ENDS Flavors

From Safer nicotine wiki

It's usually necessary to view the PDF version to access the full study. If you'd like to contribute to this page, please see the instructions at the bottom of the page.

  • This page will attempt to address the following questions:
FAQ: Why are flavored ENDS products important to people who smoke?
FAQ: Why are flavored ENDS products important to people trying to prevent relapse to smoking?
FAQ: Do flavors entice youth to illegally use ENDS products?
FAQ: When comparing continuum of risk, how do flavored ENDS products compare to smoking?
FAQ: Are the flavors a threat to public health?
FAQ: Are there any unintended consequences to banning flavored ENDS products?
FAQ: Does diacetyl, a flavoring agent compound in ENDS products cause Popcorn Lung?


Personal Testimonies from people who used to smoke

All Years: Video Collection: Golden Oldies Capitol Tours

  • People who used to smoke share how long they smoked and what flavors helped them to quit smoking.


All Years: Collection 13,000+ Testimonies: CASAA - REAL PEOPLE. REAL STORIES.

  • Online submissions of personal testimonies by people who switched from smoking to harm reduction products.


2915 Blog: Cotton Candy is NOT Marketing To Kids

  • She says "honey, you need to get with the program, we were too poor when I was a kid to afford cotton candy, so now I'm having it whenever I want and any way I want it. Now give me the sweetest thing you got and I want cotton candy the next time I come here."
  • "Ma'am, if you don't mind me asking, how old are you?". She looks at me and says "82, I quit smoking 6 months ago and now I'm going to live to be 102."


Abuse Liability - All THR Products

2020: Abuse liability assessment of the JUUL system in four flavors relative to combustible cigarette, nicotine gum and a comparator electronic nicotine delivery system among adult smokers

  • Controlled use of JS (JUUL System) among adult smokers resulted in nicotine delivery, product liking, and satisfaction that were less than that of combustible cigarettes but generally greater than nicotine gum. These results support the conclusion that JS has lower abuse liability than combustible cigarettes, higher abuse liability than nicotine gum, and may provide sufficient nicotine delivery and satisfying effects to support substitution for combustible cigarettes among adult smokers.
  • PDF Version
  • Citation: Nicholas I. Goldenson, August R. Buchhalter, Erik M. Augustson, Mark L. Rubinstein, Jack E. Henningfield, Abuse liability assessment of the JUUL system in four flavors relative to combustible cigarette, nicotine gum and a comparator electronic nicotine delivery system among adult smokers, Drug and Alcohol Dependence, Volume 217, 2020, 108395, ISSN 0376-8716, doi:10.1016/j.drugalcdep.2020.108395.
  • Acknowledgement: The study was funded by Juul Labs, Inc.


2003: Subjective effects of the nicotine lozenge: assessment of abuse liability

  • In conclusion, results of the present study suggest that abuse liability of nicotine lozenges is low. Low abuse liability of the novel nicotine lozenges is in accordance with current knowledge of consumer use patterns of other, already marketed nicotine replacement therapies, which suggest little abuse of these products once they are marketed. Dose-dependent craving reduction by the lozenges in adults (22–50 years) but not young adults (18–21 years) suggests efficacy of the lozenge for adults, and reinforces the need for further studies of nicotine delivery systems as a treatment for nicotine dependence in younger adults and adolescents
  • PDF Version
  • Citation: Houtsmuller, E. J., Henningfield, J. E., & Stitzer, M. L. (2003). Subjective effects of the nicotine lozenge: assessment of abuse liability. Psychopharmacology, 167(1), 20–27. doi:10.1007/s00213-002-1361-2
  • Acknowledgement: This research was supported by SmithKline Beecham Consumer Healthcare.


2002: Flavor improvement does not increase abuse liability of nicotine chewing gum

  • Improved flavor of nicotine gum does not increase abuse liability, but may be associated with enhanced craving reduction.
  • mint-flavored nicotine gum was rated as more palatable than the original nicotine gum, but the improvement in flavor did not increase abuse liability in adults (22 – 50 years old) or young adults (18 –21 years old). Since the aversive taste of the original nicotine gum was an important impediment to compliance (Rose, 1996) and treatment initiation, the availability of nicotine gum in different flavors and the development of alternative oral nicotine replacement products with appealing flavors may improve compliance and expand the range of options for those attempting to quit smoking, without posing an increased risk of abuse.
  • PDF Version
  • Citation: Houtsmuller, E. J., Fant, R. V., Eissenberg, T. E., Henningfield, J. E., & Stitzer, M. L. (2002). Flavor improvement does not increase abuse liability of nicotine chewing gum. Pharmacology Biochemistry and Behavior, 72(3), 559–568. doi:10.1016/s0091-3057(02)00723-2
  • Acknowledgement: This study was supported by SmithKline Beecham Consumer Healthcare.

Public Health Advantages / Concerns of Public Health Harms

2020: Investigation on the antibacterial activity of electronic cigarette liquids (ECLs): a proof of concept study

  • Our results have shown that flavors considerably enhance antibacterial activity.
  • This study provides important evidence that should be taken into consideration in further investigative approaches, to clarify the different sensitivity of the various bacterial species to e-liquids, including the respiratory microbiota, to highlight the possible role of flavors and nicotine.
  • Citation: Virginia Fuochi, Massimo Caruso , Rosalia Emma, Aldo Stivala, Riccardo Polosa, Alfio Distefano and Pio Maria Furneri *, “Investigation on the Antibacterial Activity of Electronic Cigarette Liquids (ECLs): A Proof of Concept Study”, Current Pharmaceutical Biotechnology (2020) 21: 1. doi:10.2174/1389201021666200903121624


2019: RE: Vape related "Popcorn Lung" debunked years ago

    • There is 750x more diacetyl in a pack of cigarettes than there is in a days worth of vaping nicotine fluid, and to date we have no confirmation that smokers are getting popcorn lung.
  • 2015 New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking
    • There's just one minor fact that is omitted completely in the article, as well as in all the media coverage.
    • That fact: All conventional cigarettes produce tobacco smoke that contains diacetyl, and the levels of diacetyl in cigarettes are a lot higher than those produced by e-cigarettes.


