ENDS Flavors: Difference between revisions

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=Personal Testimonies from people who used to smoke & Blogs=

===All Years: Video Collection: [https://www.youtube.com/channel/UCY3vMuTdXfL7Z4PAsx7Q5nA/videos Golden Oldies Capitol Tours]===

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

===All Years: Collection 13,000+ Testimonies: [https://casaa.org/_testimonials/ CASAA - REAL PEOPLE. REAL STORIES.]===

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

===2021: Letter: [https://clivebates.com/documents/CanadaFlavourBanSept2021.pdf Proposed vaping products’ flavour regulations – a response]===

*This submission responds to Health Canada’s Consultation on Proposed vaping products’ flavour regulations and order and related regulatory impact analysis.

===2021: Letter: [https://clivebates.com/documents/NLFlavoursResponseJan2021.pdf Regulation of e-cigarette flavours – a response]===

*This document responds to the proposed Decree of the State Secretary for Health, Welfare and Sport on the regulation of e-cigarette flavours in the Netherlands. We provide a summary followed by a detailed discussion of each of the twelve sections in the summary.

===2021 Blog: [http://mommavape.blogspot.com/2021/06/gummy-bears-and-cotton-candy.html Gummy Bears and Cotton Candy]===

*The voice of consumers who are trying to quit smoking continues to be ignored. The use of flavored e-cigarettes was associated with more than twice the odds of smoking cessation among adult users compared to those using tobacco flavors. History demonstrates the adult love of all things candy. If something candy flavored is what helps someone stop smoking, who are we to tell them they can't quit that way?

===2019 Blog: [https://clivebates.com/the-us-vaping-flavour-ban-twenty-things-you-should-know/ The US vaping flavour ban: twenty things you should know]===

*What is the chance that this level of adult panic is, in fact, driving the very behaviour it is worrying about?

===2017 Blog: [http://mommavape.blogspot.com/2017/05/cotton-candy-is-not-marketing-to-kids.html Cotton Candy is NOT Marketing To Kids]===

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*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."

===2017 Blog: [https://clivebates.com/flavors Are e-liquid flavours really “hooking another generation of kids”?]===

*To evaluate the demand to regulate these flavours (by which they mean ban them) you first need a framework for thinking about the issue – and that is not simple and may yield surprises.

=Abuse Liability - All THR Products=

===See Also: [https://safernicotine.wiki/mediawiki/index.php/Nicotine_-_Addiction/Dependence Nicotine - Addiction/Dependence]===

=~~Abuse Liability~~ - ~~All THR Products~~=

===2022: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14166-w E-cigarette addiction and harm perception: Does initiation flavor choice matter?]===

*"Traditionally flavored e-cigarette initiation produces similar risk for addiction and harm perceptions as non-traditionally flavored initiation. These findings suggest that banning non-traditional flavors alone may be ineffective in curbing e-cigarette addiction and harm perception. Additional research is needed to better understand which e-cigarette product characteristics and behaviors may be associated with greater addiction and reduced harm perceptions."

**Hung, M., Spencer, A., Hon, E.S. et al. E-cigarette addiction and harm perception: Does initiation flavor choice matter?. BMC Public Health 22, 1780 (2022). https://doi.org/10.1186/s12889-022-14166-w

===2022: [https://academic.oup.com/ntr/article/24/9/1332/6550857 The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review]===

*"E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers."

**Citation: Mari S Gades, Aleksandra Alcheva, Amy L Riegelman, Dorothy K Hatsukami, The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review, Nicotine & Tobacco Research, Volume 24, Issue 9, September 2022, Pages 1332–1343, https://doi.org/10.1093/ntr/ntac073

***Acknowledgment: This work was supported by the National Institute of Drug Abuse (T32 DA007097 and R36 DA050000 to MSG); and the National Institutes of Health (P01 CA217806 to DKH).

===2020: [https://pubmed.ncbi.nlm.nih.gov/33176942/ 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]===

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*[https://www.sciencedirect.com/science/article/pii/S0376871620305603 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: [https://pubmed.ncbi.nlm.nih.gov/12616334/ Subjective effects of the nicotine lozenge: assessment of abuse liability]===

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*[https://sci-hub.se/10.1007/s00213-002-1361-2 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: [https://pubmed.ncbi.nlm.nih.gov/12175452/ Flavor improvement does not increase abuse liability of nicotine chewing gum]===

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*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.

*[https://sci-hub.se/10.1016/s0091-3057(02)00723-2 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~~.

~~ ~~

=Marketing/Advertising/Packaging=

===2024: [https://www.tandfonline.com/doi/full/10.1080/10826084.2024.2374973 Associations Between Noticing E-Cigarette Advertising Features and E-Cigarette Appeal and Switching Interest Among Young Adult Dual Users]===

*Results: "Noticing fruit flavors (AOR = 1.67 and 1.28) and fruit images (AOR = 1.53 and 1.21) was positively associated with having any e-cigarette product appeal and switching interest. Noticing price promotions (AOR = 1.23) was positively associated with product appeal. In contrast, noticing nicotine warnings (AOR = 0.74 and 0.86), smoker-targeted claims (AOR = 0.78 and 0.89), and tobacco flavors (AOR = 0.92 and 0.90) was negatively associated with product appeal and switching interest."

= Multiple Points=

=Multiple Points=

===2022: [https://media.thr.net/strapi/34d52398d9056adece15e8bda5172870.pdf?updated_at=2023-08-29T12:28:33.423Z THE CASE FOR FLAVOURS IN TOBACCO HARM REDUCTION, TO SAVE LIVES]===

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=Public Health Advantages / Concerns of Public Health Harms=

===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0378427423001091 A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro]===

*"We show that the tested flavours do not increase overall toxicity levels in a flavour or concentration-dependent manner. In fact, we demonstrate that the toxicity of e-cigarette aerosols in vitro derived from all the analysed flavour variants were > 95% reduced when compared to cigarette smoke toxicity."

