A significant majority of adult vapers of non-tobacco flavoured e-cigarettes, and who would be possibly impacted by flavour restrictions, oppose flavour bans, but the public health implications of possible flavour restrictions are not clear, according to a recent study.

The study, conducted by the International Tobacco Control Policy Evaluation Project at the University of Waterloo, examined whether regular vapers from Canada, England and the United States who only use non-tobacco flavoured e-cigarettes, would support or oppose a ban on all non-tobacco flavours and how they would potentially respond to such a policy. The study did not report data from vapers who use tobacco flavours and who may be less affected by flavour restrictions, representing approximately a third of the sample of vapers in the study.

There are thousands of flavoured vaping products on the market, including tobacco, menthol, mint, fruit, and candy. With rising rates of youth vaping, regulators in some countries are grappling with decisions on how to best regulate vaping product flavours to protect public health. A ban on flavoured vaping products intends to discourage vaping among youth; however, it is not clear whether flavour restrictions would also discourage use among adult vapers who are smoking and vaping, or who have quit smoking and switched to vaping, and prefer non-tobacco flavours.

“Our study helps to fill the gaps in evidence of the possible impact of e-cigarette flavour bans, following from other studies that have predicted how smokers respond to tobacco control policies such as tax increases and menthol bans,” said Professor Geoffrey Fong, co-author and the principal investigator of the ITC Project.

In the subsample of vapers who would be most affected by potential restrictions, 82 per cent of the 851 respondents surveyed in the three countries say they oppose a flavour ban, 13 per cent support it, and five per cent are unsure.

Vapers were then asked what they might do if there was a ban on the flavours they were currently vaping. While responses to the hypothetical flavour ban were mixed, and largely varied by smoking and vaping status, and by the level of support of a flavour restriction policy, slightly more than half (57%) reported that if non-tobacco flavours were banned they would either continue vaping an available flavour (tobacco in the US and tobacco or menthol in Canada and England) or find a way to get banned flavours, which would likely be through illicit channels or online. Few vapers (one in ten) who had already switched from smoking to vaping reported that they would stop vaping and return back to smoking cigarettes, and just over a quarter of smokers who were also vaping reported that they would stop vaping and continue smoking. Thus, it is uncertain how many current smokers would have eventually transitioned away from smoking if they had continued to vape.

“At this time, it is not clear what net population-level consequences would occur if non-tobacco flavoured e-cigarettes were prohibited. While a majority of vapers in this study opposed this policy, and many vapers would not be willing to switch to available flavours, there was considerable variability in their responses. It should be noted however that only those who use the flavours that would be banned were included in this study, thus those who vape the flavours that would remain unrestricted, as well as less regular vapers and never-smokers were not taken into consideration. This could impact any estimation of a public health impact’ said ITC research assistant professor Shannon Gravely, who was lead author of the study.

The study, “Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors: Findings from the 2020 ITC Smoking and Vaping Survey in Canada, England and the United States,” was recently published in the journal Addictive Behaviors.

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