2019: High Content Screening in NHBE cells shows significantly reduced biological activity of flavoured e-liquids, when compared to cigarette smoke condensate

  • Our results clearly show a lower toxicity of e-liquids, including flavoured e-liquids, when compared to CSC (cigarette smoke condensate). Typically, more than 100 times higher concentrations of CFs (commercial flavoured e-liquids) are required to elicit the same response as those observed for 3R4F CSC in specific endpoints.
  • Flavours play a critical role in attracting, and retaining smokers to e-cigarettes.
  • PDF Version
  • Citation: Lukasz Czekala, Liam Simms, Matthew Stevenson, Edgar Trelles-Sticken, Paul Walker, Tanvir Walele, High Content Screening in NHBE cells shows significantly reduced biological activity of flavoured e-liquids, when compared to cigarette smoke condensate, Toxicology in Vitro, Volume 58, 2019, Pages 86-96, ISSN 0887-2333, doi:10.1016/j.tiv.2019.03.018.
  • Acknowledgements: This work was funded and supported by Fontem Ventures B.V., part of Imperial Brands Group PLC.
  • Keywords: Flavours, In vitro, Normal Human Bronchial Epithelial cells, High Content Screening, E-liquids, Cigarette, flavor, flavoring, flavored


2019: Toxicity classification of e-cigarette flavouring compounds based on European Union regulation: analysis of findings from a recent study

  • The vast majority of flavouring (flavoring) compounds in e-cigarette liquids as reported in a recent study were present at levels far lower than needed to classify them as toxic.
  • PDF Version
  • Farsalinos, K., Lagoumintzis, G. Toxicity classification of e-cigarette flavouring compounds based on European Union regulation: analysis of findings from a recent study. Harm Reduct J 16, 48 (2019). doi: 10.1186/s12954-019-0318-2
  • Acknowledgements: The authors report no conflict of interest for the past 36 months. For the past 60 months, KF has published 2 studies funded by the non-profit association AEMSA and 1 study funded by the non-profit association Tennessee Smoke-Free Association.


2019: Effects of flavoring compounds used in electronic cigarette refill liquids on endothelial and vascular function

  • Our data indicate that flavorings typically present in e-cig refill liquids do not cause endothelial dysfunction that would result in impaired vasodilation upon acute exposure. In contrast, most of the tested compounds caused endothelium-independent vasorelaxation, albeit at fairly high concentrations that appear to exceed by far the plasma concentrations expected to occur upon vaping flavored liquids.
  • PDF Version
  • Citation: Wölkart G, Kollau A, Stessel H, Russwurm M, Koesling D, Schrammel A, et al. (2019) Effects of flavoring compounds used in electronic cigarette refill liquids on endothelial and vascular function. PLoS ONE 14(9): e0222152. https://doi.org/10.1371/journal.pone.0222152
  • Acknowledgement: This work was supported by the Austrian Science Fund (FWF) grant [P24946] to BM.


2018: A QUESTION OF TASTE: THE PUBLIC HEALTH CASE FOR E-CIGARETTE FLAVORS

  • The available evidence on flavored e-cigarettes suggests that flavors in and of themselves are not especially appealing to non-smoking adults or adolescents. There is, however, a substantial and growing literature on how and why these products appeal to smoking adults and their potential to help consumers switch from smoking to less-harmful vaping.
  • Any policy that harms the exclusive makers of reduced-risk products such as e-cigarettes more than the makers of traditional cigarettes is not in the interests of public health.
  • Report Author (55 pages): Guy Bentley


2018: Paper: E-cigarette flavors and aldehyde emissions: another failure to verify findings from a previous study

    • Our results were revealing in identifying a very small contribution of flavorings on aldehyde emissions. In fact, aldehyde levels were so low that consumption of 5 grams e-liquid per day would expose vapers to less formaldehyde and acetaldehyde than just staying at home and breathing air. For acrolein, exposure was orders of magnitude lower compared to NIOSH-defined recommended safety limits. To give you an idea of the differences in results, the authors of the original study found up to 7000 ug/g formaldehyde, while we found a maximum of 62 ug/g.
  • 2017: Study: Do flavouring compounds contribute to aldehyde emissions in e-cigarettes?
    • In conclusion, we confirmed that flavouring compounds can contribute to aldehyde emissions from ECs, but such contribution, detected in only 3 liquids and two flavours herein, was minimal. (flavor, flavors, flavoring, flavorings)
    • PDF Version
    • Citation: Farsalinos, K. E., & Voudris, V. (2018). Do flavouring compounds contribute to aldehyde emissions in e-cigarettes? Food and Chemical Toxicology, 115, 212–217. doi:10.1016/j.fct.2018.02.059
    • Acknowledgement: The study was funded by Public Health England.
  • 2017: Follow Up: Comment on “Flavoring Compounds Dominate Toxic Aldehyde Production during E Cigarette Vaping”
    • We would like to point out that the finding is in a stark contrast to previous results.
    • The high levels only happen under dry puff conditions, something avoided by vapers as it is very unpleasant.


2017: Evaluation of Chemical Exposures at a Vape Shop

  • We collected air samples for flavoring chemicals (diacetyl, 2,3-pentanedione, 2,3-hexanedione, acetaldehyde, and acetoin), nicotine, formaldehyde, and propylene glycol.
  • Concentrations of vaping-related chemicals in our air samples were below occupational exposure limits.
  • Citation: NIOSH 2017. Evaluation of chemical exposures at a vape shop. By Zwack LM, Stefaniak AB, LeBouf RF. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Hazard Evaluation Report 2015-0107-3279


2016: Cigarette smoking and electronic cigarette vaping patterns as a function of e-cigarette flavourings

  • The findings suggest that adoption of e-cigarettes in smokers may influence smoking rates of people who smoke.
  • E-cigarette vaping rates are influenced by flavorings by people transitioning from smoking.
  • These findings have implications for the utility of e-cigarettes as a nicotine replacement device and for the regulation of e-cigarettes for harm reduction.
  • PDF Version
  • Citation: Litt MD, Duffy V, Oncken C. Cigarette smoking and electronic cigarette vaping patterns as a function of e-cigarette flavourings, Tobacco Control 2016;25:ii67-ii72.
  • Acknowledgement: Support for this project was provided by Grant 1 R01 DA036492 from the National Institute on Drug Abuse, and in part by General Clinical Research Center Grant M01-RR06192 from the National Institutes of Health.


2015: Medical journal misrepresents a case of hypersensitivity pneumonitis as popcorn lung disease caused by e-cigarette

  • It was shocking to see a public statement reporting a case of popcorn lung disease in a patient using e-cigarettes. The title of the public release is: “Case report finds 'popcorn lung' in patient using e-cigarettes. Report points to possibility of diacetyl, a flavoring agent in e-cigarettes, to bronchiolitis obliterans syndrome”
  • The case report is NOT about popcorn lung disease. The article then goes on to explain why it can’t be popcorn lung.