**Citation: Bishop E, East N, Miazzi F, Fiebelkorn S, Breheny D, Gaca M, Thorne D. A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro. Toxicol Lett. 2023 May 1;380:1-11. doi: 10.1016/j.toxlet.2023.03.006. Epub 2023 Mar 17. PMID: 36935081.

===2022: [https://pubmed.ncbi.nlm.nih.gov/36250607/ Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey]===

*E-cigarette use is positively associated with both making a quit attempt and quit success, and those using flavored e-cigarettes are more likely to successfully quit smoking, with no statistically significant differences between the use of menthol or mint-flavored e-cigarettes versus the use of other nontobacco flavored products.

**Citation: Mok Y, Jeon J, Levy DT, Meza R. Associations Between E-cigarette Use and E-cigarette Flavors With Cigarette Smoking Quit Attempts and Quit Success: Evidence From a U.S. Large, Nationally Representative 2018-2019 Survey. Nicotine Tob Res. 2023 Feb 9;25(3):541-552. doi: 10.1093/ntr/ntac241. PMID: 36250607; PMCID: PMC9910159.

===2022: [https://tobaccocontrol.bmj.com/content/31/e1/e10 Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA]===

*Non-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use.

**Citation: Harlow AF, Fetterman JL, Ross CS, et alAssociation of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USATobacco Control 2022;31:e10-e17.

===2020: [https://pubmed.ncbi.nlm.nih.gov/32881666/ Investigation on the antibacterial activity of electronic cigarette liquids (ECLs): a proof of concept study]===

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**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.

*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 [http://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html 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.

=== 2015 [http://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking] ===

**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.

*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: [https://www.sciencedirect.com/science/article/pii/S0887233318307768?via%3Dihub High Content Screening in NHBE cells shows significantly reduced biological activity of flavoured e-liquids, when compared to cigarette smoke condensate]===

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*[https://sci-hub.st/10.1016/j.tiv.2019.03.018 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: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-019-0318-2?optIn=false Toxicity classification of e-cigarette flavouring compounds based on European Union regulation: analysis of findings from a recent study]===

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*[https://harmreductionjournal.biomedcentral.com/track/pdf/10.1186/s12954-019-0318-2.pdf 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: [https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0222152&fbclid=IwAR1Rqtl6D0eLtqU0-pqJ5vlSlLK2xlJk8rs0djo90oeUAwIdX9IgmYgByZY Effects of flavoring compounds used in electronic cigarette refill liquids on endothelial and vascular function]===

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*[https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0222152/1/pone.0222152.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210106%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210106T115250Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 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: [https://reason.org/wp-content/uploads/public-health-case-e-cigarette-flavors.pdf A QUESTION OF TASTE: THE PUBLIC HEALTH CASE FOR E-CIGARETTE FLAVORS]===

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**[https://sci-hub.se/10.1016/j.fct.2018.02.059# 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: [https://pubs.acs.org/doi/10.1021/acs.est.6b06030 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.

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*[https://tobaccocontrol.bmj.com/content/tobaccocontrol/25/Suppl_2/ii67.full.pdf 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: [http://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/234-bo Medical journal misrepresents a case of hypersensitivity pneumonitis as popcorn lung disease caused by e-cigarette]===

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*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.”

*[https://sci-hub.se/10.1016/j.yrtph.2015.05.018 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.

*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: [https://www.mdpi.com/1660-4601/10/10/5146/htm Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour (Vapor) Extract on Cultured Myocardial Cells]===

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*[https://sci-hub.do/10.3390/ijerph10105146 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=

===2024: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-01003-z Exploring the opinions and potential impact of unflavoured e-liquid on smoking cessation among people who smoke and smoking relapse among people who previously smoked and now use e-cigarettes: findings from a UK-based mixed methods study]===

*"The findings highlight that people who smoke and vape could be impacted by flavour restrictions in a range of ways, some of which could have a potential adverse impact on harm reduction efforts in the UK (e.g., by making smoking more appealing than vaping)."

**Citation: Khouja, J.N., Dyer, M.L., Havill, M.A. et al. Exploring the opinions and potential impact of unflavoured e-liquid on smoking cessation among people who smoke and smoking relapse among people who previously smoked and now use e-cigarettes: findings from a UK-based mixed methods study. Harm Reduct J 21, 90 (2024). https://doi.org/10.1186/s12954-024-01003-z

===2024: [https://www.nber.org/papers/w32534 Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults]===

*"The vast majority of youth e-cigarette users consume flavored e-cigarettes, raising concerns from public health advocates that flavors may drive youth initiation into and continued use of e-cigarettes...Our findings suggest that statewide comprehensive flavor bans may have generated an unintended consequence by encouraging substitution towards traditional smoking in some populations."

**Citation: Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults, Henry Saffer, Selen Ozdogan, Michael Grossman, Daniel L. Dench, and Dhaval M. Dave, NBER Working Paper No. 32534, June 2024, JEL No. H07,I12,I18,J13

===2024: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntae151/7697906?login=false The Impact of New Jersey’s 2020 E-cigarette Flavor Ban on E-cigarette, Cigarette, and Cigar Sales in New Jersey]===

*"Flavored e-cigarette sales were declining prior to the ban but the pace of the decline accelerated following federal and state restrictions on flavored e-cigarette sales, then slowed by the second half of 2020, with a brief period of increased cigarette and cigar sales immediately following the ban."

