- Higher vape use led to significantly greater reduction in daily cigarette smoking
- Smokers given fruit or mint flavoured vapes used them more often than those given tobacco-flavoured ones, and were more likely to cut down or quit smoking as a result
- Use of flavoured vapes led to lower exposure to a key tobacco-related carcinogen
- Researchers say appealing vape options are key to helping vulnerable groups switch away from cigarettes
Flavoured vapes can significantly improve quit rates among smokers – especially those from high-risk groups – according to a new analysis of three U.S. clinical trials.
The study, published in Addictive Behaviours, shows that people who were given their choice of flavoured vapes used them more frequently. As a result, they smoked fewer cigarettes and had lower levels of a cancer-causing chemical found in tobacco.
The research adds to a growing body of evidence suggesting that flavoured vapes play a vital role in helping adult smokers reduce or quit cigarettes, especially in vulnerable populations.
“This study provides clear evidence that access to preferred e-cigarette flavours helps high-risk smokers use vapes more consistently, which in turn helps them smoke fewer cigarettes,” said the researchers.
“Flavoured e-cigarettes can play a key role in reducing harm, especially when paired with very low nicotine cigarettes.”
Harm reduction among high-risk smokers
Researchers analysed data from three randomised controlled trials involving more than 300 adult smokers from groups considered at higher risk of tobacco-related harm.
These included people with mental health conditions, opioid use disorder, and women of reproductive age with lower educational attainment.
Participants were all daily smokers with no immediate plans to quit. They were randomly assigned to receive either very low nicotine content (VLNC) cigarettes alongside tobacco-flavoured vapes, or VLNC cigarettes plus a choice of preferred vape flavours, such as mango, mint, fruit medley or crème brûlée.
Over the 16-week trial period, all participants could use any combination of the provided cigarettes and vapes they preferred. The study tracked daily cigarette use, vape use frequency, and levels of NNAL – a tobacco-specific nitrosamine that serves as a biomarker for carcinogen exposure.
Flavours increased vape use and reduced smoking
Participants given a choice of flavoured vapes used them more often than those who only received tobacco-flavoured vapes, averaging 4.3 days of use per week compared to 3.4 days. This higher frequency of use proved to be the key factor in helping them cut down on smoking.
By week 16, those in the flavoured vape group were smoking significantly fewer cigarettes per day (8.6 vs 12.8) than those in the tobacco-flavour group.
Interestingly, the effect of flavour disappeared when researchers accounted for vape use frequency, indicating that it was the increased usage – driven by more appealing flavours – that caused the reduction in cigarette smoking.
The study also found that more frequent vape use led to lower levels of NNAL, indicating reduced exposure to harmful tobacco-related chemicals.
The researchers concluded: “Greater frequency of e-cigarette use was a mechanism by which preferred-flavor e-cigarettes led to reductions in smoking and tobacco-toxicant exposure, demonstrating the potential for appealing e-cigarettes to reduce harm among high-risk populations who smoke.”
Implications for tobacco regulation
The U.S. Food and Drug Administration (FDA) has proposed a national standard to reduce nicotine levels in cigarettes, a move designed to make smoking less addictive.
However, the effectiveness of this strategy may depend on the availability of viable, appealing alternatives for adults who are unable or unwilling to quit nicotine altogether.
Currently, the FDA has restricted authorised vape flavours to tobacco and menthol, aiming to reduce youth vaping. But the new findings suggest this move could also undermine smoking reduction efforts among adults, especially those who struggle to quit without help.
The findings come after a separate study published in February found that banning vape flavours leads to less young adults vaping but more smoking. The research, published in the Journal of American Medical Association (JAMA), studied data from almost 400,000 Americans aged 18 to 29 years.
It found that state restrictions on the sale of flavoured vapes are associated with a 3.6 per cent decrease in vaping, but a 2.2 per cent increase in far more harmful smoking.
