big League Healthcare Savings

The WasteWatcher is the staff blog of Citizens Against Government Waste (CAGW) and the Council for Citizens Against Government Waste (CCAGW). For questions, contact blog@cagw.org.


In the twenty-first century, remarkable technology innovations have improved nearly every aspect of everyone's lives. Smart TVs and smartphones are the most well-known examples; however, these innovations even extend to smoking.

By 2025, health experts approximate that there will be nearly 1 billion cigarette smokers around the world.  While cigarette smoking has declined in the U.S., tobacco companies are still working to provide consumers with healthier alternatives to traditional cigarettes.  The advent of these new technologies will require a shift in the federal regulatory structure; so far, however, that has not occurred.

E-cigarettes were invented in 2003 by a Chinese pharmacist, Hon Lik, whose father died as a result of smoking cigarettes.  Lik believed that the technology of e-cigarettes could help reduce the harm of tobacco-related diseases.  Michael Russell, a South African psychiatrist and research scientist, often considered to be the godfather of tobacco control, warned that “people smoke for nicotine but they die from tar.”

Nicotine, when removed from tobacco combustion, is relatively benign, though not completely risk-free.  Products like e-cigarettes primarily rely on nicotine delivery through synthetic and non-toxic nicotine-laced “juice.”  The nicotine juice is then heated by a battery, rather than being combusted.  The action of heating the nicotine juice (or tobacco, for that matter), rather than burning it, removes some of the harmful components of smoking a cigarette.

The technology behind heat-not-burn products is similar to an e-cigarette, whereas a heat-not-burn product still uses tobacco instead of nicotine based vape juice.  It goes without question that the most harmful aspect of smoking a cigarette derives from combusting tobacco with the flame of a lighter.  Therefore, heating tobacco at a controlled temperature, similar to heating vape juice, reduces the release of the harmful aerosols associated with cigarette smoke.

As small manufacturers and large tobacco companies develop e-cigarettes and heat-not-burn products in order to promote and provide a healthier alternative to smoking cigarettes, the federal government and its army of regulators have clung to a regulatory regime that is suited to traditional cigarettes, rather than the harm-reduction products like e-cigarettes.  The Food and Drug Administration already regulates e-cigarettes, and continues to try to impose all regulations on the new products as they do on traditional cigarettes, even though there are mountains of research that conclude that e-cigarettes are a healthier alternative than smoking a cigarette.  In other words, federal regulators are committed to maintaining the same restrictions on products that have the potential to save millions of lives and hundreds of billions of taxpayer dollars in tobacco-related healthcare costs that they do on traditional tobacco products.

The U.S. spends nearly $170 billion per year, or 8.7 percent of all healthcare costs, on tobacco-related illnesses and diseases.  E-cigarettes and heat-not-burn products have the potential to reduce the financial stress that smoking cigarettes has put on the U.S. healthcare system and reduce the human toll that arises from traditional smoking.

Even if cigarette use decreased by a modest 5 to 10 percent, that would be a huge win, not only financially, but healthwise for the millions of American who now smoke traditional cigarettes.

The primary goal of government regulators should be to reduce both the adverse financial and health impacts that cigarettes impose on the budget and the healthcare system.  E-cigarettes and heat-not-burn products are paving the way to this future.  But an overzealous government operating under an archaic regulatory regime and keen on regulating “Big Tobacco” out of business is putting that future in jeopardy.

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