**Citation: Mary Hrywna, Arjun Teotia, Erin Miller Lo, Daniel P Giovenco, Cristine D Delnevo, The Impact of New Jersey’s 2020 E-cigarette Flavor Ban on E-cigarette, Cigarette, and Cigar Sales in New Jersey, Nicotine & Tobacco Research, 2024;, ntae151, https://doi.org/10.1093/ntr/ntae151

===2023: [https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4586701 E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales]===

*"Over 375 US localities and 7 states have adopted permanent restrictions on sales of flavored electronic nicotine delivery systems (“ENDS”). These policies’ effects on combustible cigarette use, a more harmful habit, remain unclear. Matching new flavor policy data to retail sales data, we find a tradeoff of 12 additional cigarettes for every 1 less 0.7 mL ENDS pod sold due to ENDS flavor restrictions. Further, cigarette sales increase even among brands disproportionately used by underage youth. Thus, any public health benefits of reducing ENDS sales via flavor restrictions may be offset by public health costs from increased cigarette sales."

**Citation: Friedman, Abigail and Liber, Alex C. and Crippen, Alyssa and Pesko, Michael, E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales (September 26, 2023). Available at SSRN: https://ssrn.com/abstract=4586701 or http://dx.doi.org/10.2139/ssrn.4586701

===2023: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad258/7492743 Responses to real-world and hypothetical e-cigarette flavor bans among US young adults who use flavored e-cigarettes]===

*"Young adults who vape flavored e-cigarettes have mixed responses to e-cigarette flavor bans. Under both real-world and hypothetical e-cigarette flavor bans, most who use flavored e-cigarettes continue vaping. Under a real-world ban, the second most common response among those who exclusively vape is to switch to smoking; under a hypothetical federal ban, it is to quit all tobacco."

*Citation: Jamie Tam, Evelyn Jimenez-Mendoza, John Buckell, Jody Sindelar, Rafael Meza, Responses to Real-World and Hypothetical E-Cigarette Flavor Bans Among US Young Adults Who Use Flavored E-Cigarettes, Nicotine & Tobacco Research, 2023;, ntad258, https://doi.org/10.1093/ntr/ntad258

===2022: [https://www.sciencedirect.com/science/article/abs/pii/S0091743522001116 Effect of flavored E-cigarette bans in the United States: What does the evidence show?]===

*However, in this paper, we propose an evidence-based version of this model based on several years' worth of longitudinal and econometric research, which suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking. From this analysis, we propose a re-evaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults.

**Citation: Siegel M, Katchmar A. Effect of flavored E-cigarette bans in the United States: What does the evidence show? Prev Med. 2022 Dec;165(Pt B):107063. doi: 10.1016/j.ypmed.2022.107063. Epub 2022 Apr 20. PMID: 35452711.

===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287473/ Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas]===

*Results from this study highlight heterogeneity in young adult e-cigarette users’ reactions to existing flavored e-cigarette sales restrictions and hypothetical restrictions. Some reduced e-cigarette use, but many reported intentions to continue e-cigarette use, by using tank-based e-cigarettes, available flavors, or flavors accessed through alternative sources. More concerning, some switched to cigarettes. Similarly, in response to future restrictions of all flavored e-liquids, young adult e-cigarette users largely indicated that they would either quit vaping – the ideal scenario – or switch to cigarettes – the least desirable scenario. Another major concern highlighted was access to flavored e-cigarettes despite restrictions (e.g., online, across state lines). Collectively, findings suggest that implications of flavored e-cigarette sales restrictions are complex, with the potential for both reductions in e-cigarette use and unintended consequences among young adults, including continued use of flavored e-cigarettes or switching to cigarettes, and retail and consumer circumvention of restrictions.

**Citation: Romm KF, Henriksen L, Huang J, Le D, Clausen M, Duan Z, Fuss C, Bennett B, Berg CJ. Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas. Prev Med Rep. 2022 Jul 9;28:101901. doi: 10.1016/j.pmedr.2022.101901. PMID: 35855926; PMCID: PMC9287473.

===2022: [https://academic.oup.com/ntr/article/24/9/1332/6550857 The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review]===

*"E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers."

**Citation: Mari S Gades, Aleksandra Alcheva, Amy L Riegelman, Dorothy K Hatsukami, The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review, Nicotine & Tobacco Research, Volume 24, Issue 9, September 2022, Pages 1332–1343, https://doi.org/10.1093/ntr/ntac073

***Acknowledgment: This work was supported by the National Institute of Drug Abuse (T32 DA007097 and R36 DA050000 to MSG); and the National Institutes of Health (P01 CA217806 to DKH).

===2022: PREPRINT: [https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1 A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults]===

*"We demonstrated the value of this decision aid using data from various sources to estimate the impact of a flavour ban in three populations: the general UK population, low-socioeconomic position UK population, and the general US population. All three examples suggested a negative net population impact of a ban. These reports were then presented to the all-party parliamentary group for vaping."

*[https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1.full.pdf PDF of full paper]

**Citation: A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults Mark J Gibson, Marcus R Munafò, Angela S. Attwood, Martin J. Dockrell, Michelle A. Havill, Jasmine N Khouja medRxiv 2022.11.14.22282288; doi: https://doi.org/10.1101/2022.11.14.22282288

===2022: [https://pubmed.ncbi.nlm.nih.gov/36328469/ Removal of mango-flavoured Juul pods created opportunity for adulterated mango Juul-compatible pods with altered chemical constituents]===

*"Adulterated Juul-compatible products may expose e-cigarette consumers to more chemical constituents at higher concentrations than previously found in the original product, despite similarity in product design."

