TOBACCO HARM REDUCTION 101:
January 24, 2020
Overwhelmingly, youth are using vapor products because friends and/or family members are using the products. In Heartland’s analysis of available youth surveys in five states, only 15.6 percent of high school students cited using e-cigarettes because of flavors.
Existing evidence indicates that flavor bans have not reduced youth e-cigarette use in several localities that track this data.
Adults rely on flavors in tobacco harm reduction products. In a 2018 survey of nearly 70,000 American adult e-cigarette users, 83.2 percent and 72.3 percent reported vaping fruit and dessert flavors.
The vaping industry provided more than $24 billion in economic activity in 2018, including 87,581 direct vaping-related jobs and provided $4.9 billion in taxes. Flavors made up 78 percent of e-liquid sales in 2016.
In an effort to deter youth use of electronic cigarettes and vaping devices, policymakers are moving forward with prohibitive policies that would ban the sale of flavored e-liquids in vapor products. Although curbing youth use of all tobacco products is laudable, flavor bans are ineffective policies and restrict adult access to tobacco harm reduction products.
1. Flavors Aren’t Main Driver of Youth Use
Despite media alarmism, youth tobacco surveys overwhelmingly indicate that flavors are not the primary reason youth are using electronic cigarettes. For example, only 23.9 percent of Connecticut high school students reported “flavors” as a reason for using e-cigarettes in 2017, compared to 41.6 percent who reported they used a vapor product because a friend and/or family member had used them. Similarly, only 26.4 percent of Hawaii high school students cited flavors as a reason to use e-cigarettes in 2017. In 2019, only 4.5 percent of Rhode Island high school students claimed to have used e-cigarettes because they were available in flavors, while 12.5 cited the influence of a friend and/or family member who used them. Only 17 percent of Vermont high school students reported flavors as a reason to use e-cigarettes in 2017, and 33 percent cited friends and family members. Lastly, only 6.2 percent of Virginia high school students reported using e-cigarettes because of flavors, while 11.3 percent used them because a friend and/or family member used them.
2. Flavor Bans Don’t Reduce Youth Use
Although lawmakers would have you believe otherwise, flavor bans have not reduced youth use. The Heartland Institute analyzed results from the 2017-18 California Youth Tobacco Survey (CYTS) and found that despite flavor restrictions in some localities, youth use of e-cigarettes in those areas increased after the bans went into effect. Santa Clara County, California banned flavored tobacco product sales to age-restricted stores in 2014. Yet, youth e-cigarette use increased while the ban was in effect. For instance, in the 2015-16 CYTS, 7.5 percent of Santa Clara high school students reported current use of e-cigarettes. In the 2017-18 CYTS, this increased to 10.7 percent.
3. Flavors Help in Tobacco Harm Reduction
A 2018 survey of nearly 70,000 American adult vapers “found flavors play a vital role in the use of electronic cigarettes and vaping devices.” Moreover, 83.2 percent and 72.3 percent of survey respondents reported vaping fruit and dessert flavors, respectively, “at least some of the time.” A 2017 study discovered older adults “use of an e-cigarette flavored with something other than tobacco (69.3%) was … significantly higher than the same at initiation (44.1%).” Thus, e-cigarette users often first consume tobacco flavored e-liquids and products but then transition to other flavors, helping aid their cessation of combustible cigarettes.
4. Flavor Bans Produce Negative Economic Effects
Ultimately, a flavor ban would destroy the vapor industry. According to the Vapor Technology Association, in 2018, the industry created 87,581 direct-vaping related jobs, including manufacturing, retail, and wholesale jobs, which generated more than $3.2 billion in wages alone. Moreover, the industry has created thousands of secondary jobs in the United States, bringing the industry’s total economic impact in 2018 to $24,457,512,300. In the same year, the industry provided more than $4.9 billion in taxes. In 2016, 78 percent of e-liquid sales were flavored, and 69 percent of disposable vapor product sales were flavored and menthol products.
Despite recent fearmongering, the use of vapor products is significantly safer than traditional cigarettes, as noted by numerous public health groups including the Royal College of Physicians, Public Health England, and the American Cancer Society. E-cigarettes are also twice as effective in helping smokers quit. Further, their use could save states billions in health care-related costs. As with any policy area, lawmakers should refrain from outright bans and seek out alternative solutions that reduce youth use, while maintaining adult access to tobacco harm reduction products.
1. Overwhelmingly, youth are using vapor products because friends and/or family members are using the products. In Heartland’s analysis of available youth surveys in five states, only 15.6 percent of high school students cited using e-cigarettes because of flavors.
2. Existing evidence indicates that flavor bans have not reduced youth e-cigarette use in several localities that track this data.
