- Flavour restrictions in the U.S. lead to 3.6 per cent cut in vaping – and 2.2 per cent RISE in smoking
- Flavour bans lead to 3.1 to 4.4 additional daily smokers for every five fewer daily vapers
- Bans on flavours therefore ‘potentially offset’ any public health gains
- More than a quarter of U.S adults live in areas where flavours are restricted
Banning vape flavours leads to less young adults vaping but MORE smoking, a major new study has found.
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.
The study said: “These findings suggest that restricting flavoured ENDS (electronic nicotine delivery system) sales is associated with reduced vaping but increased cigarette smoking among young adults, potentially offsetting these policies’ public health benefits.”
According to the report, more than a quarter of U.S. residents live in states or localities where flavoured vapes are restricted, often with the aim of reducing the number of young people who vape.
The impact of flavour bans on vaping and smoking
The researchers, from the Yale School of Public Health and the University of Missouri, set out to understand the impact of these policies on both vaping and smoking rates.
Analysing data from the annual Behavioral Risk Factor Surveillance System (BRFSS) from 2016 to 2023, they found flavour restrictions led to significant decreases in vaping but also “marked increases in cigarette smoking” compared with trends expected without any restrictions.
From 3.1 to 4.4 more smokers for every five fewer vapers
The figures showed that state restrictions on flavoured vapes led to between 3.1 and 4.4 additional daily smokers for every five fewer vapers. The study said: “While these point estimates may seem small at first glance, they represent a 22 per cent to 30 per cent increase in daily smoking and a 76 per cent to 80 per cent reduction in daily vaping compared with young adults’ rates in 2018, one year before the first state-level restriction on flavoured ENDS sales went into effect.”
Therefore, the researchers said, making vapes less appealing through policies such as restricting flavours is likely to lead to a rise in cigarette smoking.
They said: “These findings concur with a growing body of evidence that ENDS and cigarettes are economic substitutes among youth, implying that policies that make ENDS more expensive (taxes) or less appealing (flavour restrictions) are likely to increase use of more dangerous combustible cigarettes in this age group.
“These findings reinforce the need to consider young adults as a high-priority group when developing tobacco and nicotine policies.”
Different pattern in Maryland
The study found the pattern was different in the state of Maryland, where only non-menthol flavours in disposable and cartridge products (which are rarely refillable) are banned. There, the rise in smoking rates was not as significant as other states with restrictions.
The researchers said: “Although our findings will disappoint advocates of aggressive ENDS flavor restrictions, the findings regarding Maryland’s policy suggest an alternative.. Because that policy exempts the open-system ENDS used more by adults than youth, it may offer a better target for interventions to reduce youth use without impeding adult smokers’ substitution away from combustible cigarettes.”
They added, however, that exempting menthol vapes may have simply nudged more people to this flavour than to smoking.
Until mid-2024, the U.S. Food and Drug Administration (FDA) had not authorised marketing for any non-tobacco flavoured vapes. This shifted slightly last June with the approval of four menthol vapes submitted by the manufacturer NJOY.
The study concluded: “Future research should further investigate the potential of ENDS flavour restrictions that exempt open-system devices and/or menthol to reduce young adult vaping without increasing cigarette smoking.”
