A recently released UC San Diego study claims that vaping flavour bans are instrumental in dropping vaping rates. However, legislators should be cautious about using it to inform future policy.
A research paper published in JAMA Health, called Local Flavoured Tobacco Bans and Youth Electronic Nicotine Delivery Systems Use has set out to explore the impact of flavour bans on youth vaping.
NBC San Diego reported on the study and even had one of the researchers on. However, I feel like the conclusion could be used as fuel to implement further flavour bans across the US, which would be a big mistake.
The paper
First off, there is a lot to like about the paper. The scope and ambition are there. The central questions were basically:
- What happens when you ban all vape flavours except tobacco?
- Does vaping then decrease among youth?
- Does smoking then increase among youth?
To find out, the researchers used the California Healthy Kids Survey, taken in schools by students in grades 7, 9 and 11 from 2017 to 2022. From there, they sorted into two camps by whether there was a flavoured vape ban in their area and tracked vaping prevalence over time.
What did the paper find?
The researchers tracked 2.8 million California kids from 2017 to 2022. They found that current users (defined as vaping at any time over the last 30 days) were on average 7.5% over these years.
However, when broken down into two primary groups:
- Use was 6.2% among students in jurisdictions where a flavour ban was in effect at the time of the survey.
- Use was 7.7% in jurisdictions that never adopted a local flavour ban.
They also looked at smoking, which was around 2% for current use in both jurisdictions. When measured by areas both with and without the flavour ban, this percentage held.
In other words, the paper reported two primary findings:
- Tobacco-only flavour bans help reduce current youth vaping use.
- Youths who quit didn’t start smoking, which is another nail in the gateway conspiracy theory (my emphasis).
How much stock can we put in the author's conclusion?
There are a number of things that we need to consider about the study and the findings.
#1. The study did not test for daily users
As stated above, the cohorts under analysis here were current users, i.e., people who vaped at any time over the last 30 days. While daily users are contained within this group, they are in the minority. Data from 2022 suggest that daily vape youth users in California were around 2.3% of high school students.
To me, it makes sense that social or recreational users were less likely to use tobacco-flavoured vapes, so these less frequent users are more susceptible to flavour bans.
#2. Youth use was declining already
As the esteemed Charles A. Gardner shows above, US youth vaping declined dramatically between 2019 and 2024, which covers some of the years under question.
The EVALI conspiracy theory, COVID, and the general winding down of vapes' brief “trendiness” among youth were also factors. So, we can’t put full stock in the flavour ban.
#3. Flavours are a part of the appeal
Here is some deductive reasoning for you:
- People like flavours.
- Teens are people.
- Therefore, teens like flavours.
It’s to be expected that when you make products worse or limited, they will appeal to fewer people. Flavours are a big reason why adults like vapes, and many studies have shown they are essential for both quitting and staying off cigarettes.
The youth vapers under question in the study didn’t transition to cigarettes after a flavour ban. Likely, they didn’t have a history with cigarettes to fall back on. However, you can be sure there were adults in these regions who did, and may have started smoking once more because the product they used to quit became less effective.
Final thoughts
While this study is very interesting, I think we need to exercise some caution over how it could be interpreted. The biggest worry is that it may be used as justification for overall flavour bans, which would hurt adult vapers.
In the study, teens did not start smoking because flavours were banned. However, when adults are surveyed about the impact of flavour bans internationally, as many as 40% say they will return to smoking if they can’t access vaping in a way that works for them.