2015: An approach to ingredient screening and toxicological risk assessment of flavours in e-liquids

  • In vitro and Animal
  • Individual flavours or groups of flavours were added to the tobacco rod and the resultant smoke was analysed for priority smoke constituents and tested in several in vitro tests as well as 90-day rat inhalation studies. In general, addition of the flavours had no effect on, or reduced the levels of most of the measured smoke constituents.”
  • PDF Version
  • Citation: S. Costigan, C. Meredith, An approach to ingredient screening and toxicological risk assessment of flavours in e-liquids, Regulatory Toxicology and Pharmacology, Volume 72, Issue 2, 2015, Pages 361-369, ISSN 0273-2300, doi: 10.1016/j.yrtph.2015.05.018.
  • Acknowledgements: This work was joint funded by Nicoventures and British American Tobacco (BAT), and the authors are full time employees of Nicoventures and British American Tobacco (BAT).


2013: Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour (Vapor) Extract on Cultured Myocardial Cells

  • Smoking is an important risk factor for cardiovascular disease and cigarette smoke (CS) has well-established cytotoxic effects on myocardial cells. The purpose of this study was to evaluate the cytotoxic potential of the vapour of 20 EC (e-cigarette) liquid samples and a “base” liquid sample (50% glycerol and 50% propylene glycol, with no nicotine or flavourings) on cultured myocardial cells. Included were 4 samples produced by using cured tobacco leaves in order to extract the tobacco flavour. Methods: Cytotoxicity was tested according to the ISO 10993-5 standard.
  • In conclusion, from 20 commercially-available EC liquids that were tested in vapour form, four were found to be cytotoxic on cultured cardiomyoblasts. Cytotoxicity was mainly observed in most (but not all) samples produced by using tobacco leaves, while one sample using food-approved flavoring was marginally cytotoxic. EC vapour production by using higher-voltage devices caused a decrease in cell survival. Overall, EC vapour extracts showed significantly higher cell viability compared to CS extract, based on a realistic-use rather than a standardized comparative level of exposure. This supports the concept that ECs may be useful as tobacco harm reduction products.
  • PDF Version
  • Citation: Farsalinos, K., Romagna, G., Allifranchini, E., Ripamonti, E., Bocchietto, E., Todeschi, S., … Voudris, V. (2013). Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour Extract on Cultured Myocardial Cells. International Journal of Environmental Research and Public Health, 10(10), 5146–5162. doi:10.3390/ijerph10105146
  • Acknowledgement: The study was funded in part by the Greek Association of E-cigarette Businesses (SEEHT).


Regulations or Unintended Consequences

2021: Reactions to sales restrictions on flavored vape products or all vape products among young adults in the US


2021: Testimony in Netherlands pertaining to a potential flavour / flavor ban: Regulation of e-cigarette flavours – a response

  • Signed by 24 experts from around the world
  • Covers 12 key points


2020: Association of vaping‐related lung injuries with rates of e‐cigarette and cannabis use across US states

  • Policymakers should proceed with caution when considering bans on flavored nicotine e‐liquids: restricting legal sales may push some vapers towards illicit sources, user‐modified e‐liquids (e.g. to add flavoring) or even conventional cigarette use. Given EVALI’s potential lethality and a myriad of work suggesting that conventional cigarette use is probably far more dangerous than vaping nicotine, these outcomes could be disastrous for public health. There is no link between nicotine liquids and EVALI. It appears to have come from illicit cannabis products.
  • Link above is to the PDF version
  • Citation: Friedman, A. S. (2020). Association of Vaping‐related Lung Injuries with Rates of E‐cigarette and Cannabis Use across US States. Addiction. doi:10.1111/add.15235
  • Acknowledgement: Research reported in this publication was supported by grant number 3U54DA036151‐08S2 from the National Institute On Drug Abuse of the National Institutes of Health and FDA Center for Tobacco Products (CTP).


2020: The impact of a comprehensive tobacco product flavor ban in San Francisco among young adults

  • Among the 18–24 age group, there was a significant increase in cigarette smoking.
  • Cigarette smoking increased among 25–34 years old.
  • Banning flavors in e-cigarettes can push some e-cigarette users to turn to cigarette smoking and could prompt some youth to initiate into smoking instead of e-cigarette use.
  • The proportions of e-cigarettes, cigarettes, and cigars obtained over the internet increased after the ban, and the proportions obtained from retailers outside of San Francisco also increased overall.
  • PDF Version
  • Citation: Yang, Y., Lindblom, E. N., Salloum, R. G., & Ward, K. D. (2020). The impact of a comprehensive tobacco product flavor ban in San Francisco among young adults. Addictive Behaviors Reports, 11, 100273. doi:10.1016/j.abrep.2020.100273
  • Acknowledgement: This research was supported by the National Institute of Drug Abuse of the National Institutes of Health (R03DA048460).


2020: Article: Yale Study on Lung Disease Forecasts Dire Consequences for Flavor Bans

  • A new study from Yale School of Public Health should serve as a warning to e-cigarette opponents and public health officials pushing e-cigarette flavor bans and restrictions around the country.
  • By pushing people into the black market for flavored products, they are increasing the risk that we will see another wave of consumers sickened by unregulated, illegal goods.
  • Citation: Elizabeth Sheld, Real Clear Policy, October 01, 2020.


2019: Changes in Flavor Preference in a Cohort of Long-Term Electronic Cigarette Users

  • Our results regarding anticipated reactions to FDA e-cigarette flavor regulation suggest complexities such that the benefits and risks of flavor ban need to be carefully evaluated.
  • A majority anticipated that they would personally attempt to circumvent potential FDA regulations of e-cigarettes by obtaining e-cigarette flavors from various illicit sources (e.g., Internet orders from foreign countries) or even self-making flavors.
  • The use of flavoring agents purchased from unregulated sources could lead to additional unanticipated toxicities.
  • It is also concerning that some established e-cigarette users believed that they would return to cigarette smoking if nontobacco e-cigarette flavors were banned. Thus, for adult e-cigarette users who use certain flavors to facilitate smoking cessation or reduction, banning all nontobacco flavors could precipitate relapse to smoking.
  • PDF Version
  • Citation: Ann Am Thorac Soc Vol 17, No 5, pp 573–581, May 2020, Copyright © 2020 by the American Thoracic Society, DOI: 10.1513/AnnalsATS.201906-472OC
  • Acknowledgement: Supported by the National Institute on Drug Abuse of the National Institutes of Health (NIH) and the Center for Tobacco Products of the U.S. Food and Drug Administration (FDA) (P50-DA-036107) for the Penn State Tobacco Center of Regulatory Science.


