City of Los Angeles Add E-Cigarettes To

The City of Los Angeles Adds E-Cigarettes to Its Tobacco Regulations

Key Takeaways

• The Los Angeles City Council voted unanimously to ban the sale of flavored tobacco products, including e-cigarettes, menthol cigarettes, and flavored cigars, effective Jan. 1, 2023.

• The ban aims to protect public health, especially among youth and marginalized communities, who are more likely to use flavored tobacco products and become addicted to nicotine.

• The ban does not affect the possession or use of flavored tobacco products for those aged 21 and older, nor the existing hookah lounges that sell shisha tobacco for on-site or off-site use.

• The ban is part of a more significant trend of regulating e-cigarettes and other tobacco products in California and across the nation as more evidence emerges about their health effects and risks.

Tobacco use is one of the leading causes of preventable death and disease in the United States, killing more than 480,000 people every year. Despite the well-known harms of tobacco, millions of Americans still smoke cigarettes or use other tobacco products, such as cigars, pipes, hookahs, chewing tobacco, snuff, and snus. Among these products, e-cigarettes have gained popularity in recent years, especially among young people, who are attracted by the variety of flavors, the sleek design, and the perception that they are safer than regular cigarettes.

However, e-cigarettes are not harmless. They contain nicotine, a highly addictive substance that can affect brain development and cause various health problems. They also produce aerosols that contain harmful chemicals, metals, and ultrafine particles that can damage the lungs and other organs. Moreover, e-cigarettes can expose non-users to secondhand emissions that may pose health risks. Furthermore, e-cigarettes can act as a gateway to other tobacco products or illicit drugs, especially for youth and young adults.

In response to the growing public health concern over e-cigarettes and other tobacco products, many states and localities have enacted laws and policies to regulate their sale, distribution, marketing, and use. One of the most recent and comprehensive examples is the City of Los Angeles, which voted unanimously to ban the sale of flavored tobacco products, including e-cigarettes, menthol cigarettes, and flavored cigars, effective Jan. 1, 2023. This ban is expected to have significant implications for the tobacco industry, the consumers, and the public health in Los Angeles and beyond.

This article will explore the history and science of e-cigarettes, the legal and social implications of e-cigarettes and other tobacco products, and the case of Los Angeles: a ban on flavored tobacco products. We will also provide recommendations and suggestions for further action and research on this critical topic.

The History and Science of E-Cigarettes

E-cigarettes, also known as electronic cigarettes, e-cigs, vapes, vape pens, mods, tanks, or pod systems, are battery-powered devices designed to heat a liquid solution, typically containing nicotine, flavorings, and other additives. This process generates an aerosol that users inhale. These devices vary widely in appearance, from disposable options resembling traditional cigarettes to reusable products with refillable cartridges or pods, often featuring customizable features.

Invented in China during the early 2000s by pharmacist Hon Lik, who sought a safer alternative to smoking after his father's death from lung cancer, e-cigarettes were patented in 2003 and introduced to the Chinese market in 2004. The popularity of e-cigarettes quickly expanded to other regions, including Europe, Japan, and the United States. Initially marketed as smoking cessation aids or recreational products, by 2018, an estimated 41 million people worldwide were using e-cigarettes, with the United States serving as the largest market.

The health effects and risks of e-cigarettes still need to be fully understood due to their relatively recent introduction, and ongoing studies aim to provide comprehensive insights. Evidence suggests that e-cigarettes may have both positive and negative impacts on health, contingent on factors such as usage patterns and comparisons with traditional smoking.

On the positive side, e-cigarettes may aid some adult smokers in quitting or reducing cigarette consumption. By delivering nicotine without the tar and toxic substances found in combustible tobacco, studies indicate that e-cigarettes could be more effective than nicotine patches or gum in assisting smokers to quit. Additionally, some research suggests potential reductions in exposure to harmful chemicals and improved health outcomes for smokers who completely switch to e-cigarettes.

Conversely, e-cigarettes may pose health risks to both users and bystanders. They contain nicotine and other potentially harmful substances that can impact cardiovascular, respiratory, and neurological systems. Studies have indicated that e-cigarettes can elevate blood pressure, heart rate, and arterial stiffness while causing inflammation, oxidative stress, and DNA damage in cells. The emissions from e-cigarettes expose users and bystanders to secondhand and thirdhand substances, including nicotine, metals, volatile organic compounds, and ultrafine particles, which can penetrate deep into the lungs, leading to irritation, inflammation, or infection.

