An Abundance of Improved Health: Bringing the Abundance Agenda to the Realm of Nicotine Policy

One of the most interesting policy discussions happening in the US today is being driven by authors Ezra Klein of the New York Times and Derek Thompson of The Atlantic, who teamed up to write “Abundance.”

The book is written from the perspective of two pundits who identify as liberal Democrats who have become disillusioned by their party’s adherence to policies that tend to limit growth and, by extension, harm the very constituencies they are meant to uplift.

The book focuses on a broad range of issue areas, but the archetypical example is housing. Over the course of decades, progressive leaders have enacted policies at all levels of government that have sought to advance good, solid liberal aims: protecting the natural environment through zoning regulations, capping rents or requiring affordable housing units in multi-family buildings, preserving the character of historic neighborhoods, promoting equitable access among racial and other groups, etc.

Each of these policies has been promoted and then zealously defended by an array of interest groups.

While the intentions of these policies are good, the primary result has been that building new housing in America’s biggest and most progressive cities has become a nightmare of bureaucratic red tape and unnecessary cost. Therefore, little housing gets built. Scarcity and unaffordable high prices ensue, and working people get priced out.

Klein and Thompson’s concern is the Democratic party – and their challenge to the political Democratic establishment is to break free of the power of the interest groups and refocus on an agenda that aims toward abundant housing, energy, food, healthcare, education at all levels, and more.

In essence, they argue that given the immense power and entrenched nature of “The Groups,” the only way that the Biden administration thought it could advance their infrastructure agenda was to work around government and regulation. How perverse a concept for the branch of government whose primary focus is to implement the laws as they preside over the administrative state.

Inherent in Klein and Thompson’s call is a focus on innovation and technology, which is the enabler of all abundance.

Stepping out of politics entirely, there are many themes present in this discussion that intersect with my interest in nicotine policy, which, over the past decade, has been driven by what can be called a “scarcity mindset.” In this worldview, espoused by most if not all of the biggest interest groups that advocate around tobacco and nicotine policy, there is a zero-sum fight between corporations on one side and public health on the other. A win for one must be a loss for the other. There can be no “win-win” outcomes. Even more alarming, a concept that looks like it could have broad support, especially from industry - whether or not the firm is legacy tobacco - must be rejected out of hand.

This zero-sum approach may have made sense when the only product being offered by the industry was the deadly combustible cigarette. But it is no longer the case in an era of unprecedented innovation and technological advances in smoke-free nicotine products. These innovations offer an opportunity for an abundant outcome – a world in which adults who smoke can choose among many alternatives that satisfy their desire for nicotine, enable them to transition completely away from cigarettes, yet pose substantially reduced risk to their health.

Unfortunately, so far, the scarcity mindset continues to entrap the organizations that shape the public dialogue around tobacco and nicotine policy, which, in turn, limits the actions of policymakers and regulators at all levels of government.

As much as anything, that is why we sit today, more than fifteen years after the passage of the Tobacco Control Act, more than a decade after the advent of the JUUL system, and more than five years after the FDA deadline for PMTA submissions, with still only a tiny handful of authorizations for alternative products having been issued. This is the very antithesis of abundance. It is the government creating artificial scarcity, just like in housing and other sectors. And, as in those sectors, the perverse outcomes abound, including the flooding of the US market by illegal vapes from China.

Applying the so-called Abundance Agenda to nicotine policy offers the opportunity for a historic course-correction. We must all embrace the mindset that innovation can actually solve many of the problems we face, but that in order to achieve those outcomes, we need to be prepared to tear down outdated mindsets that prevent progress. That is the greatest challenge of our times, and one we must urgently take on if we are going to make combustible cigarettes obsolete.