2019: Article: Vape flavor ban doesn't help kids, hurts adults

  • Tobacco users who switch from combustible cigarettes to e-cigarettes experience various improvements in health.
  • Using e-cigarettes also helps people quit smoking altogether, with twice the success rate of other quit methods.
  • Researchers have yet to demonstrate that an e-cigarette flavor ban will prevent minors from obtaining and experimenting with tobacco products.
  • The ban creates a greater opportunity for people — including adolescents — to interact with law enforcement, putting them at increased risk of becoming involved with the criminal justice system.
  • Citation: Jesse Kelly & Carrie Wade, September 15, 2019, The Detroit News


2019: Article: Flavor ban will feed illegal tobacco sales, stores say

  • A retired federal law enforcement officer cautioned against banning flavors.
  • “If this bill passes and we bring in prohibition, we’re going to bring crime into the city,” Marianos, who is now an adjunct faculty member at Georgetown University, said. “We’re going to replace store owners and manufacturers with people selling out of backpacks, people selling out of cars, and worst of all, people selling directly to the children we’re trying to protect.”
  • Citation: Colin Young, November 04, 2019, 22 News WWLP


2019: Article: E-cigarette flavor ban — ineffective and dangerous

  • Bans don’t work. Bans never work. All bans do is push consumers to make different, usually more risky, choices. In this case, the likely outcome of banning e-liquid flavors people want is that they will seek to obtain them through the black market or simply return to smoking cigarettes. As a result, many more will die of smoking-related diseases or tainted products.
  • The wide array of flavors, produced by thousands of vapor companies around the country — most of them small — appear to be critical in persuading smokers to try vaping and preventing e-cigarette users from returning to their deadly combustible cigarette habit.
  • As a society, we have found satisfactory ways to address youth access to many adult products, like alcohol and marijuana. Given that e-cigarettes have the potential to save lives, regulators have a responsibility to find a similarly sophisticated solution to the youth vaping problem. Or, they can follow Michigan’s lead and learn the same lesson repeated throughout history: prohibition always causes more problems than it solves.
  • Citation: Michelle Minton, September 23, 2019, South Florida Sun Sentinel


2019: Article: Vapers Turn to Home Brew as Flavored Nicotine Bans Mount

  • “Even though I haven’t touched a cigarette in five years, the pull is always there. It’s so easy to go and buy a pack. And I don’t want to do that,” Danielle Jones said. “The only route I can see going forward if there is a ban is to try to create the product myself at home.”
  • As more states, cities and even the federal government consider banning flavored nicotine, thousands of do-it-yourself vapers like Jones are flocking to social media groups and websites to learn how to make e-liquids at home.
  • “To have people mixing their own e-cigarette liquid is crazy.” said Stanton Glantz, a professor of medicine and the director of the Center for Tobacco Control Research and Education at the University of California-San Francisco.
  • Dr. Michael Siegel, a professor of community health sciences at Boston University, worries about the risk of contaminated products as some people use the bans as an opportunity to make their own concoctions cheaply and sell them on the black market. “Who knows what they’re going to put in there?” Siegel said. “This is just what happens when you use prohibition as a regulatory approach.
  • Alex Clark, CEO of the Consumer Advocates for Smoke-Free Alternatives Association (CASAA), said he plans to warn the nonprofit’s more than 200,000 members about the dangers of making e-liquid at home. Clark notes that people should not use flavors found in the baking aisle of a grocery store.
  • Citation: Jenny Gold, November 12, 2019, Kaiser Health News KQED


2019: Article: The Vaping Overreaction Politicians who ban flavors should brace for a surge in cigarette smoking and the use of questionable bootleg vaping products.

  • The ethos of vaping is relative risk. E-cigarettes reduce harm, but can’t be called harmless. As a safer alternative than smoking for people addicted to nicotine, they are analogous to prescribing methadone for people addicted to opioids, a strategy called harm reduction. Other kinds of harm reduction, such as giving clean needles to injection-drug users and distributing condoms, pre-exposure prophylactic medication, and safe-sex information for populations at risk for HIV/AIDS, are widely endorsed by the public-health establishment.
  • In light of history, public-health advocates’ skepticism about e-cigarettes, at least when they first appeared, was understandable. But genuine advances really can occur, and the evidence suggests that the shift from smoking to vaping should be celebrated, not decried.
  • Claims that nicotine alone leads to brain damage in youth have limited empirical support; most of the relevant literature involves studies of teens exposed to the substance via smoking. I mention this not to dismiss the problem of teen vaping—the FDA and other agencies are rightly trying to curb teen access—but merely to warn against rash, misdirected responses that will prevent today’s smokers from quitting.
  • Unfortunately, the misconceptions surrounding vaping may be too well entrenched. A Kaiser poll conducted this month revealed that 49 percent of respondents support banning all e-cigarettes, not just flavored ones. That would be a deadly mistake. “If we lose this opportunity,” David S. Abrams, a professor at the New York University College of Global Public Health, told CBS Morning News last month, “we will have blown the single biggest public-health opportunity ever to get rid of cigarettes and replace them with a much safer form of nicotine for everybody.” With 35 million Americans still smoking, the stakes are high.


2019: Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions

  • Hypothetical regulations resulted in reported intentions to reduce EC (e-cigarette) use and increase CC (combustible cigarette) use; the greatest impact was found for restrictions regarding e-liquid nicotine content, followed by flavor
  • This work provides preliminary evidence that restrictive regulations regarding key EC characteristics may increase intentions to increase CC use among young adult dual EC and CC users.
  • PDF Version
  • Citation:: Lauren R. Pacek, Olga Rass, Maggie M. Sweitzer, Jason A. Oliver & F. Joseph McClernon (2019): Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions, Substance Use & Misuse, DOI:10.1080/10826084.2019.1626435
  • Acklnowledgement: This work was supported by the National Institutes of Health (K01DA043413, K23DA039294, and K23DA042898). The funding source had no other role other than financial support.


2018: Patterns of flavored e-cigarette use among adults vapers in the United States: an internet survey

  • Survey results submitted to the FDA
  • In conclusion, this cross-sectional study of a very large sample of adult US e-cigarette users, most of which were former smokers, identified the importance of non-tobacco flavors in e-cigarette use initiation and sustained use, and their contribution to smoking cessation and relapse prevention. *This information should be considered by regulators in order to avoid unintentional adverse effects of over-restrictive regulation on e-cigarette flavors.
  • PDF Version
  • Citation: Konstantinos Farsalinos, MD, MPH, Christopher Russell, PhD, George Lagoumintzis, PhD, Konstantinos Poulas, Submitted to: Docket No. FDA-2017 N-6565 for “Regulation of Flavors in Tobacco Products.”


2018: Should flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experiment

  • A ban on flavoured e-cigarettes would likely increase the choice of cigarettes in smokers, the more harmful way of obtaining nicotine.
  • PDF Version
  • Citation:Buckell J, Marti J, Sindelar JLShould flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experimentTobacco Control 2019;28:168-175.
  • Acknowledgement: Research reported in this publication was supported by grant number P50DA036151 from the National Institute on Drug Abuse (NIDA) and FDA Center for Tobacco Products (CTP).

