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August 29, 2019

As lawmakers across the country consider legislation to curb youth use of electronic cigarettes and vaping devices, one policy gaining traction is banning the sale of flavored e-cigarettes. Although addressing youth e-cigarette use is laudable, policymakers should refrain from such bans because they threaten tobacco harm reduction options for adults. Moreover, according to data from the California Youth Tobacco Survey (CYTS), flavor bans have not reduced youth use of electronic cigarettes and vaping devices.

Santa Clara County, California, banned flavored tobacco products to age-restricted stores in 2014. To purchase a flavored tobacco product in the county, the retail establishment must bar persons under 21 from entering. Despite this, data from the 2017-18 California Student Tobacco Survey for Santa Clara County found “the vast majority of high school students (82.3%) in Santa Clara County who were current tobacco users reported using a flavored tobacco product.” Popular flavored products included “current hookah users (82.9%), e-cigarette users (82.6%), and [little cigars] users (82.3%).” Regarding combustible cigarettes, 62.9 percent of respondents “reported using menthol/mint cigarettes in the last 30 days.”

More pointedly, youth e-cigarette use in Santa Clara County has increased while the flavor ban has been in effect. For example, 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.

Contra Costa County, another municipality in California that has restricted the sale of flavored e-cigarettes, has also experienced a recent increase in youth vaping rates. Although the 2015-16 CYTS survey included other localities including Marin, San Francisco, San Mateo and Solana, the 2017-2018 CYTS survey reported only on Contra Costa. In 2015-16, 8.3 percent of high school students in the various localities reported current use of electronic cigarettes and vaping devices. In the 2017-18 CYST survey of solely Contra Costa County high school students, this number increased to 17.2 percent reporting current e-cigarette use.

It should be noted that the CYTS defines “current use” as any use within the past 30 days. This definition makes it difficult to understand whether these students are casual vapers, i.e., they used a vaping product a few times in the past 30 days, or whether they were using these products every day, for the past 30 days.  

Lawmakers should not interpret these results as a need to further restrict access to flavored e-cigarettes. Without a doubt, this would harm millions of former American adult smokers who have finally quit combustible cigarettes by switching to electronic cigarettes and vaping devices.

In the largest survey of American adult vapers, flavors were vital in helping smokers quit combustible cigarettes and remain abstinent from smoking. This 2018 survey, conducted by researchers at the Onassis Cardiac Surgery Center, Greece, and Centre for Substance Use Research, Scotland, UK, surveyed nearly 70,000 American adults and found that 83.2 percent and 72.3 percent of survey respondents reported vaping fruit and dessert flavors, respectively. Only 20 percent of respondents reported using tobacco flavors at the point of e-cigarette initiation.

Further, it is highly likely that banning flavored e-cigarette products could prompt former smokers to return to tobacco cigarettes. A 2017 study by the National Bureau of Economic Research concluded banning flavors “would result in the increased choice of combustible cigarettes.” Indeed, the authors expect e-cigarette use to decrease by approximately 10 percent if flavors are banned.

Despite recent media fearmongering, e-cigarettes are at least 95 percent less harmful than tobacco cigarettes. In fact, in June 2019, the American Cancer Society (ACS) noted that “e-cigarette use is likely to be significantly less harmful than smoking regular cigarettes.” ACS contributes this to the fact that e-cigarettes “do not contain or burn tobacco.” Moreover, e-cigarettes are twice as effective as nicotine replacement in helping smokers quit.

Despite good intentions, policies such as increasing the tobacco purchasing age to 21 and taxing electronic cigarettes and vaping devices have not decreased youth use of e-cigarettes. In fact, the exact opposite has happened: youth use of e-cigarettes has increased while these regulations have been on the books.

Rather than restricting adult access to e-cigarettes and vaping devices, policymakers should redirect current tobacco moneys (mostly from the Master Settlement Agreement) to education and prevention programs. Furthermore, municipalities ought to implement consequences for youth who are found in possession of e-cigarettes instead of across-the-board bans and other restrictive measures.

Nothing in this Research & Commentary 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.

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