Patient Care Protected: E-Cigarette Regulation and Taxation
By Sean Price Texas Medicine August 2023


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2023 Legislative Wrap-Up: TMA Secured Big Wins With a New Strategy

TMA Priority: Increase funding for vaping prevention and cessation programs and create an excise tax to deter youth from buying e-cigarettes.

Physician-Led Results: State lawmakers gave tobacco-control advocates – among them Texas physicians – a big victory by allocating a nearly $4.3 million increase for nicotine cessation and prevention efforts.

“We were all pleasantly surprised and grateful for the amount that was put into the budget this year,” said Austin pediatrician and adolescent medicine specialist Maria Monge, MD, the new chair of the Texas Public Health Coalition, of which the Texas Medical Association is a member.

That money is needed to help adjust prevention and cessation efforts to reflect how nicotine is now advertised to young people, she says. E-cigarettes – not traditional tobacco products – are now overwhelmingly the nicotine-delivery system of choice among minors, according to the 2022 National Youth Tobacco Survey. In Texas, 3.7% of high school students smoke cigarettes, while 18.7% use e-cigarettes, according to the Campaign for Tobacco-Free Kids.

“We’re hopeful that some of this money can go toward looking at prevention of vaping and e-cigarettes as well as just traditional tobacco products,” Dr. Monge said.

Successful anti-nicotine efforts typically couple cessation and prevention initiatives with a tax on nicotine products, she adds. Such a tax can help fund cessation and prevention efforts while also putting nicotine products financially out of reach for young people. In Texas, cigarettes are taxed, but e-cigarettes do not meet the state’s statutory definition of a cigarette.

House Bill 4772 by Rep. Shawn Thierry (D-Houston) attempted to begin closing that loophole with a tax on any noncombustible nicotine products. The bill won approval by the House but did not make it out of the Senate.

However, a measure that makes it more difficult for tobacco companies to market e-cigarettes to young people did clear the legislature and has been signed by Gov. Greg Abbott. House Bill 4758, also by Representative Thierry, prohibits containers that show celebrities, cartoon characters, candy, or other images that have traditionally appealed to children – a big win for anti-nicotine efforts, Dr. Monge says.

“We know that adolescent brains are susceptible to all sorts of influences, including sexy marketing,” she said. “Big tobacco also knows that and has taken advantage of that fact for years.”

Other public health wins TMA supported include:

  • Senate Bill 629 by Sen. Jose Menendez (D-San Antonio), which requires each school district to make an opioid antagonist like naloxone available on all campuses that serve students in grades 6 through 12. It also allows districts to provide opioid antagonists to campuses that serve younger children.
  • A $30 million budget increase for the prevention of HIV and sexually transmitted diseases.
  • Maintaining funding of $300 million for the Cancer Prevention & Research Institute of Texas, a state agency that invests in cancer research, prevention efforts, and product development.


Last Updated On

August 04, 2023

Originally Published On

August 02, 2023

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Leadership | Texas legislation | Tobacco