3. Adults rely on flavors in tobacco harm reduction products. In a 2018 survey of nearly 70,000 American adult e-cigarette users, 83.2 percent and 72.3 percent reported vaping fruit and dessert flavors.
4. The vaping industry provided more than $24 billion in economic activity in 2018, including 87,581 direct vaping-related jobs and provided $4.9 billion in taxes. Flavors made up 78 percent of e-liquid sales in 2016.
 Connecticut Department of Public Health, “Connecticut Youth Tobacco Survey Results,” 2017, https://portal.ct.gov/-/media/Departments-and-Agencies/DPH/dph/hems/tobacco/PDF/2017-CT-Youth-Tobacco-Survey-Results.pdf?la=en.
 Lance Ching, Ph.D., et al., “Data Highlights from the 2017 Hawai’i Youth Tobacco Survey,” Hawai’i State Department of Health, June 29, 2018, http://www.hawaiihealthmatters.org/content/sites/hawaii/YTS_2017_Report.pdf.
 Rhode Island Department of Health, “2019 Youth Risk Behavior Survey Results, Rhode Island High School Survey,” 2019, https://health.ri.gov/materialbyothers/yrbs/2019HighSchoolDetailTables.pdf.
 Vermont Department of Health, “2017 Vermont Youth Risk Behavior Survey Statewide Report,” May, 2018, https://www.healthvermont.gov/sites/default/files/documents/pdf/CHS_YRBS_statewide_report.pdf.
 Virginia Department of Health, “Virginia High School Survey,” 2017 Youth Risk Behavior Survey Results, April, 2017, http://www.vdh.virginia.gov/content/uploads/sites/69/2018/04/2017VAH-Detail-Tables.pdf.
 Lindsey Stroud, “Research & Commentary: Flavor Bans Do Not Reduce Youth E-Cigarette Use,” Research & Commentary, The Heartland Institute, August 29, 2019, https://www.heartland.org/publications-resources/publications/research--commentary-flavor-bans-do-not-reduce-youth-e-cigarette-use.
 Lindsey Stroud, “Research & Commentary: Largest Vaping Survey Finds Flavors Play Important Role in Tobacco Harm Reduction,” Research & Commentary, The Heartland Institute, October 2, 2018, https://www.heartland.org/publications-resources/publications/research--commentary-largest-vaping-survey-finds-flavors-play-important-role-in-tobacco-harm-reduction.
 Ali Anderson, “Ex Smokers Prefer Fruity E-Liquids Says Doctor’s FDA Survey,” Vaping, August 14, 2018, https://vaping.com/blog/news/ex-smokers-prefer-fruity-e-liquids-says-doctors-fda-survey/.
 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.
 Vapor Technology Association, “The Economic Impact of the Vapor Industry, UNITED STATES,” 2019, https://vta.guerrillaeconomics.net/reports/feb3d6c6-3567-4d6b-afad-5e293efcd89b?.
 Nicole M. Kuiper et al., “Trends in Unite Sales of Flavored and Menthol Electronic Cigarettes in the United States, 2012-2016,” Preventing Chronic Disease, Centers for Disease Control and Prevention, August 23, 2018, https://www.cdc.gov/pcd/issues/2018/17_0576.htm.
 Royal College of Physicians, Nicotine without Smoke: Tobacco Harm Reduction, April 2016, https://www.rcplondon.ac.uk/projects/outputs/nicotinewithout-smoke-tobacco-harm-reduction-0.
 A. McNeill et al., “Evidence review of e-cigarettes and heated tobacco products 2018,” Public Health England, February 2018, https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/684963/Evidence_review_of_e-cigarettes_and_heated_tobacco_products_2018.pdf.
 The American Cancer Society, “What Do We Know About E-Cigarettes?” June 19, 2019, https://web.archive.org/web/20190806152535/https://www.cancer.org/cancer/cancer-causes/tobacco-and-cancer/e-cigarettes.html.
For more information, please refer to:
Tobacco Harm Reduction 101: A Guidebook for Policymakers
This booklet by Lindsey Stroud aims to inform key stakeholders on the much-needed information on the benefits of electronic cigarettes and vaping devices. Tobacco Harm Reduction 101 details the history of e-cigarettes, including regulatory actions on these products. The booklet also explains the role of nicotine, addresses tax policy and debunks many of the myths associated with e-cigarettes, including assertions about “popcorn lung,” formaldehyde, and the so-called youth vaping epidemic.
Nothing in this Policy Tip Sheet is intended to influence the passage of legislation, and it does not necessarily represent the views of The Heartland Institute or Tobacco Harm Reduction 101.