**Citation: Dell LG, Page MK, Leigh NJ, Goniewicz ML. Removal of mango-flavoured Juul pods created opportunity for adulterated mango Juul-compatible pods with altered chemical constituents. Tob Control. 2022 Nov;31(Suppl 3):s230-s233. doi: 10.1136/tc-2022-057476. PMID: 36328469; PMCID: PMC9664127.

===2021: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145156/ A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California]===

*San Francisco’s ban on flavored tobacco product sales was associated with increased smoking among minor 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 flavored tobacco use among those who vaped. This raises concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking. Indeed, analyses of how minimum legal sales ages for electronic nicotine delivery systems are associated with youth smoking also suggest such substitution.

*Citation: Friedman AS. A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California. JAMA Pediatr. 2021;175(8):863-865. doi:10.1001/jamapediatrics.2021.0922

===2021: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntab154/6332852?redirectedFrom=fulltext Reactions to sales restrictions on flavored vape products or all vape products among young adults in the US]===

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*Free version of full study or PDF not available

*Citation: Heather Posner, MPH, Katelyn F Romm, PhD, Lisa Henriksen, PhD, Debra Bernat, PhD, Carla J Berg, PhD, MBA, Reactions to Sales Restrictions on Flavored Vape Products or All Vape Products Among Young Adults in the United States, Nicotine & Tobacco Research, 2021;, ntab154, doi: 10.1093/ntr/ntab154

===2021: [https://f1000research.com/articles/10-619/v1 Vaping liquid flavour preferences, oral nicotine pouch and cannabis use: A survey of participants in the 2019 Oceania Vape Expo (version 1; peer review: awaiting peer review)]===

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*[https://f1000research.com/articles/10-619/v1/pdf?article_uuid=853423ae-6086-4c13-a7bc-87b28d81a4a6 PDF Version]

*Citation: Glover M, Phillips CV, Selket K and Jeffares Y. Vaping liquid flavour preferences, oral nicotine pouch and cannabis use: A survey of participants in the 2019 Oceania Vape Expo [version 1; peer review: awaiting peer review]. F1000Research 2021, 10:619 doi:10.12688/f1000research.54582.1

*Acknowledgement: This study was conducted by the Centre of Research Excellence: Indigenous Sovereignty & Smoking as part a wider programme of research aimed at building scientific knowledge on how to reduce tobacco-related harms among Indigenous peoples. The funding for that programme of work was obtained following submission of a researcher-initiated application for funding from the Foundation for a Smoke-Free World. The Foundation had no involvement in the conception, design, analysis or writing of the study results, nor did they have any input into the decision to publish. That is, this study was not commissioned by the Foundation.

~~ ~~

===2021: Testimony in Netherlands pertaining to a potential flavour / flavor ban: [https://www.clivebates.com/documents/NLFlavoursResponseJan2021.pdf Regulation of e-cigarette flavours – a response]===

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*Covers 12 key points

===2021: [https://www.sciencedirect.com/science/article/pii/S0306460321003373 Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors: Findings from the 2020 ITC Smoking and Vaping Survey in Canada, England and the United States]===

*Conclusion: "At this time, it is not yet clear exactly how NVP flavor bans will play out as they are implemented across national and sub-national jurisdictions. However, by extrapolating from this study, and the other limited studies available, it appears that the outcomes will be mixed and complex. While our study suggests most vapers are opposed to a ban, and some vapers indicated that such a ban would lead to unintended consequences (e.g., taking up cigarette smoking again, or turning to illicit channels), many vapers said that they would be willing to vape available flavors. Thus, it is important for policy makers to weigh the potential for public health consequences, as well as possible benefits."

**Citation: Gravely S, Smith DM, Liber AC, Cummings KM, East KA, Hammond D, Hyland A, O'Connor RJ, Kasza KA, Quah ACK, Loewen R, Martin N, Meng G, Ouimet J, Thompson ME, Boudreau C, McNeill A, Sweanor DT, Fong GT. Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors: Findings from the 2020 ITC Smoking and Vaping Survey in Canada, England and the United States. Addict Behav. 2022 Feb;125:107152. doi: 10.1016/j.addbeh.2021.107152. Epub 2021 Oct 14. PMID: 34695685; PMCID: PMC9094050.

***Acknowledgment: This study was supported by grants from the US National Cancer Institute (P01 CA200512), the Canadian Institutes of Health Research (FDN-148477), the National Health and Medical Research Council of Australia (APP 1106451). GTF was supported by a Senior Investigator Award from the Ontario Institute for Cancer Research (IA-004) and the Canadian Cancer Society 2020 O. Harold Warwick Prize. AH and RJO are supported by a Tobacco Centers of Regulatory Science US National Cancer Institute grant (U54 CA238110). AL is supported by the Center for the Assessment of Tobacco Regulations (U54CA229974). AM is a National Institute for Health Research (NIHR) Senior Investigator. These funders/supporting agencies had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Declarations of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. KMC has served as paid expert witness in litigation filed against cigarette manufacturers. GTF and DH have served as expert witnesses on behalf of governments in litigation involving the tobacco industry. AM is a UK National Institute for Health Research (NIHR) Senior Investigator. The views expressed in this article are those of the authors and not necessarily those of the NIHR, or the UK Department of Health and Social Care.

