In the last few years, e-liquid flavors have become a hotly debated topic in the vape industry. To vapers, flavored e-liquids are just tasty alternatives to the more traditional tobacco and mint flavorings. To others, they threaten the health of youths all over the U.S.
The Problem With Flavored E-Liquid
In 2003, Chinese pharmacist Hon Lik created e-cigarettes. He wanted e-cigarettes to be a healthier alternative to cigarettes and a handy tool for smokers who want to quit smoking for good.
In a 2020 interview, Lik remarked, “I didn’t think of developing fruit flavors, but it has certainly been effective.”1“Imperial Brands Science – James Campbell,” imperialbrandsscience.com. https://imperialbrandsscience.com/blog/interview-with-hon-lik-original-inventor-of-the-e-cigarette/ He goes on to say, “I personally think regulators should focus on enforcing age limits rather than banning flavors – we should all be as strict as possible on any potential adoption by vulnerable populations like youth.”
Some people accept flavors such as Berry, Blackcurrant, and Banana, but draw the line at e-liquids called Bubblegum, Tutti Frutti, and Candyfloss. Many legislators, campaign groups, and parents argue that fun names and recognizable flavors target adolescent vapers.
Vape Flavor Bans in the U.S.
Legislators in the U.S. have been developing their anti-vape stance for the last two decades.
In 2009, the Tobacco Control Act came into effect. It banned “all e-liquids with characterizing flavors, except menthol and tobacco.”2C. for T. Products, “Family Smoking Prevention and Tobacco Control Act – An Overview,” FDA, Dec. 2023, Available: https://www.fda.gov/tobacco-products/rules-regulations-and-guidance/family-smoking-prevention-and-tobacco-control-act-overview This landmark piece of legislation was backed by concerns that young people start vaping to try all the fun, flavorful e-liquids on offer.
In 2020, the Federal Drug Administration (FDA) banned e-cigarette flavors that appeal to children,3C. for T. Products, “Enforcement Priorities for Electronic Nicotine Delivery System (ENDS) and Other Deemed Products on the Market Without Premarket Authorization,” U.S. Food and Drug Administration, Apr. 29, 2020. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/enforcement-priorities-electronic-nicotine-delivery-system-ends-and-other-deemed-products-market such as fruit and mint. Following this federal law, individual states implemented local laws to slow the increase in youth initiation.
Adolescent Vaper Statistics
Concerns around youth initiation of e-cigarettes have reached an all-time high, but do the statistics paint a different picture?
According to the National Tobacco Survey in 2023, more than 2.1 million middle and high school students reported currently using e-cigarettes4FDA, “Results from the Annual National Youth Tobacco Survey,” FDA, Nov. 2023, Available: https://www.fda.gov/tobacco-products/youth-and-tobacco/results-annual-national-youth-tobacco-survey.
- More than 1 in 4 use e-cigarettes daily
- Almost 9 out of 10 use flavored e-cigarettes
- The most commonly reported products are Elf Bar (56.7%) Esco Bars (21.6%), Vuse (20.7%), JUUL (16.5%), and Mr. Fog (13.6%)
In 2022, the National Tobacco Survey found that 2.5 million middle and high school students reported currently using e-cigarettes5“Results from the Annual National Youth Tobacco Survey – Tobacco Education Resource Library Web Pages,” digitalmedia.hhs.gov. https://digitalmedia.hhs.gov/tobacco/webpages/3327. Of those who used e-cigarettes, almost 85% used flavored e-cigarettes.
Although 2023 saw a decrease in the overall number of young vapers, approximately 5% more of the young people who used e-cigarettes used flavored e-cigarettes.
The Link to E-Liquid Initiation
For years, legislators have used e-liquid flavors as a target for their dislike of Big Vape. Senator Dick Durbin is one of the main proponents of the anti-vape movement sweeping America and, like a lot of passionate protestors, he is determined to ban e-liquid flavors.