Relapse Prevention or Long Term Abstinence

2020: Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers

  • Qualitative research suggests e-cigarettes can meet many of the needs of ex-smokers by substituting physical, psychological, social, cultural and identity-related aspects of tobacco addiction.
  • According to a time-series analysis of data from the Smoking Toolkit study, in which repeated cross-sectional surveys are conducted with a representative sample of households in England, increasing prevalence of e-cigarette use in current smokers was predictive of higher success rates of quit attempts.
  • Most participants were self-reported long-term abstinent smokers (86.3%).
  • Those who start on a low self-reported nicotine e-liquid concentration (strength) will be more likely to relapse to tobacco smoking than those starting on a higher nicotine e-liquid, after controlling for cigarettes per day (CPD) before cessation.
  • Results suggest a change in flavor choices over the course of vaping initiation and uptake. There was a reduction in the proportion of people using a tobacco flavor, and increase in the proportion using a fruit/sweet/food flavor, from initial to current flavor choice
  • According to the 2017 ASH-A survey, among current users, fruit flavors were the most popular.
  • PDF Version
  • Citation: Gentry, S.V., Ward, E., Dawkins, L. et al. Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers. Harm Reduct J 17, 70 (2020). doi:10.1186/s12954-020-00418-8
  • Acknowledgement: This research was funded by Cancer Research UK (CRUK), Grant Number C54889/A22732.


2019: Article: E-Cigarette Flavor Bans Will Drive More People Back to Smoking

  • These laws will result in thousands of ex-smokers returning to cigarette smoking because the e-cigarettes they rely upon are taken off the shelves, while tobacco cigarettes remain. The absurdity of these proposals is that they restrict the sale of e-cigarettes more severely than the sale of actual cigarettes, the ones that are killing more than 400,000 Americans each year. Why would regulators want to give a competitive advantage to cigarettes over the much safer alternative?
  • By creating barriers to a much healthier product, these laws will simply force former smokers to return to cigarette smoking. Lawmakers are doing a huge favor not for the public’s health, but for Marlboro, which is going to see a windfall in the ex-smoker market as all of its competition from vaping products is eliminated.
  • Citation: Michael Siegel, February 19, 2019, Inside Sources


Smoking Cessation

2021: How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys

  • Use of fruit and other sweet flavored e-liquids is positively related to smokers’ transition away from cigarettes.
  • Citation: Lin Li, PhD, Ron Borland, PhD, Kenneth Michael Cummings, PhD, Geoffrey T Fong, PhD, Shannon Gravely, PhD, Danielle M Smith, MPH, Maciej L Goniewicz, PhD, Richard J O’Connor, PhD, Mary E Thompson, PhD, Ann McNeill, PhD, How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys, Nicotine & Tobacco Research, Volume 23, Issue 9, September 2021, Pages 1490–1497, doi: 10.1093/ntr/ntab033


2020: Associations of Flavored e-Cigarette Uptake With Subsequent Smoking Initiation and Cessation

  • Adults who began vaping nontobacco-flavored e-cigarettes were more likely to quit smoking than those who vaped tobacco flavors.
  • Banning flavors altogether may be too blunt an instrument for the current problem (youth use of vapor products).
  • PDF Version
  • Citation: Friedman, A. S., & Xu, S. (2020). Associations of Flavored e-Cigarette Uptake With Subsequent Smoking Initiation and Cessation. JAMA Network Open, 3(6), e203826. doi:10.1001/jamanetworkopen.2020.3826
  • Acknowledgment: : Ms Xu was supported by a T32 National Research Service Award from the Agency for Healthcare Research and Quality (HS017589).


2019: The role of flavors in vaping initiation and satisfaction among U.S. adults

  • Most common reasons for vaping initiation were as an alternative to cigarettes (43.7%) and because respondents viewed e-cigarettes as less harmful than other tobacco products (31.2%). Flavor was the third most commonly reported reason.
  • Satisfaction among those who bought flavored e-liquid was higher than those who did not buy flavored e-liquid.
  • PDF Version
  • Citation: Landry, R. L., Groom, A. L., Vu, T.-H. T., Stokes, A. C., Berry, K. M., Kesh, A., … Payne, T. J. (2019). The role of flavors in vaping initiation and satisfaction among U.S. adults. Addictive Behaviors, 106077. doi:10.1016/j.addbeh.2019.106077
  • This research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) and the FDA Center for Tobacco Products (CTP) under Awards P50HL120163 and U54HL120163.


2019: Vaping patterns, nicotine dependence and reasons for vaping among American Indian dual users of cigarettes and electronic cigarettes

  • The ten-item Penn State Dependence Index (PSDI) suggested greater dependence on smoking than vaping
  • The most common reasons for vaping were to reduce smoking (79%), enjoyment of flavors (78%), and ability to vape where smoking is not allowed (73%). Perceptions of less harm to others (69%) or to self were the next most common (65%). Fewer than half used ECs to reduce stress, for affordability, or because others used them.
  • PDF Version
  • Citation: Rhoades DA, Comiford AL, Dvorak JD, Ding K, Hopkins M, Spicer P, Wagener TL, Doescher MP. Vaping patterns, nicotine dependence and reasons for vaping among American Indian dual users of cigarettes and electronic cigarettes. BMC Public Health. 2019 Sep 2;19(1):1211. doi: 10.1186/s12889-019-7523-5. PMID: 31477072; PMCID: PMC6721166.
  • Acknowledgement: Grants from the National Cancer Institute of the National Institutes of Health (P20CA202921 to University of Oklahoma, and 5P20CA202923 to Cherokee Nation) supported this study.


2019: Video: Can Flavors Help People Who Smoke Quit Smoking?

  • Minnesota Smoke-Free Alliance
  • Do flavors help adults quit smoking? Is there "right" flavored products and "wrong" flavored products? Do we have the right to tell people they have to quit smoking using a method we approve of? (English)


2019: Article: Flavors make vaping more palatable, help cigarette smokers kick the habit

  • Flavored e-cigarettes were not invented by “Big Tobacco,” nor are they an unscrupulous marketing plot from the thousands of small, independently owned vape companies in the United States to addict kids. Non-tobacco vape flavors are a user innovation.
  • Fruit, candy, bakery, mint, and beverage flavors were introduced to vaping in 2008 by pioneering users of the technology who were desperate to use e-cigarettes to replace smoking.
  • Flavors like cotton candy, bubble gum, and the many other examples opponents claim are obviously targeted to youth are in fact flavors someone trying to quit smoking wanted to vape and mixed themselves. These innovations in home-mixing resulted in the commercial market about to be banned today.
  • The preponderance of evidence indicates that non-tobacco flavors, including fruit, dessert, and candy, are essential to vaping as an effective way to quit smoking and avoid relapse.
  • Citation: Amelia Howard, September 21, 2019, Pro/Con: As vaping-related illnesses rise, should flavored e-cigarettes be banned?, The Philadelphia Enquirer


