Tobacco Business

[ 16 ] TOBACCO BUSINESS [ NOVEMBER / DECEMBER | 21 ] R STARTUP / LEGISLATION Recent peer-reviewed studies show that banning f lavored tobacco products or f lavored vapor products has significant negative public health impacts that policymakers must consider when they are deciding the proper scope of regulation. In fact, several studies indicate that banning all f lavored tobacco products actually increases the number of young people who smoke combustible cigarettes. The first study, published in June 2020 in Science Direct-Addictive Behavior Reports , considered the City of San Francisco’s total f lavored tobacco ban, finding that after the ban was in force for nearly a year, f lavored tobacco product use was reduced, but cigarette smoking among 18-24-year-olds increased by over 35 percent. The study also found that most consumers of f lavored tobacco find other sources for these products. The second study, which was published in May 2021 in JAMA Pediatrics , also concerned the City of San Francisco’s f lavored tobacco ban and compared youth smoking rates among high school students in the San Francisco school district to the smoking rates of high school students in seven other metropolitan school districts that were located in cities without a f lavored tobacco ban. That study concluded: “San Francisco’s ban on f lavored tobacco product sales was associated with increased smoking among underage high school students relative to other school districts. While the policy applied to all tobacco products, its outcome was likely greater for youths who vaped than those who smoked due to higher rates of f lavored tobacco use among those who vaped. This raises concerns that reducing access to f lavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking.” According to the study, the smoking rate for San Francisco high school students under the age of 18 increased from 4.7 percent in 2017 before the adoption of the city’s ordinance to 6.2 percent in 2019, the year after the ordinance was enacted, a 32 percent increase in underage youth cigarette smoking rates in the San Francisco school district . At the same time, underage smoking rates in the other metropolitan school districts in cities without a f lavored tobacco product sales ban continued to decline and averaged 2.8 percent as of 2019. A third study, which was published in July 2021 in Nicotine & Tobacco Research, found similar implications of f lavored vapor bans on young adult tobacco users: “[I]f vape product sales were restricted to tobacco f lavors, 39.1 percent of users reported being likely to continue using e-cigarettes, but 33.2 percent were likely to switch to cigarettes. If vape product sales were entirely restricted, e-cigarette users were equally likely to switch to cigarettes versus not (~40 percent).” The three above studies clearly demonstrate that the unintended but very real consequence of broad f lavor bans is to switch youth and young adults who use vapor products, which are generally considered to be lower on the continuum of risk, to cigarettes, which are considered to present more risk. Similarly, a paper published in August 2021 in the American Journal of Public Health by 15 former presidents of the Society for Research on Nicotine and Tobacco, the world’s leading professional organization dedicated to the subject, advised policymakers considering restrictions on vaping products that “the potential lifesaving benefits of e-cigarettes for adult smokers deserve attention equal to the risks to youths.” The paper noted findings of several studies that “policies intended to restrict e-cigarette use may have unintentionally increased cigarette smoking,” including a Minnesota e-cigarette tax that led to increased adult cigarette smoking. Each new study clarifies that, for public health purposes, policymakers should not rely on a simple, one-sided view that all tobacco products are identical and should be regulated identically, or that all f lavored tobacco products should be eliminated to protect young people. TB Consequences of Flavor Bans Contributed by Thomas Briant, Executive Director, National Association of Tobacco Outlets (NATO) Recent studies find negative health effects of flavor bans, vaping restrictions.