Banning flavoured vapes has led to a rise in young people smoking, a new report reveals.
Governments around the world have increasingly been implementing bans on flavoured vapes to reduce their appeal to young people. This is in line with advice from the World Health Organisation.
In 2020, the U.S announced a countrywide ban on most vape flavours except tobacco and mint amid concerns about vaping among teens.
However, a major new working paper published in the National Bureau of Economic Research has found "evidence of an unintended effect" in the country’s youngest vape users.
Rather than quit nicotine products altogether in the face of flavoured vape bans, they appear to have moved to smoking far more dangerous cigarettes.
"The restrictions are associated with a decline in flavoured electronic nicotine delivery system (ENDS) sales, but also an increase in cigarette sales," says the paper titled ‘The Effect of E-Cigarette Flavour Bans on Tobacco Use’.
The study, by researchers from respected institutions including Michigan State University and San Diego State University, shows that restricting flavours has led to a significant reduction in youth vaping by 1.2 to 2.5 percentage points.
“Notable increase” in cigarette smoking
However, it has also led to a "notable increase" in combustible cigarette smoking specifically among 18 to 20-year-olds.
"The reduction in vaping appears to occur via substitution towards combustible cigarette smoking. Such substitution is arguably more surprising and noteworthy," the authors wrote.
They found that restrictions on vape flavours were associated with a 2.4 to 2.6 percentage point increase in the likelihood of smoking cigarettes.
The researchers analysed data from the State and National Youth Risk Behaviour Surveys and the Behavioural Risk Factor Surveillance System. The study - the first to examine the effect of state and local restrictions on the sale of flavoured vapes - was funded with a grant from Global Action to End Smoking, an independent, U.S nonprofit organisation.
Previous research found same link
This is not the first time research has found a link between flavoured vape bans and increased smoking in young people. Research published by Yale University's School of Public Health in 2021 found restrictions on vapes led to “the opposite effect intended” and pushed teenagers towards traditional cigarettes.
"Given the plausibly higher health risks of combustible cigarettes relative to e-cigarettes, such substitution implies that the net effect of ENDS flavour restrictions on public health may be limited or potentially even negative," the Yale researchers found.
The study also found that while flavour restrictions effectively reduced vaping among younger users, they had little to no impact on older adults, who showed no significant change in vape use.
Secondary analyses revealed that various flavour bans did not lead to significant increases in other risky behaviours such as binge drinking or illicit drug use.
The primary concern remains the shift from vaping to smoking, which poses a greater health risk due to the higher levels of toxicants in cigarette smoke compared to e-cigarette vapour.
Many studies also show that vapes are significantly less risky to health than tobacco and can help to reduce its harms, with some flavours and lower prices important for encouraging smokers to switch.
In the US, the Food and Drug Administration (FDA) has federal authority to regulate vaping products, but most vape bans happen at the state and local levels.
As of last year, nine states in the U.S, the District of Columbia, and more than 370 localities had adopted policies restricting the sale of flavoured e-cigarettes.