“I am convinced that e-cigarettes represent the ‘re-invention of smoking’,”6“Durbin To E-Cigarette Industry: Gummy Bear-Flavored Liquid Nicotine Helps Adults Quit Smoking? Prove It | U.S. Senator Dick Durbin of Illinois,” www.durbin.senate.gov. https://www.durbin.senate.gov/newsroom/press-releases/durbin-to-e-cigarette-industry-gummy-bear-flavored-liquid-nicotine-helps-adults-quit-smoking-prove-it- Durbin said, “Cooked up by Big Tobacco to hook a new generation. Unfortunately, kids don’t understand that e-cigarettes are highly addictive, harmful to their developing brains, and can lead to a lifetime of tobacco addiction. These products, especially flavors that shamelessly appeal to kids, are doing more harm than good.”
Modern research backs the idea that e-liquid flavors entice young people. A study from 2019 analyzed the role of flavors in vaping initiation and satisfaction among Americans7R. L. Landry et al., “The role of flavors in vaping initiation and satisfaction among U.S. adults,” Addictive Behaviors, vol. 99, p. 106077, Dec. 2019, doi: https://doi.org/10.1016/j.addbeh.2019.106077 and found that flavors (particularly fruit flavors) are more likely to motivate young adults aged 18 to 24 to initiate vaping than adults aged 35 to 44.
Here are the other interesting findings.
- Those who used flavors (particularly mint/menthol and flavors other than tobacco) had higher odds of reporting high satisfaction with vaping
- Those who used flavors (particularly mint/menthol and flavors other than tobacco) had higher odds of perceived addiction to vaping
Another source conducted an exploratory review into perceptions and reasons for e-cigarette use and concluded that “Adults’ perceptions and reasons for e-cigarette use are often related to smoking cessation, while youth like the novelty of the product.”8K. Romijnders, L. van Osch, H. de Vries, and R. Talhout, “Perceptions and Reasons Regarding E-Cigarette Use among Users and Non-Users: A Narrative Literature Review,” International Journal of Environmental Research and Public Health, vol. 15, no. 6, p. 1190, Jun. 2018, doi: https://doi.org/10.3390/ijerph15061190 Although e-liquid flavors are not explicitly mentioned, we can assume that fun flavors, colors, and designs create novelty in e-liquids.
Popularity of E-Liquid Flavors Among Age Groups
The crux of the problem is that people love fruit, candy, and dessert-flavored e-liquids.
One in-depth study collected information on vapers in New Jersey, New York, and Washington before and after the flavor bans in those states9Y. Yang, E. N. Lindblom, K. D. Ward, and R. G. Salloum, “The impact of flavored e-cigarette bans on e-cigarette use in three US states,” medRxiv (Cold Spring Harbor Laboratory), May 2023, doi: https://doi.org/10.1101/2023.05.19.23290249. There were 1,624 participants from all races, careers, and ages, though the majority (59.9%) of participants were young adults between 25 and 34 years old.
This table details the age of the vapers, whether they intended to quit vaping before the ban, and the frequency of e-cigarette use before the ban.
