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E-cigarettes users may pay a penalty for health insurance

Under the Affordable Care Act (Obamacare), tobacco users can have a penalty of up to 50% added to their health insurance costs. As reported in the MPR blog on May 8, 2014, there is consideration of adding a health insurance penalty for users of e-cigarettes (e-cigs). MPR is the Monthly Prescribing Reference that provides data on new drugs and health issues to medical professionals and researchers.

Up in e-cig smoke
Photo by Andrew Burton/Getty Images

At the present time, the FDA does not have jurisdiction over e-cigs. The FDA is seeking the ability to regulate e-cigs as it does for other tobacco products. In an ironic twist, the limited information available on the effects of e-cigs will be used to justify the rate increase until clinical data has been established as to the additional risk of e-cigs on the users and the public.

In the meantime, e-cigs are being promoted to minors through advertisements that glamorize use of e-cigs and “flavoring agents” that appeal to middle and high school students. The Huffington Post produced an article 9 Terribly Disturbing Things About Electronic Cigarettes in an updated version published Dec. 19, 2013.

While cigarette companies say they don’t market to kids, e-cigarettes com in flavors like cherry, strawberry, vanilla and cookies and cream milkshake.

The tobacco industry is vigorously advertising and lobbying Congress to promote the idea that e-cigs are safe. Given that the liquids in e-cigs are nicotine, a known poison, and a hydrocarbon propellant, this claim is totally false. The Center of Disease Control (CDC) refutes the idea that e-cigs are safe. Without FDA regulation, e-cigs and e-cig "juice" does not carry any health risk warning labels. Warnings will be required when the FDA regulation of e-cigs occurs.

The second major force that will drive approval of the FDA jurisdiction over e-cigs is that this will allow the collection of excise taxes that are now levied on all other tobacco products. The ability to collect excise taxes requires that e-cigs are regulated by the FDA. The tobacco lobby claims of safety and e-cigs as a way to stop smoking conventional cigarettes will be lost in the fog of additional tax money. Adding taxes to e-cigs will increase the costs, which will reduce the growth of e-cigs among middle and high school students and the general population.

Putting e-cigs in the same category as conventional cigarettes will also enable regulation of the use of e-cigs in public places that prohibit smoking. The vaporization products of e-cigs are a second-hand smoke danger. While e-cigs do not have the same tar, and a thousand other chemical substances, as conventional cigarettes, they contain nicotine that has been documented to be as addictive as heroin and cocaine. Heroin was once promoted as a remedy for opium addiction.

You can read the full EMR article Should E-Cigarette Users Pay More for Insurance? that discusses the arguments that justify e-cigarette regulation by the FDA and the additional penalty in health insurance premiums for e-cig users.

The Affordable Care Act allows health insurance companies to charge smokers and other tobacco users up to 50% more than non-smokers, but it is unclear if e-cigarette users should also pay this increased rate. The FDA currently does not have the authority to regulate e-cigarettes, although it has proposed a new rule that would change this. If the proposal is approved, insurance companies could charge customers who smoke e-cigarettes more in their premiums. Although some advocates claim that e-cigarettes are safer than other tobacco products and users should not have to pay this surcharge, there are no long-term studies on the health risks of the products.

You can also read the full article produced by the Huffington Post on the dangers of e-cigs. The CDC fact sheet of e-cig risks are well defined.

While many abhor the interference of government in “individual” activities, this pressure to treat electronic cigarettes as any other tobacco product will protect the public from second-hand smoke, reduce the growth in use by minors, and shift the health care costs back on the users. This is a victory of logic over tobacco lobbyists, and we will all benefit, including the e-cig users. This is an example of the FDA actually supporting the public safety in defiance of the tobacco lobby. Adding excise taxes and increases in health insurance costs will reduce the appeal of e-cig use and consumption.

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