Long-term Study of E-cigarette Users: Adults Prefer Flavored Products; Ban May Fuel Black Market

Since the U.S. Food and Drug Administration (FDA) began enforcing previously issued new guidelines on February 6, flavored e-cigarettes have officially exited the U.S. vaping market.

However, even though the flavor ban in this policy has received support from Trump and praise from local governments and child protection agencies, emphasizing that banning flavored e-cigarettes can reduce the likelihood of youth vaping, it has also raised concerns among many researchers. They believe that banning flavored e-cigarettes may affect adult users, making it easier for them to obtain illegal flavored products from the black market.
 
According to a report from Science and Technology Network, a new study from Penn State University found that adults enjoy flavored e-cigarettes just as much as teenagers, indicating that this policy may also impact adults.

The research team studied a group of long-term adult e-cigarette users' changing flavor preferences and found that over time, preferences for traditional tobacco, menthol, and mint flavors decreased, while preferences for chocolate, candy, and other sweet flavors increased.

The lead author of the study, Dr. Du Ping, an associate professor of medicine and public health sciences at Penn State College of Medicine, stated: "Our data show that flavors are popular not only among young people but also among adults." The study was also published in the Annals of the American Thoracic Society.

"Many participants in our study reported using e-cigarettes as a means to quit smoking or avoid relapse to cigarette use, and these flavored e-cigarettes may be part of the reason they are willing to use e-cigarettes long-term," Dr. Du added.

According to reports, researchers analyzed reports from 383 adult e-cigarette users aged 22 to 75, who completed an online e-cigarette survey from 2012 to 2014 and were followed up between 2017 and 2019.

In both surveys, participants were asked to list their preferred e-liquid flavors.

Preferences for fruit flavors remained stable.

However, preferences for tobacco, menthol, or mint flavors decreased from 40% at baseline to 22% in follow-up; among young people aged 18 to 45, the preference for chocolate, candy, and other sweet flavors was most pronounced, increasing from 16% at baseline to 29% in follow-up.

During the follow-up survey, researchers asked participants to describe their reactions to the FDA's new regulations. About 50% indicated that if their preferred non-tobacco flavors were banned, they would seek other purchasing methods or add flavoring agents themselves.

Professor Jonathan Foulds of the College of Medicine believes that most participants in this study used traditional e-cigarettes, and these users could continue to purchase bottled flavored e-liquids from vape shops.
 
For now, consumers may still be able to purchase disposable flavored e-cigarettes, but it is unclear whether these products will be banned after May. May 12 is the deadline for e-cigarette manufacturers to submit PMTA (Pre-Market Tobacco Application) to the FDA.

Members of the Pennsylvania Cancer Institute commented that restricting all non-tobacco e-cigarette flavors may help prevent non-users, especially teenagers, from starting to use e-cigarettes.

However, it is worth noting that teenagers or adults can still obtain different flavors through other means, such as online video tutorials that demonstrate how to add flavoring agents or make their own flavored e-liquids, which may make it easier for users to access unregulated products from the market.

"Using unauthorized additives or purchasing products of unknown origin on the street is very dangerous for personal health, as the chemical composition of these products is unknown," Dr. Du stated.

Additionally, about 10% of survey respondents indicated that if their preferred flavors were banned, they would consider returning to traditional cigarettes.

Dr. Du noted that these study results may help explain the earlier concerns of clinicians and researchers: many long-term users admitted that if flavored e-cigarettes were banned, they would seek illegal sources for products, which could lead to unpredictable problems.
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"We do not know what the long-term effects of this new policy will be," Dr. Du emphasized, "but the evidence we have collected suggests that adult long-term e-cigarette users who prefer sweet flavors may seek homemade ways to obtain products that reduce their own health risks."

Summary: U.S. E-Cigarette Users Have It Tough

Since mid-last year, U.S. e-cigarette users have been in an environment of constant regulatory changes. Even though the degree of e-cigarette regulation varies from state to state, most will affect the rights of adult e-cigarette users.

We are not trying to be overly critical of regulation; we simply want to advocate for U.S. e-cigarette users.

Because local regulatory agencies have confirmed that the harm of e-cigarettes is far lower than that of cigarettes, yet they still forcibly deprive adults of their right to choose.

Cigarettes have no flavor, yet the smoking rate among teenagers remains high;

Combustible tobacco is more harmful, yet convenience stores are still everywhere.

Is the flavor ban really a problem for teenagers? Or is it a problem for lawmakers? One can only say that a Chinese e-cigarette user is indeed much happier than a U.S. e-cigarette user...

After all, under regulation, they do not even have the right to choose their flavors.