Recently, Stan Glantz and colleagues called for a ban on electronic cigarette flavorings. Other anti-smoking groups have also urged the FDA to implement a ban on the use of flavors in electronic cigarettes. I have already explained why such an intervention makes no sense because it essentially represents a ban on electronic cigarettes, prevents brand differentiation, and greatly decreases the appeal of these products, thus forever protecting the market share of tobacco cigarettes. Today, I explain why the flavors in electronic cigarettes probably play a role in deterring youth smoking. Thus, I provide another argument for why the FDA should not ban electronic cigarette flavors.
The Rest of the Story
The argument being made by the CDC, as well as many other anti-smoking groups and advocates, is that electronic cigarettes are a gateway to youth smoking. In other words, youth who have never smoked before are going to try electronic cigarettes, become addicted to nicotine, and then move on to tobacco cigarette smoking.
This argument might have some plausibility if electronic cigarettes were "starter cigarettes." In other words, if electronic cigarettes were much milder versions of tobacco cigarettes, with milder tobacco flavor, then it might be expected that youth could advance from an electronic cigarette to a real one. Electronic cigarettes with tobacco or menthol flavoring, for example, might be expected to get kids used to the taste of a tobacco cigarette and thus to promote cigarette smoking initiation.
However, is the same thng true of a flavored e-cigarette?
Based on the experience of vapers, there is strong and compelling evidence that the flavors lead vapers away from tobacco taste, not towards it. Vapers consistently report that the use of the flavors helps them lose their taste for tobacco and makes it more difficult for them to return to cigarette smoking.
One would expect a similar experience with youth e-cigarette experimenters. Once they get used to the sweet flavors of electronic cigarettes, it is hard to fathom that they could then be drawn to the harsh taste of tobacco. It is difficult to imagine a youth switching from a gummy bear flavored e-cigarette to a Marlboro.
In fact, it could well be that flavored electronic cigarette use inhibits youth smoking by making it much less likely that a youth is going to enjoy his or her first experience with real tobacco cigarettes. The oral and respiratory tracts that are used to fruit or candy flavors are most likely not going to be able to tolerate or enjoy the harsh taste and sensation of a tobacco cigarette. For this reason, it is entirely conceivable that the use of electronic cigarettes might actually be a deterrent to cigarette smoking.
However, this deterrent effect - if present - depends upon the availability of flavored electronic cigaretttes. If only tobacco and menthol e-cigarettes were to be allowed on the market, this deterrent effect could no longer take place.
For this reason, the FDA should think long and hard before jumping into a decision to ban the flavors in electronic cigarettes. It is possible that despite encouraging experimentation among some nonsmoking youth, flavored electronic cigarettes may actually have a net positive effect on the public's health by serving as an overall deterrent to youth smoking.
In the absence of data demonstrating that flavored electronic cigarettes are serving as a gateway to youth smoking, there is no public health justification for a ban on flavors in electronic cigarettes, and such a measure could cause more public health harm than good.