CDC Survey Shows Flavors Aren’t Driving Youth Vaping
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CDC Survey Shows Flavors Aren’t Driving Youth Vaping

The CDC finds only 22 percent of young people say they tried e-cigarettes because they “are available in flavors, such as mint, candy, fruit or chocolate.”

Over 75 percent of youth vapers apparently don’t care much about flavors, according to the most recent survey conducted by the Centers for Disease Control and Prevention. 

“Among middle and high school students who ever tried using e-cigarettes, the most common reasons for e-cigarette use were ‘I was curious about them.’ (55.3 percent),” the CDC reports in its report “Tobacco Product Use and Associated Factors Among Middle and High School Students — United States, 2019.”

Given the choice of selecting any and/or all of 12 different reasons for why they had tried vaping in the first place, only 22.3 percent of young people said because e-cigarettes “are available in flavors, such as mint, candy, fruit or chocolate.” That’s about the same number of them who said they use e-cigarettes because “I can use them to do tricks.”

Nevertheless, despite the lack of association between flavors and youth vaping, the Trump administration recently directed the Food and Drug Administration to pull all flavored vaping cartridges from the market, except menthol and tobacco flavors. 

On Fox Business Network’s Kennedy, I briefly elaborated on the negative public health implications of this policy:

“Flavors happen to be a very important factor when adults are making their decisions on whether they’re going to switch from combustible-dangerous-carcinogenic cigarettes to vaping … If you look at the surveys for teen use, and when you ask them why they’re using, ‘curiosity’ by far is the number one reason why they’re using them and flavors happen to be way, way down the totem pole—only [about] 23 percent of teens say flavors even enter any sort of consideration when they are choosing to vape.”

 

The role that flavors play in helping adults quit smoking has been verified by some of the world’s most prestigious medical journals. A study in The BMJ, formerly the British Medical Journal, concluded that if flavors were removed from the e-cigarette market, barring no changes to cigarette availability, there would be about an 11.1 percent decrease in vaping, but an 8.3 percent increase in smoking among adults. This is because e-cigarettes happen to be twice as effective at helping adults quit cigarettes as the current FDA-approved smoking cessation products, according to a randomized controlled trial published by The New England Journal of Medicine

For smokers looking to quit, vaping flavors tend to make the experience more enjoyable. The Trump administration’s recent regulation banning flavors is likely to cause fewer smokers to shift to vaping, which is bad for public health. Another study in The BMJ estimates that if every adult smoker completely switched over to e-cigarettes over a 10-year period there would be “6.6 million fewer premature deaths” from smoking with a total of “86.7 million fewer life years lost.” 

This finding is further supported by a study in the Journal of the American Medical Association, which finds: “Compared with cigarette-only smokers, e-cigarette–only users were found to have significantly lower concentrations of all major nicotine metabolites … [polycyclic aromatic hydrocarbon] biomarkers … [and volatile organic compounds]”—basically the stuff that kills smokers.

Although young people who vape also prefer flavors, there is no evidence that flavors are uniquely appealing to children versus adults. Despite groups like the Campaign for Tobacco Free Kids arguing that “flavored tobacco products are intentionally designed to attract kids,” studies show that both adults and youth tend to prefer flavors at similar rates, with consumption in both age groups mostly reflecting what is purchased by adults in the legal market.

Before Juul voluntarily pulled its fruit-flavored e-cigarette pods from convenience stores, both youth and adults preferred fruit flavors. But after Juul discontinued its fruit flavors, following mounting pressure and raids from the FDA, the mint flavor moved up to assume 75 percent of Juul’s flavor distribution and both adults and youth used mint at the highest rate. Going forward, following the recent prohibition of most characterizing flavors, young people will most likely still vape the menthol and tobacco flavored pods most easily available—just like their adult role models—and the overall youth vaping rates that public health leaders consider an “epidemic” will likely still persist.

Just like with cigarettes, youth use tends to reflect adult use. But with enormous potential public health gains to be had from e-cigarettes making conventional cigarettes obsolete, public policy would be more effective if it is focused on what has proven to be most successful in reducing youth use of all vices: education. Before any historic reduction in youth use of any substance, increased “perception of great risk” has always come first. That’s because young people tend to be smart enough to figure out ways to acquire the products they want, regardless of the law, and thus if the government is looking to prevent youth use it is most advantageous to educate young people about why they shouldn’t vape in the first place.

In 2017, the Truth Initiative conducted a survey and found that over 63 percent of Juul users aged 15-24 didn’t even know that Juul e-cigarettes always contained nicotine. At that time, Juul had only been on the market for a year, and without that knowledge, teens were much more likely to try Juul. With their disproportionate fear of cigarettes and other tobacco products, knowing Juul contained nicotine likely would’ve stopped some teens from trying it.

Today there is good news: the smoking rates among teenagers are at record lows. As a result, it should not be too hard to teach teens that e-cigarettes carry some legitimate risks, such as nicotine addiction, that should be considered. An approach focused on education rather than prohibition is far more likely to successfully reduce teen vaping, while also allowing the adult access to vaping products that might save millions of smokers’ lives.

Jacob James Rich is a policy analyst at Reason Foundation.