Associations of Flavored E-Cigarette Uptake With Subsequent Smoking Initiation and Cessation

Bottom Line: This study examines whether there's an association between smoking cessation and flavored e-cigarettes. It concludes that flavors are indeed associated with increased smoking cessation yet not with increased youth smoking initiation. These findings suggest states are wrong to ban flavored e-cigarettes.

Advocacy groups have voiced widespread concern that e-cigarette flavors lead to youth initiation of vaping. The US Food and Drug Administration announced that it will enforce sales restrictions on e-cigarette cartridges with flavors other than tobacco and menthol unless the product has obtained Food and Drug Administration premarket authorization.

Yet a growing body of research concludes that flavors are vital in helping people quit smoking. For instance, one analysis of individuals aged 18 to 64 years who currently smoke or recently quit smoking concluded that a federal ban on e-cigarette flavors would increase smoking. Qualitative evidence also finds that young adults who smoke perceive flavors as helpful in cutting down conventional cigarette use. Understanding how flavored e-cigarette use is related to smoking initiation and cessation is critical to guiding policy.

The results of this study show that adults who began vaping non-tobacco-flavored e-cigarettes were more likely to quit smoking than those who vaped tobacco flavors. Favoring flavored e-cigarettes was not associated with greater youth smoking initiation. Specifically, among adults who smoked and began vaping, the odds of cessation for those favoring nontobacco flavors were 2.3 times that of those who used tobacco-flavored e-cigarettes.

Because early smoking cessation has substantial health benefits, with those who quit smoking before age 35 years experiencing a life expectancy similar to that of those who never smoked, increased cessation among individuals aged 18 to 54 years has substantive implications for population health.

Critically, this study’s findings suggest that efforts to ban flavored e-cigarettes could increase smoking. Although proponents of flavor bans have claimed that tobacco-flavored e-cigarettes are adequate to help individuals who smoke, these results call for evidence to support that claim before it is acted on. 

Read the full study HERE.