San Francisco residents overwhelming voted on Tuesday to ban the sale of flavored tobacco products citywide, sending a big blow to the tobacco industry, who invested millions into defeating the ballot measure.
“If history proves anything, it’s that prohibition does not work,” says the voice-over for a No On Proposition E campaign ad, while black and white images show prohibition agents dumping barrels of alcohol.
San Francisco residents have been buried in advertisements like these, urging them to vote ‘no’ on Prop E. Even so, roughly 69 percent of voters approved the ballot.
The R.J. Reynolds Tobacco Company, an industry giant that produces the country’s best-selling menthol (mint) cigarette Newport, is behind the aforementioned ad and had contributed nearly $12 million into defeating Prop E. Supporters of the ban haven’t spent as much; by comparison, former New York City Mayor Michael Bloomberg raised roughly a fourth of that, at $3.6 million.
Most R.J. Reynolds tobacco ads have been framing the debate as an outright prohibition on tobacco, but San Francisco voters actually decided to prohibit retailers from selling flavored tobacco products, including menthol cigarettes. The ordinance would become effective after 30 days of enactment, and any retailer who violates the health code will have their sale permit suspended. The ban extends to hookah (meaning, lounges couldn’t sell, for example, lemon mint or white gummy hookah anymore) and vaping products (meaning, goodbye cool cucumber-flavored Juul); and the latter is the primary motivation behind the ban, as vaping such fun flavors has become popular among the youth.
“They make it look and smell exactly like candy but it’s a deadly addiction. Here is Big Tobacco’s newest strategy to hook our kids on flavored tobacco,” says a doctor in a Yes on Proposition E ad by coalition group San Francisco Kids vs. Big Tobacco. The group is made up of doctors, parents, and community organizations and has dozens of supporters, including the American Medical Association, National Union of Healthcare Workers, and the Sierra Club.
In June 2017, the San Francisco Board of Supervisors approved an ordinance to ban the sale of flavored tobacco, but an R.J. Reynolds Tobacco Company-backed group blocked it. Now, the ban will soon go into effect, with the approval of voters.
The citywide debate reflects a national dilemma on what to do about a technology that was intended to help adult smokers quit but has instead spiraled into a new kind of bad habit — but for kids.
“To Juul (the brand has become a verb) is to inhale nicotine free from the seductively disgusting accoutrements of a cigarette: the tar, the carbon monoxide, the garbage mouth, the smell,” writes the New Yorker‘s Jia Tolentino, of the San Francisco-based product Juul, a sleek vaporizer that looks like a flash drive. They come in eight flavors, like Fruit Medley and Crème Brûlée, cost about $16 for a pack of four pods, and, as such, have become increasingly popular among teens.
One in six high school students currently use e-cigarettes, according to one estimate from the Department of Health and Human Services. As of March, Juul represented more than half of the e-cigarette retail market, a lucrative market expected to reach $48 billion by 2023.
Federal officials are wrestling how to regulate the e-cigarette market, with the Food and Drug Administration (FDA) taking a first step in March. Officials are asking the public for comments, data, and research on the role of flavors in attracting young people to tobacco products. Comments, which close on June 19, will inform regulatory actions.
“There’s a lot of interest in this subject,” FDA Commissioner Scott Gottlieb told Kaiser Health News. “The question is how much of that will be scientific, that can inform our rule-making.”
Over the weekend, Gottlieb warned tobacco companies to “step up soon.”
“So far, I must say, I’ve mostly been disappointed by the tepid response from companies that know that a meaningful portion of their sales are being derived from kids,” he said during an annual American Society of Clinical Oncology meeting.
Alternatively, localities have sought to restrict flavored tobacco — just not to the degree that the San Francisco ban proposes. Chicago, for example, became the first major city in 2016 to ban the sale of menthol cigarettes within 500 feet of schools. But researchers with Johns Hopkins University Bloomberg School of Public Health found poor compliance with the partial ban thus “highlight[ing] the need for comprehensive efforts.”
The best research to date shows that vaping increases the chances that young people will begin smoking cigarettes, as Vox‘s Julia Belluz notes. And they might not be as helpful for adults trying to quit smoking cigarettes, but they are better than smoking conventional cigarettes, which kill one in five people in the United States each year.
This post has been updated to reflect the results of the ballot initiative.