| All, N=1624 | New Jersey, N=600 | New York, N=745 | Washington, N=279 | ||
| Gender | Male | 61.2 | 63.3 | 61.7 | 54.8 ** |
| Female | 38.9 | 36.7 | 38.3 | 45.2 ** | |
| Age, in years | 18-24 | 13.7 | 11.2 | 13.6 | 19.7 ** |
| 25-34 | 56.9 | 59.5 | 58.1 | 48.0 ** | |
| 35-54 | 26.1 | 26.0 | 25.1 | 29.0 ** | |
| 55 and above | 3.3 | 3.3 | 3.2 | 3.2 ** | |
| Race /ethnicity | White | 59.4 | 53.5 | 55.6 | 64.9 ** |
| Black | 13.9 | 15.0 | 15.7 | 6.8 ** | |
| Asian | 8.5 | 8.5 | 8.3 | 9.0 ** | |
| Hispanic | 18.2 | 19.7 | 18.0 | 15.4 ** | |
| Other/mixed race | 3.0 | 3.3 | 2.4 | 3.9 ** | |
| Educational attainment | High school or less | 7.6 | 6.8 | 7.1 | 10.8 ** |
| Less than bachelor and more than high school | 25.6 | 22.8 | 23.6 | 36.6 ** | |
| Bachelor or higher | 66.8 | 70.3 | 69.3 | 52.7 ** | |
| Household income | Less than $24,999 | 17.9 | 15.3 | 19.2 * | 19.7 * |
| $25,000 to $49,999 | 32.3 | 34.7 | 30.7 * | 31.2 * | |
| $50,000 to $74,999 | 23.8 | 25.0 | 24.3 * | 19.7 * | |
| $75,000 to $99,999 | 14.2 | 13.2 | 14.2 * | 16.1 * | |
| $100,000 or more | 12.0 | 11.8 | 11.5 * | 13.3 * | |
| Smoking status (cigarettes or cigars) | Daily or most days of the week | 30.9 | 32.2 | 29.7 | 31.2 |
| Weekly smoker | 44.4 | 45.5 | 46.9 | 35.5 ** | |
| Former smoker | 19.2 | 16.5 | 17.7 | 28.7 ** | |
| Never smoker | 5.6 | 5.8 | 5.8 | 4.7 * | |
| History using e-cigarettes | <=1year | 14.8 | 12.5 | 16.0 * | 16.5 ** |
| 2-3 years | 44.5 | 44.5 | 42.8 | 49.1 ** | |
| 4-5 years | 25.1 | 26.0 | 26.2 | 20.1 ** | |
| >5 years | 15.6 | 17.0 | 15.0 | 14.3 ** | |
| Reason for using e-cigarettes | It comes/came in flavors I like/liked | 54.4 | 52.8 | 53.8 | 59.1 ** |
| Using them helps people to quit smoking cigarettes | 36.6 | 37.3 | 33.6 | 43.0 ** | |
| Frequency of e-cigarettes use before the ban | Used e-cigarettes daily | 44.5 | 41.5 | 41.2 | 59.5 |
| Used e-cigarette weekly | 55.5 | 58.5 | 58.8 | 40.5 | |
| Intention to quit using e-cigarettes before the ban | Very much | 24.1 | 25.7 | 26.3 | 14.7 ** |
| Somewhat | 55.7 | 57.7 | 56.9 | 48.0 ** | |
| Not all | 20.3 | 16.7 | 16.8 | 37.3 ** | |
| Awareness of the ban when surveyed | 67.7 | 63.3 | 70.9 ** | 68.5 * | |
| Support for the ban when surveyed | Strongly supportive | 10.2 | 11.8 | 11.1 | 4.3 ** |
| Supportive | 25.7 | 26.5 | 28.5 | 16.5 ** | |
| Neutral | 36.1 | 37.5 | 34.9 | 36.2 ** | |
| Not supportive | 13.9 | 13.5 | 12.9 | 17.2 ** | |
| Strongly not supportive | 14.2 | 10.7 | 12.6 | 25.8 ** | |
| Perceived compliance of local retailers with the ban (among respondents aware of ban before the survey) | >75% | 14.8 | 11.3 | 13.1 | 26.7 ** |
| >50% – <=75% | 19.0 | 16.3 | 19.3 | 23.6 ** | |
| >25% – <=50% | 34.8 | 36.1 | 35.6 | 29.8 ** | |
| <=25% | 31.4 | 36.3 | 32.0 | 19.9 ** |
Note: boldface indicates the statistical significance of chi-tests, with the state of New Jersey as the reference, * for P<0.05, and ** for P<0.01
1Any flavors other than tobacco and menthol, such as fruit, coffee, and candy
52% of the participants from New Jersey, 53.8% of the participants from New York, and 59.1% of the participants from Washington used e-cigarettes because ‘It came in a flavor I liked.’ Across the board, participants from every age group started vaping because of e-liquid flavors.
