Did restrictions on flavored e-cigarettes lead to sales reductions?

Many teenagers who use e-cigarettes tend to gravitate towards flavored cigarettes. Restricting the sale of flavors has been seen as one way to discourage use among this population group. A study examines whether statewide bans have led to improvements in curbing the use of the devices.

The introduction of e-cigarettes roughly 15 years ago led to a backslide in progress made by smoking prevention programs in the United States. Their use is not uncommon among teenagers and one of the common factors linked to this usage is flavored products. Flavors, with the exception of menthol, were banned in traditional cigarettes in 2009. Moves were made to discourage flavored e-cigarettes in 2020, including the US Food and Drug Administration stating that they wanted to prohibit the sale of all menthol flavored items. A report examines whether statewide restrictions in Massachusetts, New York, Rhode Island, and Washington were tied to reduced e-cigarette sales.1

The investigators ran a cross-sectional study that examined e-cigarette retail sales from Massachusetts, Rhode Island, and Washington, which restricted flavored e-cigarette sales in October 2019 as well as New York, which started restricting these sales in May 2020. They compared them to sales in 35 states that did not have restrictions during this time period. The sales were grouped into 4-week periods and the sales were put into 4 flavor categories: tobacco, menthol, mint, and other.

They found that statewide restrictions on flavored e-cigarette brands were linked to a reduction in the average 4-week total sales from October 2019 to December 2020 in the 4 states with prohibitions (30.65% [95% CI, 24.08%-36.66%] in New York, 31.26% [95% CI, 11.94%-46.34%] in Rhode Island, and 25.01% [95% CI, 18.43%-31.05%] in Washington) when compared to the control states. Massachusetts saw a reduction of 94.38% in 4-week sales. In the control sales, the average sales decreased by 28.4% from August 2019 to February 2020. However, there was a 49.9% increase in sales from February to December 2020

The investigators concluded that restriction of the sale of non-tobacco flavored e-cigarettes was linked to a reduction in all e-cigarette sales. The findings suggest that many e-cigarette users did not switch over to nonflavored following the sale restriction and indicate that a large scale restriction would lead to fewer teenagers using e-cigarette devices.

Reference

  1. Ali F, Vallone D, Seaman E, et al. Evaluation of Statewide restrictions on flavored e-cigarette sales in the US from 2014 to 2020. JAMA Netw Open. 2022;5(2):e2147813. doi:10.1001/jamanetworkopen.2021.47813