- 40% of vapers reduced use after the ban, including 22% who quit entirely
- 6% started smoking cigarettes and linked this to the policy
- 10.8% reported using alternative products more, “predominantly cigarettes”
- Most quitters (73%) did not switch to another product
A major new study on the Netherlands’ flavour ban is being used to support tougher regulation – but a closer look at the data suggests a more complex and potentially concerning picture.
The research, led by the Dutch public health institute RIVM, found that vaping fell sharply after non-tobacco flavours were removed from the market. But it also identified a measurable shift into smoking among some users.
Smoking uptake linked to the ban
The study, based on a survey of more than 1,000 people who used vapes before the ban, reports that: “Six per cent of all participants started cigarette smoking and attributed this initiation to the e-cigarette flavour ban.”
It also found that some existing users increased their cigarette consumption. “A minority of participants who smoked before the ban increased their cigarette consumption: 10.0% reported smoking more due to the ban,” it said.
Overall, “10.8% of all N=1005 respondents reported an increased use of previously used alternative products, predominantly cigarettes.”
Vaping falls sharply – but interpretation disputed
At the same time, the authors highlight a substantial drop in vaping.
“As a result of the ban, 40% (95% CI 36% to 43%) of respondents reduced vaping, including 22% (95% CI 20% to 25%) who quit entirely,” the study said.
Most of those who quit did not switch to another product. “Most consumers (73%) who quit vaping due to the ban did not use a substitution product.”
The paper concludes: “The e-cigarette flavour ban effectively reduced e-cigarette use among pre-ban users, potentially benefiting public health.”
And it goes further, recommending: “international adoption of similar measures or other strategies to restrict cross-border purchasing.”
Critics: smoking signal downplayed
However, critics say the study’s headline conclusion risks obscuring important unintended effects.
Behavioural scientist Arielle Selya said the results show a significant trade-off between reduced vaping and increased smoking.
“Six per cent of all participants started cigarette smoking and attributed this initiation to the e-cigarette flavor ban.”
She argues this matters more than the headline decline in vaping, noting: “It doesn’t matter that overall rates of combustible tobacco use went down in absolute terms; this is in spite of the increase in smoking, and could have been even lower if people who smoke would have been allowed to keep using flavored e-cigarettes.”
She also points to additional shifts within the data, saying: “All in all this is 10.8% who compensated by smoking more + 5.5% who initiated cigarette smoking, which totals 16.3% who increased their cigarette smoking.”
Questions over missing behaviour changes
Further concerns have been raised about how the study accounts for dual use – people who both smoke and vape.
Harm reduction expert Clive Bates said the analysis may not fully capture important behavioural shifts. He said: “One aspect of the study I am super-concerned about is dual use.”
He notes that dual use fell sharply over the study period but questions what happened to those users: “Most of the sample was ‘dual use’ at baseline (53.9%) but this fell to 20.4% at evaluation 9 months later = -33.5% of the entire sample were no longer dual users.”
He added: “It is not obvious to me that they have been fully accounted for.”
Cross-border sales and workarounds
The study also highlights how users adapted to the ban rather than simply quitting.
Among those still using banned flavours, “the largest group (35.6%) purchased them in physical shops abroad.” This points to the limits of national restrictions in a single market like the EU, where cross-border purchasing remains possible.
Policy implications
While the authors frame the policy as a success, they acknowledge some unintended effects.
“In addition, 9.1% of respondents initiated replacement products as substitutes for e-cigarettes, with 5.5% starting to smoke cigarettes,” the study says. They also note this outcome is “notable and concerning on the individual level.”
The findings add to a growing debate over whether flavour bans reduce harm overall – or risk pushing some users towards more dangerous products.
For policymakers, the key question may not be whether vaping falls, but what replaces it.
Arielle Selya is an employee of Pinney Associates and consults to Juul Labs on tobacco harm reduction. She also serves as a scientific advisor to the Global Forum on Nicotine. Her opinions here are her own and do not necessarily reflect those of her employers or clients.