===2020: [https://sci-hub.st/https://onlinelibrary.wiley.com/doi/10.1111/add.15235# Association of vaping‐related lung injuries with rates of e‐cigarette and cannabis use across US states]===

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*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: [https://www.sciencedirect.com/science/article/pii/S2352853220300134 The impact of a comprehensive tobacco product flavor ban in San Francisco among young adults]===

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*[https://sci-hub.st/10.1016/j.abrep.2020.100273 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: [https://www.realclearpolicy.com/articles/2020/10/01/yale_study_on_lung_disease_forecasts_dire_consequences_for_flavor_bans_579308.html Yale Study on Lung Disease Forecasts Dire Consequences for Flavor Bans]===

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*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: [https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201906-472OC Changes in Flavor Preference in a Cohort of Long-Term Electronic Cigarette Users]===

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*[https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201906-472OC PDF Version]

*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: [https://www.detroitnews.com/story/opinion/2019/09/16/opinion-vape-flavor-ban-doesnt-help-kids-hurts-adults/2291817001/ Vape flavor ban doesn't help kids, hurts adults]===

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*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: [https://www.wwlp.com/news/state-politics/flavor-ban-will-feed-illegal-tobacco-sales-stores-say/ Flavor ban will feed illegal tobacco sales, stores say]===

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*“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: [https://www.sun-sentinel.com/opinion/commentary/fl-op-com-minton-e-cigarette-ban-ineffective-dangerous-20190923-svobcmjbdjeptduwlqdx6blcii-story.html E-cigarette flavor ban — ineffective and dangerous]===

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*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: [https://www.kqed.org/science/1950849/vapers-turn-to-home-brew-as-flavored-nicotine-bans-mount Vapers Turn to Home Brew as Flavored Nicotine Bans Mount]===

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*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: [https://www.theatlantic.com/ideas/archive/2019/10/danger-vaping-bans/600451/ The Vaping Overreaction Politicians who ban flavors should brace for a surge in cigarette smoking and the use of questionable bootleg vaping products.]===

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*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: [https://www.tandfonline.com/doi/abs/10.1080/10826084.2019.1626435?journalCode=isum20 Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions]===

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*[https://sci-hub.se/10.1080/10826084.2019.1626435 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: [https://www.regulations.gov/document?D=FDA-2017-N-6565-22941 Patterns of flavored e-cigarette use among adults vapers in the United States: an internet survey]===

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*[https://www.regulations.gov/contentStreamer?documentId=FDA-2017-N-6565-22941&attachmentNumber=1&contentType=pdf 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: [https://tobaccocontrol.bmj.com/content/28/2/168 Should flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experiment]===

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*[https://tobaccocontrol.bmj.com/content/tobaccocontrol/28/2/168.full.pdf 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: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00418-8 Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers]===

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*[https://sci-hub.st/10.1186/s12954-020-00418-8# 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: [https://www.insidesources.com/e-cigarette-flavor-bans-will-drive-more-people-back-to-smoking/ E-Cigarette Flavor Bans Will Drive More People Back to Smoking]===

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*Citation: Michael Siegel, February 19, 2019, Inside Sources

~~ ~~

=Smoking Cessation=

===2021: [https://academic.oup.com/ntr/article-abstract/23/9/1490/6149939 How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys]===

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*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: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275248/ Associations of Flavored e-Cigarette Uptake With Subsequent Smoking Initiation and Cessation]===

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*[https://sci-hub.st/10.1001/jamanetworkopen.2020.3826# 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: [https://www.sciencedirect.com/science/article/abs/pii/S0306460318311821 The role of flavors in vaping initiation and satisfaction among U.S. adults]===

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*[https://sci-hub.st/10.1016/j.addbeh.2019.106077# 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: [https://pubmed.ncbi.nlm.nih.gov/31477072/ Vaping patterns, nicotine dependence and reasons for vaping among American Indian dual users of cigarettes and electronic cigarettes]===

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*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721166/pdf/12889_2019_Article_7523.pdf 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: [https://www.youtube.com/watch?v=WqTdqLZQUCo Video: Can Flavors Help People Who Smoke Quit Smoking?]===

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*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: [https://docs.google.com/document/d/18yNyRhNe0liQ_uP3tSEcaLV9JB-gLyMEnCuE8aLBtPc/edit?usp=sharing Flavors make vaping more palatable, help cigarette smokers kick the habit]===

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*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: [https://web.archive.org/web/20191129093506/https://www.chieftain.com/opinion/20191128/banning-flavored-e-cigarettes-has-consequences Banning flavored e-cigarettes has consequences]===

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*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: [https://academic.oup.com/ntr/article-abstract/20/8/977/4061315?redirectedFrom=fulltext Advice From Former-Smoking E-Cigarette Users to Current Smokers on How to Use E-Cigarettes as Part of an Attempt to Quit Smoking]===

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*[https://sci-hub.do/10.1093/ntr/ntx176# 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.

===2018: [https://bmjopen.bmj.com/content/8/3/e018329.full Motivation and main flavour of use, use with nicotine and dual use of electronic cigarettes in Barcelona, Spain: a cross-sectional study ]===

*The most prevalent motivation for using e-cigarettes was to reduce tobacco smoking 48%, followed by quitting smoking 39.2%, and to use e-cigarettes in places where tobacco smoking was prohibited 10.2%.

*Citation: Bunch K, Fu M, Ballbè M, et alMotivation and main flavour of use, use with nicotine and dual use of electronic cigarettes in Barcelona, Spain: a cross-sectional studyBMJ Open 2018;8:e018329. doi: 10.1136/bmjopen-2017-018329

*Acknowledgement: The project was cofunded by the Instituto de Salud Carlos III, Subdirección General de Evaluación, Government of Spain (PI15/00291). The project was also cofunded by ISCIII-Subdirección General de Evaluación and by FEDER funds/European Regional Development Fund (ERDF)—a way to build Europe—in 2015 and Ministry of Universities and Research, Government of Catalonia (grant 2017SGR608).

