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SALT LAKE CITY — More nicotine in electronic cigarettes could make it easier for children to get addicted and face long-term health consequences.
But restricting the amount of nicotine, as Utah has for the past few years, could make it harder for adults to use tools to quit smoking, and cause hurdles for companies selling e-cigarettes.
Those were some of the arguments presented in a public forum Monday over a proposed rule that the Utah Department of Health and Human Services is considering after a period of public comment.
The rule would change a Utah law, which limits nicotine to 3% in an e-cigarette, to also allow products that are approved by the FDA's premarket tobacco product application, which officially allows products at 5% but has approved products with concentrations between 1.5% and 6%.
Braden Ainsworth, program manager for the Utah Department of Health and Human Services Tobacco Prevention and Control Program, has said that the department does not recommend the use of e-cigarette and vape products, but wants to align with the FDA's program.
Ainsworth said the department's priority is creating policies that give Utahns "fair and equitable opportunities to live safe and healthy lives."
The change stems fromthe settlement of a lawsuit filed by the Utah Vapor Business Association against the state regarding the law that set the 3% limit, but some Utah residents say a lawsuit settlement is not a good reason for the state to back down on its stance.
PTA, pediatricians and others oppose the rule
"The state of Utah and the health department are being pushed around by vape sellers," said Walter Plumb, an attorney who spoke as a representative of Prosperous Utah Communities.
He said the department should not have agreed to support the change from 3% to 5%, although he said it is not unusual for litigation from companies to bring products like vapes back on the market around the U.S.
"We think that's a violation of the Utah administrative code," he said.
Plumb said the arguments in the case were weak, and it should have not been settled. He said no health groups are in favor of the change and the legislative committee also voted against the change. He said the tobacco industry "has a kids' menu" and wants to addict kids because it is easier to addict them and evidence supports lower nicotine levels reducing addiction in kids.
"It's time that the state of Utah protects kids instead of vape shops," he said.
Gayle Ruzicka, president of Utah Eagle Forum, said small Juul pod cartridges at 5% of nicotine have as much as a whole pack of cigarettes. She spoke about a young woman who thought she could try it without getting addicted and quickly did before seeking help from her parents.
"I think it's important that we not raise this nicotine level, that we protect the children in every way that we can," Ruzicka said.
She urged the Utah Department of Health and Human Services to keep the regulation in Utah, and not rely on the federal government to regulate nicotine amounts.
Jennifer Wadsworth, who represented the Utah PTA, said the proposed rule "jeopardizes our vulnerable youth." She said 38% of youth who vape report using e-cigarettes more than 20 times a month, and 22% report using them daily.
"The Utah PTA is asking the Department of Health and Human Services to stand up for Utah's children and youth and prioritize their health and well-being by maintaining the 3% nicotine rule," she said.
Alisa Stoddard, representing the Utah Chapter of the American Academy of Pediatrics, said there is no acceptable level of nicotine for children. She said it is "completely unethical and problematic" to study what level would be appropriate for children and urged the department to prioritize Utah, its children and their health over increased sales and ease of sales.
Support from think tank, retailers
The Utah Department of Health and Human Services did not make any comments at the hearing aside from an explanation of the rule. However, it is the organization that is proposing the rule.
Dave Davis, president and CEO of the Utah Food Industry Association, said the Food and Drug Administration went through a significant process to make sure the products it approves are safe, and the funds are not available for Utah to go through the same evaluations. He said he spoke on behalf of convenience stores and that the retail community is behind keeping products away from children, and that workers go through training to prevent sales to children.
"We stand shoulder to shoulder with the advocates in ensuring that these products don't get into the hands of youth," he said.
Guy Bentley, director of a Virginia-based think tank called the Reason Foundation, said 1,300 smokers die in Utah each year when there are many safer alternatives to smoking that have been approved by the FDA — including e-cigarettes. But he said reducing the nicotine content in e-cigarettes makes it harder for people to reduce their addiction to cigarettes; he said people using ones with higher concentrations than Utah allows currently are twice as likely to stop.
He said adult smoking is declining much more slowly than youth vaping right now, which has fallen over 50% since 2019.
"There is no inherent conflict of interest in allowing adult smokers more options to quit and more effective options to quit and protecting youth," Bentley said.
Gregory Conley, who represented the American Vapor Manufacturers Association, said that people who die from smoking die from the tar in cigarettes. He applauded the Utah Department of Health and Human Services for proposing the settlement that he said would protect consumers, while giving the opportunity for manufacturers to sell products that have been approved by the FDA.
Ainsworth said the Utah Department of Health and Human Services will summarize and respond to public comments before the rule is either enacted, amended or withdrawn.
