Optimizing Risk Proportionate E-Cigarette Regulation
For current smokers, switching to e-cigarettes improves health outcomes. But e-cigarette use among never-smokers represents a net increase in harms. Optimally, e-cigarette regulation should encourage current smokers to switch to safer alternatives, and discourage uptake by anyone for whom e-cigarette use represents a net increase in harms. To date widely adopted e-cigarette regulations have failed to balance these goals. Attempts to prioritize protections for youth have led to unintended consequences; not only reducing adult smoking cessation, but also nudging young e-cigarette users towards more dangerous products. Risk-proportionate regulation would encourage substitutions to lower risk products. However, regulations that make e-cigarettes more attractive to smokers, often make e-cigarettes attractive to non-smokers, since some preferences are common to both groups. Does the goal of supporting smoking cessation necessarily trade-off against youth experimentation? Not necessarily. Opportunities exist to optimizing risk-proportionate regulation; creating differentials that encourage smokers to switch to safer alternatives while still taking steps to discourage uptake by non-smokers.