===2017: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800112/ Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes]===

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*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800112/pdf/ijerph-15-00012.pdf 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: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808473/ Preferred Flavors and Reasons for E-cigarette Use and Discontinued Use Among Never, Current, and Former Smokers]===

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*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808473/pdf/nihms739529.pdf 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: [https://www.mdpi.com/1660-4601/10/12/7272/htm Impact of Flavour Variability on Electronic Cigarette Use Experience: An Internet Survey]===

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*[https://sci-hub.st/10.3390/ijerph10127272# 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: [https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.2000.tb06686.x Tobacco Dependence: Global Public Health Potential for New Medications Development and Indications]===

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*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)=

===2021: [https://thr.ams3.cdn.digitaloceanspaces.com/strapi/0cbd3b34cef86dad0032528c324d2f7b.pdf THE CASE FOR FLAVOURS IN TOBACCO HARM REDUCTION, TO SAVE LIVES]===

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*[https://www.youtube.com/watch?v=BwlJVEBk1o8&t=121s Webinar]

**This webinar discussed the above flavors report and took place on 15 December 2021, and featured Dr Konstantinos Farsalinos, Dr Delon Human, Dr Kgosi Letlape, Prof Heino Stöver, and Charles A. Gardner, PhD.

===2020: [https://pubmed.ncbi.nlm.nih.gov/33748862/ Choice and variety-seeking of e-liquids and flavour (flavor) categories by New Zealand smokers using an electronic cigarette: a longitudinal study]===

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*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.

*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: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022703/ Changing patterns of first e-cigarette flavor used and current flavors used by 20,836 adult frequent e-cigarette users in the USA]===

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*[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022703/pdf/12954_2018_Article_238.pdf 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: [https://academic.oup.com/ntr/article-abstract/17/10/1255/1028251?redirectedFrom=fulltext The Impact of Flavor Descriptors on Nonsmoking Teens’ and Adult Smokers’ Interest in Electronic Cigarettes]===

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*[https://www.casaa.org/wp-content/uploads/Shiffman-on-flavors-1255-62.pdf 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: [https://www.sciencedirect.com/science/article/abs/pii/S1054139X12004090 Adolescent Males' Awareness of and Willingness to Try Electronic Cigarettes]===

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*[https://sci-hub.st/10.1016/j.jadohealth.2012.09.014# 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: [https://cei.org/issue_analysis/perverse-psychology/ Report Summary: Perverse Psychology How Anti-Vaping Campaigners Created the Youth Vaping “Epidemic”]===

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*Teen vaping did not escalate despite the increased anti-vaping messaging. Adolescents’ curiosity and subsequent experimentation with vaping rose because of anti-vaping messaging.

*[https://cei.org/sites/default/files/Michelle%20Minton%20-%20Perverse%20Psychology.pdf PDF of Full report]

===2020: [https://www.nber.org/papers/w26811 Paper: Intended and Unintended Effects of Banning Menthol Cigarettes]===

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*Menthol bans shifted smokers’ cigarette purchases away from grocery stores and gas stations to First Nations reserves (where the menthol bans do not bind).

*[https://sci-hub.st/10.3386/w26811# PDF Full Paper]

===2020: [https://www.youtube.com/watch?v=O4_l-klxqCQ Video: Vaping: what people are getting wrong]===

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*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: [https://www.clivebates.com/the-us-vaping-flavour-ban-twenty-things-you-should-know/ The US vaping flavour (flavor) ban: twenty things you should know]===

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

*[https://www.clivebates.com/documents/Flavours20Nov2019.pdf PDF Version]

===2017: Blog: [http://mommavape.blogspot.com/2017/12/paint-me-green-and-hear-me-roar.html Confessions of an e-liquid mixologist]===

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*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: [https://vaping360.com/learn/popcorn-lung-diacetyl/ Does Diacetyl in Vaping Cause Popcorn Lung?]===

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

===2019: Cancer Research UK: [https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/does-vaping-cause-popcorn-lung Does vaping cause popcorn lung?]===

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*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: [https://www.cmaj.ca/content/re-vape-related-popcorn-lung-debunked-years-ago RE: Vape related "Popcorn Lung" debunked years ago]===

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*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: [http://www.ecigarette-research.org/research/index.php/research/2018/262-flavors Paper: E-cigarette flavors and aldehyde emissions: another failure to verify findings from a previous study]===

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*2017: [https://sci-hub.se/10.1016/j.fct.2018.02.059 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.

===2017: [https://pubs.acs.org/doi/10.1021/acs.est.6b06030 Comment on “Flavoring Compounds Dominate Toxic Aldehyde Production during E Cigarette Vaping”]===

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*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: [http://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/234-bo Medical journal MISPRESENTS a case of hypersensitivity pneumonitis as popcorn lung disease caused by e-cigarette]===

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*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 [http://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking]===

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*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=

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~~ ~~

=Further Reading=

===2023: Yale School of Public Health: [https://ysph.yale.edu/news-article/tobacco-purchases-rise-following-restrictions-on-e-cigarette-sales/ Tobacco purchases rise following restrictions on e-cigarette sales]===

===2021: Policy Analyst Testimony: [https://www.cga.ct.gov/2021/PHdata/Tmy/2021SB-00326-R000208-Stroud,%20Lindsey,%20Policy%20Analyst-Taxpayers%20Protection%20Alliance-TMY.PDF Testimony before the Connecticut Public Health Committee Regarding Prohibiting the Sale of Flavored Tobacco and Vapor Products]===

===2021: Commentary: [https://www.myjournalcourier.com/opinion/article/Commentary-Lindsey-Stroud-Want-fewer-teen-16184278.php Want fewer teen smokers? Stop all the bans]===

