A Question of Taste: The Public Health Case for E-Cigarette Flavors

Bottom Line: Evidence suggests flavored e-cigarettes are not especially appealing to non-smoking adults or adolescents, yet are appealing to smoking adults, potentially helping them switch to less-harmful vaping. A tobacco product standard that prohibits the vast majority of e-cigarette flavors will not just degrade the value proposition of these products, it will stifle further innovation in the market for reduced-risk nicotine products.  

Developing a tobacco product standard that limits or prohibits e-cigarette flavors would be counterproductive, degrading the appeal and user experience of products which, when used exclusively in place of combustible cigarettes, dramatically reduce the risks of tobacco-related disease. The FDA itself has stated that e-cigarettes are a vital part of the policy mix to reduce deaths from smoking, and Scott Gottlieb has said that if every smoker in America switched to e-cigarettes, it would be a net benefit to public health.  

The key objective for FDA should be to maximize the public health potential of e-cigarettes by ensuring widespread availability of e-cigarette products in the forms that actually appeal to adult smokers, which is for the most part in non-tobacco flavors. At the same time, FDA must use its authority to limit sales of these products to youth as much as possible. To tackle youth use, FDA should use its enforcement power to prevent and punish illegal sales of these products to minors.  

The claim that e-cigarette flavors are especially appealing to children, particularly those who have never used any tobacco product, is made extensively but lacks substantive empirical support. While flavor plays a role in the decision of some youth to try vaping, the evidence shows that it is one of many factors and is often not the leading reason for youth vaping. There is no reason to believe that banning e-cigarette flavors would, in fact, reduce youth vaping. 

A systematic review of consumer preference for e-cigarette attributes including flavors, found that both young adults and adults over the age of 25 preferred sweet flavors. This runs counter to the view that sweet or other non-tobacco e-cigarette flavors are designed to and are solely appealing to youth. Indeed, many adult vapers directly attribute their success in quitting smoking to the availability of e-cigarette flavors. 

A study published in 2018 examined 20,836 adults in the U.S. who were using e-cigarettes on a frequent basis, of whom 75.9% had completely switched from cigarettes to e-cigarettes. It found frequent e-cigarette users are now most likely to have started vaping with products flavored to taste like fruit or a fruit drink and are increasingly likely to have started vaping with dessert or pastry flavors.  

Read the full report here.