2019: Article: Banning flavored e-cigarettes has consequences

  • Instead of clamping down on teen vaping or socking it to Juul, a total vape flavor ban would shut down more than 14,000 small businesses and put at least 166,000 people out of work, while denying millions of Americans access to the tools they used to quit smoking.
  • E-cigarettes are known to be at least 95 percent safer than combustible cigarettes. If every smoker in America switched to vaping, as many as 6.6 million lives could be saved over the next decade.
  • Additionally, a study published in the New England Journal of Medicine found e-cigarettes to be almost twice as effective as traditional nicotine replacement therapies at helping smokers quit.
  • The consequences of banning flavors are as obvious as they are tragic. Analyzing the potential effects of different tobacco flavor bans, researchers at the Yale School of Public Health concluded that banning e-cigarette flavors would result in more smoking.
  • Citation: Guy Bentley, November 28, 2019, The Pueblo Chieftain


2018: Advice From Former-Smoking E-Cigarette Users to Current Smokers on How to Use E-Cigarettes as Part of an Attempt to Quit Smoking

  • This study describes the advice that former-smokers who used e-cigarettes to quit smoking would offer to smokers who are considering using an e-cigarette to support an attempt to quit smoking. Vapers advised smokers to find the right combination of device, flavors and nicotine strength, continue to smoke and vape for a while if they wished, not be deterred by past failed attempts to quit smoking, and expect health to improve after they have switched to vaping. Encouraging smokers to interact with vaping peers in vape shops and in online vaping-dedicated discussion forums may help significantly more smokers switch to vaping.
  • PDF Version
  • Citation: Christopher Russell, PhD, Tiffany Dickson, MSc, Neil McKeganey, PhD, Advice From Former-Smoking E-Cigarette Users to Current Smokers on How to Use E-Cigarettes as Part of an Attempt to Quit Smoking, Nicotine & Tobacco Research, Volume 20, Issue 8, August 2018, Pages 977–984, doi: 10.1093/ntr/ntx176
  • Acknowledgement: Funding for this study was provided by Nicoventures.


2017: Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes

  • To the extent that dual users substantially lower the number of cigarettes, they will reduce health risks from smoking. However, from a medical point of view, exclusive vaping is preferable to dual use;
  • Differences between dual users and switchers center around variables proximal to the vaping behavior and its experienced effects rather than hinging on more general vaping-related beliefs and attitudes.
  • After e-cig initiation, dual users decreased tobacco consumption by 82% and were low-to-moderately cigarette dependent.
  • The two groups (dual users and switchers) reported mostly using a flavor other than tobacco.
  • PDF Version
  • Citation: Adriaens K, Van Gucht D, Baeyens F. Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes. Int J Environ Res Public Health. 2017 Dec 23;15(1):12. doi: 10.3390/ijerph15010012. PMID: 29295483; PMCID: PMC5800112.


2015: Preferred Flavors and Reasons for E-cigarette Use and Discontinued Use Among Never, Current, and Former Smokers

  • Never users had significantly lower prevalence of use of alcohol, marijuana, and other tobacco products (take less risks).
  • The most commonly reported reasons for e-cigarette use were “they might be less harmful than cigarettes” (77%); “they don’t smell” (77%); “they help people quit smoking” (66%); and “they cost less than other forms of tobacco” (62%); these reasons were more frequently endorsed by former smokers.
  • Among current e-cigarette users, the most commonly used flavor was fruit flavors (67%)
  • Over 90% of former cigarette smokers who were current e-cigarette users reported using e-cigarettes to quit smoking.
  • Over half of never smokers who are former e-cigarette users said they did not recently use e-cigarettes because they “just don’t think about it”, possibly indicating that addiction did not play a role in their use.
  • PDF Version
  • Citation: Berg CJ. Preferred flavors and reasons for e-cigarette use and discontinued use among never, current, and former smokers. Int J Public Health. 2016 Mar;61(2):225-36. doi: 10.1007/s00038-015-0764-x. Epub 2015 Nov 18. PMID: 26582009; PMCID: PMC4808473.
  • Acknowledgement: This research was supported by the National Cancer Institute (1K07CA139114-01A1; PI: Berg) and the Georgia Cancer Coalition (PI: Berg).


2013: Impact of Flavour Variability on Electronic Cigarette Use Experience: An Internet Survey

  • 4,618 participants were included in the analysis, with 4,515 reporting current smoking status (current vs. former smokers).
  • More than 90% were former smokers. The mean age was 40 years
  • At the time of participation, most commonly used flavors were fruits, followed by sweets.
  • Most participants (68.3%) were switching between flavours on a daily basis or within the day, with former smokers switching more frequently. More than half of the study sample mentioned that they like the variety of flavours and that the taste gets blunt from long-term use of the same flavour. The average score for importance of flavours variability in reducing or quitting smoking was 4 (“very important”). Finally, the majority of participants stated that restricting variability of flavours would make the EC experience less enjoyable while almost half of them answered that it would increase craving for tobacco cigarettes and would make reducing or completely substituting smoking less likely.
  • The results of this survey indicate that EC liquid flavourings play a major role in the overall experience of dedicated users and support the hypothesis that they are important contributors in reducing or eliminating smoking consumption.
  • PDF Version
  • Citation: Farsalinos, K., Romagna, G., Tsiapras, D., Kyrzopoulos, S., Spyrou, A., & Voudris, V. (2013). Impact of Flavour Variability on Electronic Cigarette Use Experience: An Internet Survey. International Journal of Environmental Research and Public Health, 10(12), 7272–7282. doi:10.3390/ijerph10127272
  • Acknowledgement: No funding was received for this study.


2006: Tobacco Dependence: Global Public Health Potential for New Medications Development and Indications

  • The marketing of a mint-flavored form of nicotine gum in the United States increased the market for nicotine gum by more than 25% and contributed to increasing numbers of smokers finding a treatment that was acceptable and thereby successfully quitting smoking.
  • There is clearly a need for increased forms of nicotine delivery, possibly including those that more closely mimic the pharmacokinetics of cigarettes.
  • PDF Version
  • Citation: HENNINGFIELD, J. E., FANT, R. V., GITCHELL, J., & SHIFFMAN, S. (2006). Tobacco Dependence: Global Public Health Potential for New Medications Development and Indications. Annals of the New York Academy of Sciences, 909(1), 247–256. doi:10.1111/j.1749-6632.2000.tb06686.x
  • Acknowledgement: Portions of this paper were adapted from a paper submitted by these authors to The Economics of Neuroscience. 37 The preparation of this paper was partially supported by unrestricted funding by SmithKline Beecham Consumer Healthcare for which the authors also provide consulting services.