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=Other Resources=

===[https://docs.google.com/document/d/1CWfu0QLj347Ud07tb9NdNWESXZRqAzW9MX_VbU_NAss/edit?usp=sharing Document of pre-written tweets about flavors]===

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

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

===~~2023~~: [https://~~papers~~.~~ssrn~~.~~com~~/~~sol3~~/~~papers.cfm?abstract_id=4586701 E~~-cigarette ~~Flavor Restrictions’ Effects~~ on ~~Tobacco Product Sales~~]===

===2024: [https://pubmed.ncbi.nlm.nih.gov/39787830/ The impact of non-tobacco e-cigarette flavoring on e-cigarette uptake, cigarette smoking reduction, and cessation: A secondary analysis of a nationwide clinical trial]===

===~~2023~~: [https://~~www.sciencedirect~~.com/~~science/article/abs/pii/S0378427423001091?via%3Dihub A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro]===~~

===2024: [https://jamanetwork.com/journals/jama-health-forum/fullarticle/2828404 Flavored E-Cigarette Sales Restrictions and Young Adult Tobacco Use]===

===2022: PREPRINT: [https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1 A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults]===

*[https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1.full.pdf PDF of full paper]

~~===2022: [https://pubmed.ncbi.nlm.nih.gov~~/~~36328469/ Removal of mango~~-~~flavoured Juul pods created opportunity for adulterated mango Juul~~-~~compatible pods with altered chemical constituents]===~~

~~===2022: [https://pubmed.ncbi.nlm.nih.gov~~/~~36250607~~/ ~~Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey]===~~

*E-~~cigarette use is positively associated with both making a quit attempt~~ and quit success, and those using flavored e-cigarettes are more likely to successfully quit smoking, with no statistically significant differences between the use of menthol or mint-flavored e-cigarettes versus the use of other nontobacco flavored products.

~~===2022: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14166-w E-cigarette addiction and harm perception: Does initiation flavor choice matter?]===~~

===2022: [https://tobaccocontrol.bmj.com/content/31/e1/e10 Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA]===

*Non-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use.

~~===2022: [https://www.sciencedirect.com/science/article/abs/pii/S0091743522001116 Effect of flavored E-cigarette bans in the United States: What does the evidence show?~~]===

*However, in this paper, we propose an evidence-based version of this model based on several years' worth of longitudinal and econometric research, which suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking. From this analysis, we propose a re-evaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults.

===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287473/ Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas]===

*Results from this study highlight heterogeneity in young adult e-cigarette users’ reactions to existing flavored e-cigarette sales restrictions and hypothetical restrictions. Some reduced e-cigarette use, but many reported intentions to continue e-cigarette use, by using tank-based e-cigarettes, available flavors, or flavors accessed through alternative sources. More concerning, some switched to cigarettes. Similarly, in response to future restrictions of all flavored e-liquids, young adult e-cigarette users largely indicated that they would either quit vaping – the ideal scenario – or switch to cigarettes – the least desirable scenario. Another major concern highlighted was access to flavored e-cigarettes despite restrictions (e.g., online, across state lines). Collectively, findings suggest that implications of flavored e-cigarette sales restrictions are complex, with the potential for both reductions in e-cigarette use and unintended consequences among young adults, including continued use of flavored e-cigarettes or switching to cigarettes, and retail and consumer circumvention of restrictions.