Another study conducted a longitudinal analysis of Electronic Nicotine Delivery System (ENDs) flavor use by age group in the U.S. It concluded that “While the maintenance of fruit and candy/dessert flavors were higher among youth, adults had substantially higher maintenance percentages for menthol/mint and tobacco flavor.”10Kaplan, B., Hardesty, J. J., Welding, K., Breland, A. B., Eissenberg, T., Cohen, J. E. (2023). Electronic Nicotine Delivery System flavor use over time by age group in the US: A longitudinal analysis. Tobacco Induced Diseases, 21(May), 67. https://doi.org/10.18332/tid/162365
A different cross-sectional survey sent a questionnaire to people over the age of 18 who reported ever using an e-cigarette11Konstantinos Farsalinos, C. Russell, Riccardo Polosa, Konstantinos Poulas, G. Lagoumintzis, and A. Barbouni, “Patterns of flavored e-cigarette use among adult vapers in the USA: an online cross-sectional survey of 69,233 participants,” Harm Reduction Journal, vol. 20, no. 1, Oct. 2023, doi: https://doi.org/10.1186/s12954-023-00876-w. 69,233 people participated in the survey.
Here are the most popular flavors for e-cigarette use initiation:
- Fruit (82.8%)
- Dessert/pastry/bakery (68.6%)
- Candy/chocolate/sweet (52.2%)
20% of the participants used tobacco flavors, which were the least prevalent of all the initiation flavors among participants who never smoked. Researchers also noted a slightly higher prevalence of using fruit and dessert flavors among people who had never smoked.
These studies show that non-tobacco flavors are also extremely popular among adults, opposing the unsubstantiated (but widely held) belief that e-liquid flavors are a ploy to target young vapers. However, the data does support the belief that non-smokers start vaping because of fun, recognizable flavors.
So, Do Flavor Bans Reduce Vaping?
The research is divided.
Let’s return to the study that analyzed the effects of the flavor ban in New Jersey, New York, and Washington. Researchers surveyed thousands of adult respondents from these states who used e-cigarettes at least once a week before the ban. They found that 8.1% of respondents quit using cigarettes altogether.
Here are the other findings.
- Decrease of 74.4% to 50.8% of respondents primarily using banned menthol or other flavors
- Decrease of 20.1% to 15.6% of respondents using tobacco-flavored e-liquid
- Increase of 5.4% to 25.4% of respondents using non-flavored e-liquid
Those who primarily used banned flavors such as menthol obtained them from a few different sources.
- 45.1% from in-state stores
- 31.2% from out-of-state stores
- 32% from family, friends, or others
- 25.5% from internet/mail sellers
- 6.9% stocked up before the ban
- 5.2% from illegal sellers
- 4.2% mixed flavored e-liquids themselves
The study concluded that many local retailers did not comply with the flavor ban, which meant that residents in New York, New Jersey, and Washington still had access to their favorite e-cigarette flavors.
What About Young People?
When legislators, campaigners, and concerned parties talk about anti-vape regulations, they set their focus on young people. So, have flavor bans proven to be the smoking cessation tool that legislators hope they are?
A study from 2020 analyzed the impact of flavor bans on young people in San Francisco City12Y. Yang, E. N. Lindblom, R. G. Salloum, and K. D. Ward, “The impact of a comprehensive tobacco product flavor ban in San Francisco among young adults,” Addictive Behaviors Reports, vol. 11, p. 100273, Jun. 2020, doi: https://doi.org/10.1016/j.abrep.2020.100273. It surveyed 247 residents aged 18 to 34 who previously used tobacco products.