Use of Flavors (Youth to Sr. Citizens)

2020: Choice and variety-seeking of e-liquids and flavour (flavor) categories by New Zealand smokers using an electronic cigarette: a longitudinal study

  • Variety-seeking behaviour (behavior) was common and typically reported within the first 12 weeks of participants’ e-cigarette-assisted attempt to transition away from smoking.
  • Policies allowing diverse e-liquid flavours at specialist stores could support users’ variety-seeking and potentially create opportunities to couple e-liquid purchasing occasions with cessation advice during the first months of a transition attempt.
  • (Link above is to the PDF version)
  • Citation: Mei-Ling Blank, MPH, Janet Hoek, PhD, Choice and variety-seeking of e-liquids and flavour categories by New Zealand smokers using an electronic cigarette: a longitudinal study, Nicotine & Tobacco Research, , ntaa248, doi:10.1093/ntr/ntaa248
  • Acknowledgement: Royal Society of New Zealand Marsden Fund Grant (17-UOO-129) to Janet Hoek (PI), Mei-Ling Blank (AI), Tamlin Conner (AI), Shelagh Ferguson (AI), and Lee Thompson (AI). Both authors are members of ASPIRE 2025, a research collaboration working to achieve the New Zealand Government's Smokefree 2025 goal.


2018: Changing patterns of first e-cigarette flavor used and current flavors used by 20,836 adult frequent e-cigarette users in the USA

  • Adult frequent e-cigarette users in the USA who have completely switched from smoking cigarettes to using e-cigarettes are increasingly likely to have initiated e-cigarette use with non-tobacco flavors and to have transitioned from tobacco to non-tobacco flavors over time. Restricting access to non-tobacco e-cigarette flavors may discourage smokers from attempting to switch to e-cigarettes.
  • PDF Version
  • Citation: Russell C, McKeganey N, Dickson T, Nides M. Changing patterns of first e-cigarette flavor used and current flavors used by 20,836 adult frequent e-cigarette users in the USA. Harm Reduct J. 2018 Jun 28;15(1):33. doi: 10.1186/s12954-018-0238-6. PMID: 29954412; PMCID: PMC6022703.
  • Acknowledgements: The authors are grateful to Julie Woessner and Alex Clark (Consumer Advocates for Smoke-free Alternatives Association), Stefan Didak and Danielle Bloss (Not Blowing Smoke), Gregory Conley (American Vaping Association), Cynthia Cabrera (Cating Group), and the Board of the Smoke-Free Alternatives Trade Association, without whose assistance this study would not have been possible. Fontem Ventures, a company that makes e-cigarettes, and a wholly owned subsidiary of Imperial Brands PLC provided funding for this study.


2015: The Impact of Flavor Descriptors on Nonsmoking Teens’ and Adult Smokers’ Interest in Electronic Cigarettes

  • Nonsmoking teens’ interest in e-cigarettes was very low.
  • Adult smokers’ interest was significantly higher overall and for each flavor.
  • Teen interest did not vary by flavor, but adult interest did.
  • Past-30-day adult e-cigarette users had the greatest interest in e-cigarettes, and their interest was most affected by flavor.
  • Nonsmoking teens who had never tried e-cigarettes had the lowest interest in flavors, followed by adults who had never tried e-cigarettes
  • PDF Version
  • Citation: Saul Shiffman, PhD, Mark A Sembower, MS, Janine L Pillitteri, PhD, Karen K Gerlach, PhD, MPH, Joseph G Gitchell, BA, The Impact of Flavor Descriptors on Nonsmoking Teens’ and Adult Smokers’ Interest in Electronic Cigarettes, Nicotine & Tobacco Research, Volume 17, Issue 10, October 2015, Pages 1255–1262, doi: 10.1093/ntr/ntu333
  • Acknowledgement: This work was supported by NJOY, a company that markets electronic cigarettes, but does not make or sell any combustible tobacco products. All authors work for Pinney Associates and provide consulting services to GlaxoSmithKline Consumer Healthcare on their stop-smoking medications and to NJOY, Inc. on electronic nicotine delivery systems (ENDS). SS and JGG also own an interest in a novel nicotine medication in development. The study sponsor was involved in discussion of the study design, but had no role in study execution, data collection, data analysis, or writing of the manuscript, nor did the sponsor review the manuscript prior to submission.


2013: Adolescent Males' Awareness of and Willingness to Try Electronic Cigarettes

  • Only two participants (< 1%) had previously tried e-cigarettes.
  • Among those who had not tried e-cigarettes, most (67%) had heard of them. Awareness was higher among older and non-Hispanic adolescents.
  • Nearly 1 in 5 (18%) participants were willing to try either a plain or flavored e-cigarette, but willingness to try plain versus flavored varieties did not differ.
  • Smokers were more willing to try any e-cigarette than nonsmokers.
  • Nonsmokers who had more negative beliefs about the typical smoker were less willing to try e-cigarettes.
  • PDF Version
  • Citation: Pepper, J. K., Reiter, P. L., McRee, A.-L., Cameron, L. D., Gilkey, M. B., & Brewer, N. T. (2013). Adolescent Males’ Awareness of and Willingness to Try Electronic Cigarettes. Journal of Adolescent Health, 52(2), 144–150. doi:10.1016/j.jadohealth.2012.09.014
  • Acknowledgement: : Support for this study was provided by the American Cancer Society (MSRG-06-259-01-CPPB), the Cancer Control Education Program at UNC Lineberger Comprehensive Cancer Center (R25 CA57726), the National Institutes of Health (P50CA105632 and P30CA016058), and a NRSA in Primary Medical Care at the University of Minnesota (T32HP22239).


Youth

2020: Report Summary: Perverse Psychology How Anti-Vaping Campaigners Created the Youth Vaping “Epidemic”

  • It is reasonable for anti-tobacco advocates to worry about youth experimentation with nicotine, but the evidence is clear that their interventions have backfired and made the problem worse. Their attempts to dissuade teenagers from vaping increased their awareness of the behavior, made it more attractive, and convinced them that everyone around them was doing it.
  • Anti-tobacco advocates argue that the government can end the “epidemic” by raising the minimum tobacco age to 21, banning non-tobacco e-cigarette flavors, and increasing funding for anti-vaping education. But, as this paper has demonstrated, these measures will not only fail, they will actually make matters worse by increasing the coolness of vaping and youth attraction to it.
  • Teen vaping did not escalate despite the increased anti-vaping messaging. Adolescents’ curiosity and subsequent experimentation with vaping rose because of anti-vaping messaging.
  • PDF of Full report