Beyond these health concerns, e-cigarettes may present other risks, such as battery explosions, device malfunctions, liquid ingestion, or accidental poisoning. There's also a potential increased risk of using other tobacco products or illicit drugs, particularly among youth and young adults who may develop nicotine addiction or experiment with other substances. In 2019, a nationwide outbreak of lung injury associated with e-cigarette use, known as EVALI, was linked to the use of e-cigarettes containing THC (the psychoactive component of marijuana) and vitamin E acetate, a thickening agent added to some THC products, resulting in over 2,800 hospitalizations and 68 deaths.

The Legal and Social Implications of E-Cigarettes and Other Tobacco Products

E-cigarettes, various tobacco products, and marijuana in Florida fall under a spectrum of laws and policies established at the federal, state, and local levels, all with the overarching goal of regulating their production, distribution, marketing, sale, and use. The primary aim is safeguarding public health, particularly among vulnerable populations such as youth, pregnant women, and individuals with chronic diseases.

At the federal level, the Food and Drug Administration (FDA) wields authority over tobacco products, including e-cigarettes, via the Family Smoking Prevention and Tobacco Control Act of 2009. The FDA mandates registration, ingredient disclosure, and premarket authorization for new or modified products. It sets standards for labeling, packaging, and advertising while prohibiting the sale of tobacco products to those under 21. The FDA enforces the ban on flavored cigarettes (excluding menthol) and has proposed banning menthol cigarettes and flavored cigars.

State-level tobacco control laws in California are among the nation's most comprehensive. High tobacco taxes fund prevention and cessation programs, healthcare, and research. Smoking and vaping are restricted in numerous public spaces, and the sale of tobacco products, including e-cigarettes, is regulated through licensing. Flavored tobacco products, excluding hookah, are banned, and sales in pharmacies, vending machines, and self-service displays are prohibited³.

At the local level in California, numerous cities and counties have adopted additional tobacco control measures. These include raising the minimum age to 21, banning menthol cigarettes and flavored cigars, regulating the location and density of tobacco retailers, and establishing smoke-free and vape-free zones. Los Angeles, in particular, has played a pioneering role in tobacco control, passing ordinances to curb the availability and appeal of tobacco products, especially among youth and marginalized communities.

The arguments for and against regulating e-cigarettes and other tobacco products are rooted in different perspectives. Supporters emphasize the health risks, societal burdens, and targeting of vulnerable populations, asserting that tobacco interferes with the right to clean air and public spaces. Opponents stress personal choice, freedom, and economic benefits, arguing that tobacco products are legal, provide pleasure, and should not be stigmatized.

The impact of e-cigarettes and other tobacco products on public health is intricate. Positive effects may emerge if these products assist adult smokers in quitting or reducing cigarette consumption and prevent non-smokers from initiating smoking. However, adverse effects may manifest through increased nicotine use and addiction, especially among youth, and exposure to harmful chemicals. The net impact depends on the balance between these factors, the characteristics of the products, users, and the environment.

The Case of Los Angeles: A Ban on Flavored Tobacco Products

On June 2, 2023, the Los Angeles City Council unanimously passed a resolution to prohibit the sale of flavored tobacco products, encompassing e-cigarettes, menthol cigarettes, and flavored cigars, effective January 1, 2023. Distinguished as one of the most thorough and stringent measures nationwide, this ban encompasses all flavored tobacco products, excluding hookah shisha tobacco. The exemption applies to existing hookah lounges that obtained their permits before January.

The primary objective of this ban is to safeguard public health, mainly targeting youth and marginalized communities who are more prone to using flavored tobacco products and developing nicotine addiction. According to the Centers for Disease Control and Prevention (CDC), over 80% of young individuals who have experimented with tobacco products initiated their usage with flavored variants. Additionally, more than 70% of current youth tobacco users acknowledge the consumption of flavored products within the last 30 days. Notably, flavored tobacco products are disproportionately utilized by Black, Latino, LGBTQ, and low-income populations, frequently subjected to aggressive and misleading marketing tactics by the tobacco industry.

Anticipated to exert a substantial impact on the tobacco industry, consumers, and public health within Los Angeles and beyond, the ban faces opposition from the tobacco industry. Their arguments revolve around potential adverse effects on business, perceived infringements on rights, and concerns about the emergence of a black market for flavored tobacco products. Consumer reactions are mixed; some support the ban for its perceived health benefits, while others oppose it due to personal and economic considerations. Public health advocates commend the ban, optimistic that it will diminish tobacco use and addiction, deter youth initiation of tobacco use, and ameliorate health outcomes and disparities across diverse populations.

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