- Flavored e-cigarette use decreased from 81% to 69% among 18 to 24-year-olds
- Flavored e-cigarette use decreased from 85% to 76% among 25 to 34-year-olds
12% of young people stopped using e-cigarettes after flavored e-liquid bans, which is a step in the right direction. Researchers also note that most participants report being able to obtain flavored tobacco products through multiple sources, reinforcing the idea that illegal vapes are readily available on every street corner.
This result is reflected in another study that tracks how young adults react to flavored e-cigarette sales restrictions13K. F. Romm et al., “Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas,” Preventive Medicine Reports, p. 101901, Jul. 2022, doi: https://doi.org/10.1016/j.pmedr.2022.101901.
- 35.8% of participants used available flavors such as tobacco or menthol
- 30.4% of participants continued to use tank-based e-cigarettes
- 10.1% of participants switched to tank-based e-cigarettes
- 8.4% reduced their e-cigarette use
Some participants indicated that the ban did not impact them because they stocked up on flavors beforehand. The overwhelming message is that federal restrictions did not impact e-cigarette use in any meaningful way, with the reported percentages of smoking cessation fluctuating from 8 to 12%.
Do Flavor Bans Increase Smoking?
Pro-vape campaigners worry that anti-vape legislation will force people who have addictive personalities to turn (or return) to cigarettes. The World Vapers’ Alliance was just one of the campaign groups that spoke out against the global push to ban flavors. In a press release, Director Michael Landl wrote, “The ban is a regressive move that will inevitably drive people back to smoking, causing more harm and loss of life.”14W. V. Alliance, “Consumers Strongly Condemn WHO’s Proposed Ban on Flavoured E-Cigarettes,” World Vapers’ Alliance, Dec. 14, 2023. https://worldvapersalliance.com/en_gb/consumers-strongly-condemn-whos-proposed-ban-on-flavoured-e-cigarettes/
One study analyzed a data set of 9,225 students younger than 18 in the San Francisco area. It concluded that “San Francisco’s ban on flavored tobacco product sales was associated with higher odds of self-reported recent smoking among minor high school students”15A. S. Friedman, “A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California,” JAMA Pediatrics, vol. 175, no. 8, pp. 863–865, Aug. 2021, doi: https://doi.org/10.1001/jamapediatrics.2021.0922compared to those in other school districts.
Another large-scale, long-term analysis of policies and sales data found that for every 0.7 milliliters of e-liquid that goes unsold due to flavor restrictions, 15 additional cigarettes are sold16“E-cigarette flavor restrictions may increase cigarette sales, study finds,” News-Medical.net, Oct. 18, 2023. https://www.news-medical.net/news/20231018/E-cigarette-flavor-restrictions-may-increase-cigarette-sales-study-finds.aspx.
Although the data, methods, and hypothesis vary, studies agree that e-cigarette bans have a ripple effect on cigarette use among young people. Just as Landl said, e-cigarette restrictions increase youth initiation of cigarettes.
Final Thoughts
The controversy around vape flavors has been well-documented, but legislators still struggle to devise an effective action plan. In the last year, the number of middle and high school students who use e-cigarettes has decreased, but there has been an uptick in those who use flavored e-cigarettes.
Flavor bans have an impact, but only minimally. Besides, banning flavors does not force vapers to quit ‘cold turkey’. Instead, they stock up on items, drive out of state, and take advantage of the growing black market for e-cigarettes.
Flavored e-liquids don’t carry the same associations as tobacco e-liquids. Adolescents might be aware that tobacco is a deep, slightly bitter flavor that is more associated with older generations, but flavors like Candyfloss and Bubblegum are on their wavelength. In many ways, the invention of fun e-liquid flavors has repackaged nicotine addiction into something more palatable for younger generations.
Instead of banning flavored e-liquids, legislators should educate young people about the dangers of nicotine and tobacco as a whole. But until that day, we expect to see more inefficient, clumsy attempts to wrangle e-cigarettes away from young people. As Senator Durbin said, the ‘re-invention of smoking’ is officially here, and it isn’t going anywhere.
