Although youth combustible cigarette use remains at an all-time low, there have been reports of an increase in young Americans using electronic cigarettes and vaping devices. Indeed, in 2018, 20.9 percent of high school students reported vaping nicotine in the 30 days prior to the National Institute on Drug Abuse’s Monitoring the Future survey.[i] However, this is still a lower figure than the 36.4 percent of high school students who identified as current smokers in 1997.[ii]
One assumption is that flavors entice youth to use e-cigarettes. This assumption is probably the reason why policymakers are proposing flavor bans in an attempt to prevent youth use. Although addressing youth use of e-cigarettes is laudable, banning adult access to the sale of flavored e-cigarette products will significantly reduce the potential of tobacco harm reduction that these products provide to millions of smokers.
Flavors in electronic cigarettes and vaping devices are an essential component in aiding smokers to remain abstinent from combustible cigarettes, as noted in a 2018 survey of nearly 70,000 American adults.[iii] Indeed, 83.2 percent and 72.3 percent of survey respondents reported vaping fruit and dessert flavors. Only 20 percent of respondents reported using tobacco flavors at the point of initiation.[iv]
A 2017 study of adult e-cigarette users found the use of flavors other than tobacco “was significantly higher” than the use of tobacco flavors at initiation.[v] Thus, e-cigarette users often first consume tobacco flavored e-liquids and products and then transition to other flavors, helping aid their cessation of combustible cigarettes.
Further, restrictions on flavored e-cigarettes could lead to smokers returning to combustible cigarettes. A 2017 study published by the National Bureau of Economic Research examined the impact of flavor bans. The authors concluded banning flavors “would result in increased choice of combustible cigarettes,” and they said they expect e-cigarette use to decline by approximately 10 percent if flavors are banned.[vi] Additionally, a 2018 “systematic review of research examining consumer preference” for flavors concluded adults “in general also preferred sweet flavors.”[vii]
More importantly, lawmakers should note that although the 2015 Monitoring the Future Survey found 65-66 percent of 12th, 10th, and 8th graders reported vaping “just flavoring,” the use of nicotine among youth has increased.[viii] In 2015, 22.2 percent of 12th graders reported vaping nicotine. This increased to 29.7 percent of 12th graders in the 2018 Monitoring the Future Survey.[ix] [x]
Lawmakers should be cautious because bans on e-cigarette products lead to increased combustible cigarette use among youth. A 2015 Yale study found state bans on the sale of e-cigarettes to minors created “a statistically significant 1.0 percentage point increase in recent cigarette smoking rates among 12 to 17 year olds.”[xi] The study findings were consistent with real-life evidence. For example, Lancaster County, Nebraska reported a reduction in sales of vaping products to minors “from 21.2 percent in 2017 to 5.3 percent in 2018.”[xii] During the same period, non-vaping tobacco product sales to minors increased, from 5.9 to 8.7 percent.
Point 1: There is an issue with youth e-cigarette use, but flavor bans will unnecessarily block adults’ access to tobacco harm reduction tools.
Point 2: Only 20 percent of American adult e-cigarette users reported using “tobacco flavors” at the point of e-cigarette initiation.
Point 3: The largest survey of American adult vapers found 83.2 percent and 72.3 percent of survey respondents reported vaping fruit and dessert flavors, respectively.
Point 4: Banning flavors will likely lead to increased combustible cigarette use.
Point 5: Youth smoking is at an all-time low, but existing research indicates banning e-cigarettes leads to increased use of other tobacco products by young people.
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[i] National Institute on Drug Abuse, “Teens using vaping devices in record numbers,” December 17, 2018, https://www.drugabuse.gov/news-events/news-releases/2018/12/teens-using-vaping-devices-in-record-numbers.
[ii] Centers for Disease Control and Prevention, “Tobacco Use Among High School Students – United States, 2017,” Morbidity and Mortality Weekly Report, April 3, 1998, https://www.cdc.gov/mmwr/preview/mmwrhtml/00051762.htm.
[iii] Lindsey Stroud, “Largest Vaping Survey Finds Flavors Play Important Role in Tobacco Harm Reduction,” Research & Commentary, The Heartland Institute, October 2, 2018, https://heartland.org/publications-resources/publications/research–commentary-largest-vaping-survey-finds-flavors-play-important-role-in-tobacco-harm-reduction.
[iv] Ali Anderson, “Ex Smokers Prefer Fruity E-Liquids Say’s Doctor’s FDA Survey,” Vaping.com, August 14, 2018, https://vaping.com/blog/news/ex-smokers-prefer-fruity-e-liquids-says-doctors-fda-survey/.
[v] M.B. Harrell et al., “Flavored e-cigarette use: Characterizing youth, young adult, and adult users,” Preventative Medicine Reports, March 2017, pp. 33-40, https://www.sciencedirect.com/science/article/pii/S2211335516301346.
[vi] John Buckell, Joachim Marti, and Jody L. Sindelar, “Should Flavors Be Banned in E-Cigarettes? Evidence on Adult Smokers and Recent Quitters from a Discrete Choice Experiment,” National Bureau of Economic Research, September 2017, http://www.nber.org/papers/w23865.pdf.
[vii] Samane Zare et al., “A systematic review of consumer preference for e-cigarette attributes: Flavor, nicotine strength, and type,” PLoS ONE 13(3): e0194145. https://doi.org/10.1371/journal.pone.0194145.
[viii] Lindsey Stroud, “New Research Finds Teens Vape Because of Flavoring, Not Nicotine,” Research & Commentary, The Heartland Institute, September 6, 2016, https://heartland.org/publications-resources/publications/research–commentary-new-study-finds-teens-vape-because-of-flavoring-not-nicotine?source=policybot.
[ix] National Institute on Drug Abuse, “Monitoring the Future 2015 Survey Results,” December 2015, https://www.drugabuse.gov/related-topics/trends-statistics/infographics/monitoring-future-2015-survey-results.
[x] National Institute on Drug Abuse, “Monitoring the Future 2018 Survey Results,” December 2018, https://www.drugabuse.gov/related-topics/trends-statistics/infographics/monitoring-future-2018-survey-results.
[xi] Lindsey Stroud, “How Do Electronic Cigarettes Affect Adolescent Smoking,” Research & Commentary, The Heartland Institute, March 28, 2016, https://heartland.org/publications-resources/publications/research–commentary-how-do-electronic-cigarettes-affect-adolescent-smoking?fbclid=IwAR3MXDoO2v8rmSyez8yhSxLDNe_pTQJAPzbKRlWx8AIMTZeBMsMg88o7xnw.
[xii] 1011 Now, “Vapor product sales to minors decrease in 2018,” January 3, 2019, https://www.1011now.com/content/news/Vapor-product-sales-to-minors-decrease-in-2018-503869351.html?fbclid=IwAR2YcBCVPEmXZXQbr2EDWoeNiEcdm5JL8M4eG4EFPltJqDGW8H2YRZ-ywJY.