2020: Paper: Intended and Unintended Effects of Banning Menthol Cigarettes

  • Menthol bans significantly increased non-menthol cigarette smoking among youths, resulting in no overall net change in youth smoking rates.
  • Menthol bans shifted smokers’ cigarette purchases away from grocery stores and gas stations to First Nations reserves (where the menthol bans do not bind).
  • PDF Full Paper


2020: Video: Vaping: what people are getting wrong

  • The Economist
  • A youth vaping “epidemic” and a mysterious outbreak of lung disease in America has led to curbs on e-cigarette flavours. A backlash against vaping is perpetuating myths about nicotine-based e-cigarette products that are not backed up by scientific research. (UK / English)


2019: Article: The US vaping flavour (flavor) ban: twenty things you should know

  • A well researched article that touches on many of the myths and fears about youth use of flavored vapor products.
  • PDF Version


2017: Blog: Confessions of an e-liquid mixologist

  • Certain things really bother me. Like when anti-tobacco activists do things to destroy my pride in being an ex-smoker and helping other people quit smoking. The most hurtful thing of all, is to pervert the effort I put into creating flavors of e-liquids to appeal to adult smokers and accuse me of marketing to children, of trying to addict the next generation of kids on nicotine.
  • Not once did I create a flavor and go “hmmmm, I bet a 12 year old would like this”. Not once. I’m not a monster, I’m a mom, an aunt, a grandma, and a great grandma. All I wanted to do is help people quit smoking so they could live long enough to enjoy their extended families. I wanted to help people quit smoking so kids would no longer be exposed to 2nd hand smoke. I wanted to make the world a better place.


Addressing Myths About Flavors

2020: Article: Does Diacetyl in Vaping Cause Popcorn Lung?

  • While almost anything is possible, there’s simply no evidence that vaping causes popcorn lung.


2019: Cancer Research UK: Does vaping cause popcorn lung?

  • No. There’s no good evidence that e-cigarettes could cause the lung condition called popcorn lung. There’s been no confirmed cases of popcorn lung reported in people who use e-cigarettes.


2019: RE: Vape related "Popcorn Lung" debunked years ago

  • There is 750x more diacetyl in a pack of cigarettes than there is in a days worth of vaping nicotine fluid, and to date we have no confirmation that smokers are getting popcorn lung.


2018: Paper: E-cigarette flavors and aldehyde emissions: another failure to verify findings from a previous study

Our results were revealing in identifying a very small contribution of flavorings on aldehyde emissions. In fact, aldehyde levels were so low that consumption of 5 grams liquid per day would expose vapers to less formaldehyde and acetaldehyde than just staying at home and breathing air. For acrolein, exposure was orders of magnitude lower compared to NIOSH-defined recommended safety limits. To give you an idea of the differences in results, the authors of the original study found up to 7000 ug/g formaldehyde, while we found a maximum of 62 ug/g.
In conclusion, we confirmed that flavouring compounds can contribute to aldehyde emissions from ECs, but such contribution, detected in only 3 liquids and two flavours herein, was minimal.


2017: Comment on “Flavoring Compounds Dominate Toxic Aldehyde Production during E Cigarette Vaping”

  • We would like to point out that the finding is in a stark contrast to previous results.
  • The high levels only happen under dry puff conditions, something avoided by vapers as it is very unpleasant.


2015: Medical journal MISPRESENTS a case of hypersensitivity pneumonitis as popcorn lung disease caused by e-cigarette

  • It was shocking to see a public statement reporting a case of popcorn lung disease in a patient using e-cigarettes. The title of the public release is: “Case report finds 'popcorn lung' in patient using e-cigarettes. Report points to possibility of diacetyl, a flavoring agent in e-cigarettes, to bronchiolitis obliterans syndrome”
  • The article then goes on to explain why it can’t be popcorn lung and calls for the retraction of the study.


2015 New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking

  • There's just one minor fact that is omitted completely in the article, as well as in all the media coverage.
  • That fact: All conventional cigarettes produce tobacco smoke that contains diacetyl, and the levels of diacetyl in cigarettes are a lot higher than those produced by e-cigarettes.


Quotes / Graphics

Scott Gottlieb, MD - Former USA FDA Commissioner

Scott Gottlieb on Flavors



American Association of Public Health Physicians

AAPHP flavor statement



Observation on the variety of flavored products used

NRT vs. ENDS: Does it matter?



American Academy of Pediatricts

Flavored NRT



FDA approved manufacturers of Nicotine Replacement Therapy understand the importance of flavors

FDA approved NRT comes in flavors



Age demographics of people who eat cotton candy

Cotton Candy



Senator Dick Durbin endorses banning flavors (1)

Senator Durbin Ice Cream



Senator Dick Durbin endorses banning flavors (2)

Senator Durbin Candy

Suggested Studies, Papers, Surveys, and Articles to Add to This Page

  • If you prefer to not add information to this page yourself, drop the links here and one of our editors will do it for you


2021: Survey: Vaping liquid flavour preferences, oral nicotine pouch and cannabis use: A survey of participants in the 2019 Oceania Vape Expo

2021: Blog: Banning Flavored Tobacco Products is Just Blowing Smoke

2020: Policy Paper: Why Vape Flavors Matter

2020: Policy Blog: Montana Should Reject Proposed Ban on Flavored Vaping Products

2020: Policy Blog: How California’s Flavored Tobacco Ban Will Hurt Communities and Budgets

2020: Policy Blog: The Costs and Unintended Consequences of Tobacco and Vaping Flavor Bans

2020: Policy Blog: In 2020, Congress Replaced the War on Marijuana With a War on Flavored Tobacco Products

2020: Policy Blog: CDC Survey Shows Flavors Aren’t Driving Youth Vaping

2020: Policy Blog: The Negative Impacts of Massachusetts’ Flavored Tobacco Ban

2019: Policy Paper: TOBACCO HARM REDUCTION 101: A GUIDEBOOK FOR POLICYMAKERS

2019: Article: EDITORIAL: Vote no on flavored vaping ban

2019: The Economic Impact of a Ban on Flavored Vapor Products


2019: Policy Blog: Albany’s Proposed Flavored Tobacco Ban Misses the Mark

2019: Policy Blog: The Public Health Case for E-Cigarette Flavors

2019: Policy Blog: E-Cigarette Flavor Ban Creates Public Health Problems

2018: Testimony to FDA: Comments on FDA's Advance Notice of Proposed Rulemaking on Flavored Tobacco Products

  • Reason Foundation / Guy Bentley


2018: Policy Blog: San Francisco, Flavored Vapes, and the Next Prohibition Disaster

2018: Policy Blog: California’s Plan to Ban Vaping Flavors would Hurt Public Health

2017: Blog: Vape Shop Air Sampling by California State Health Department Suggests that Secondhand Vape Exposure is Minimal

2017: Blog: Are e-liquid flavours really 'hooking another generation of kids'?

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