~~ ~~

=Page Editor Instructions=

@@ Line 12: / Line 12: @@
 =Personal Testimonies from people who used to smoke & Blogs= <!--T:3-->
 ===All Years: Video Collection: [https://www.youtube.com/channel/UCY3vMuTdXfL7Z4PAsx7Q5nA/videos Golden Oldies Capitol Tours]=== <!--T:4-->
@@ Line 19: / Line 17: @@
 <!--T:5-->
 *People who used to smoke share how long they smoked and what flavors helped them to quit smoking.
 ===All Years: Collection 13,000+ Testimonies: [https://casaa.org/_testimonials/ CASAA - REAL PEOPLE. REAL STORIES.]=== <!--T:6-->
@@ Line 26: / Line 22: @@
 <!--T:7-->
 *Online submissions of personal testimonies by people who switched from smoking to harm reduction products.
 ===2021: Letter: [https://clivebates.com/documents/CanadaFlavourBanSept2021.pdf Proposed vaping products’ flavour regulations – a response]===
 *This submission responds to Health Canada’s Consultation on Proposed vaping products’ flavour regulations and order and related regulatory impact analysis.
 ===2021: Letter: [https://clivebates.com/documents/NLFlavoursResponseJan2021.pdf Regulation of e-cigarette flavours – a response]===
 *This document responds to the proposed Decree of the State Secretary for Health, Welfare and Sport on the regulation of e-cigarette flavours in the Netherlands. We provide a summary followed by a detailed discussion of each of the twelve sections in the summary.
 ===2021 Blog: [http://mommavape.blogspot.com/2021/06/gummy-bears-and-cotton-candy.html Gummy Bears and Cotton Candy]===
 *The voice of consumers who are trying to quit smoking continues to be ignored. The use of flavored e-cigarettes was associated with more than twice the odds of smoking cessation among adult users compared to those using tobacco flavors. History demonstrates the adult love of all things candy. If something candy flavored is what helps someone stop smoking, who are we to tell them they can't quit that way?
 ===2019 Blog: [https://clivebates.com/the-us-vaping-flavour-ban-twenty-things-you-should-know/ The US vaping flavour ban: twenty things you should know]===
 *What is the chance that this level of adult panic is, in fact, driving the very behaviour it is worrying about?
 ===2017 Blog: [http://mommavape.blogspot.com/2017/05/cotton-candy-is-not-marketing-to-kids.html Cotton Candy is NOT Marketing To Kids]=== <!--T:8-->
@@ Line 49: / Line 40: @@
 *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."
 ===2017 Blog: [https://clivebates.com/flavors Are e-liquid flavours really “hooking another generation of kids”?]===
 *To evaluate the demand to regulate these flavours (by which they mean ban them) you first need a framework for thinking about the issue – and that is not simple and may yield surprises.
+=Abuse Liability - All THR Products= <!--T:10-->
+===See Also: [https://safernicotine.wiki/mediawiki/index.php/Nicotine_-_Addiction/Dependence Nicotine - Addiction/Dependence]===
-=Abuse Liability - All THR Products= <!--T:10-->
+===2022: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14166-w E-cigarette addiction and harm perception: Does initiation flavor choice matter?]===
+*"Traditionally flavored e-cigarette initiation produces similar risk for addiction and harm perceptions as non-traditionally flavored initiation. These findings suggest that banning non-traditional flavors alone may be ineffective in curbing e-cigarette addiction and harm perception. Additional research is needed to better understand which e-cigarette product characteristics and behaviors may be associated with greater addiction and reduced harm perceptions."
+**Hung, M., Spencer, A., Hon, E.S. et al. E-cigarette addiction and harm perception: Does initiation flavor choice matter?. BMC Public Health 22, 1780 (2022). https://doi.org/10.1186/s12889-022-14166-w
+===2022: [https://academic.oup.com/ntr/article/24/9/1332/6550857 The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review]===
+*"E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers."
+**Citation: Mari S Gades, Aleksandra Alcheva, Amy L Riegelman, Dorothy K Hatsukami, The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review, Nicotine & Tobacco Research, Volume 24, Issue 9, September 2022, Pages 1332–1343, https://doi.org/10.1093/ntr/ntac073
+***Acknowledgment: This work was supported by the National Institute of Drug Abuse (T32 DA007097 and R36 DA050000 to MSG); and the National Institutes of Health (P01 CA217806 to DKH).
 ===2020: [https://pubmed.ncbi.nlm.nih.gov/33176942/ 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]=== <!--T:11-->
@@ Line 64: / Line 63: @@
 *[https://www.sciencedirect.com/science/article/pii/S0376871620305603 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: [https://pubmed.ncbi.nlm.nih.gov/12616334/ Subjective effects of the nicotine lozenge: assessment of abuse liability]=== <!--T:13-->
@@ Line 73: / Line 70: @@
 *[https://sci-hub.se/10.1007/s00213-002-1361-2 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: [https://pubmed.ncbi.nlm.nih.gov/12175452/ Flavor improvement does not increase abuse liability of nicotine chewing gum]=== <!--T:15-->
@@ Line 82: / Line 77: @@
 *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.
 *[https://sci-hub.se/10.1016/s0091-3057(02)00723-2 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.
-<br>
+=Marketing/Advertising/Packaging=
+===2024: [https://www.tandfonline.com/doi/full/10.1080/10826084.2024.2374973 Associations Between Noticing E-Cigarette Advertising Features and E-Cigarette Appeal and Switching Interest Among Young Adult Dual Users]===
+*Results: "Noticing fruit flavors (AOR = 1.67 and 1.28) and fruit images (AOR = 1.53 and 1.21) was positively associated with having any e-cigarette product appeal and switching interest. Noticing price promotions (AOR = 1.23) was positively associated with product appeal. In contrast, noticing nicotine warnings (AOR = 0.74 and 0.86), smoker-targeted claims (AOR = 0.78 and 0.89), and tobacco flavors (AOR = 0.92 and 0.90) was negatively associated with product appeal and switching interest."
-= Multiple Points=
+=Multiple Points=
 ===2022: [https://media.thr.net/strapi/34d52398d9056adece15e8bda5172870.pdf?updated_at=2023-08-29T12:28:33.423Z THE CASE FOR FLAVOURS IN TOBACCO HARM REDUCTION, TO SAVE LIVES]===
@@ Line 92: / Line 90: @@
 =Public Health Advantages / Concerns of Public Health Harms= <!--T:17-->
+===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0378427423001091 A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro]===
+*"We show that the tested flavours do not increase overall toxicity levels in a flavour or concentration-dependent manner. In fact, we demonstrate that the toxicity of e-cigarette aerosols in vitro derived from all the analysed flavour variants were > 95% reduced when compared to cigarette smoke toxicity."
+**Citation: Bishop E, East N, Miazzi F, Fiebelkorn S, Breheny D, Gaca M, Thorne D. A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro. Toxicol Lett. 2023 May 1;380:1-11. doi: 10.1016/j.toxlet.2023.03.006. Epub 2023 Mar 17. PMID: 36935081.
+===2022: [https://pubmed.ncbi.nlm.nih.gov/36250607/ Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey]===
+*E-cigarette use is positively associated with both making a quit attempt and quit success, and those using flavored e-cigarettes are more likely to successfully quit smoking, with no statistically significant differences between the use of menthol or mint-flavored e-cigarettes versus the use of other nontobacco flavored products.
+**Citation: Mok Y, Jeon J, Levy DT, Meza R. Associations Between E-cigarette Use and E-cigarette Flavors With Cigarette Smoking Quit Attempts and Quit Success: Evidence From a U.S. Large, Nationally Representative 2018-2019 Survey. Nicotine Tob Res. 2023 Feb 9;25(3):541-552. doi: 10.1093/ntr/ntac241. PMID: 36250607; PMCID: PMC9910159.
+===2022: [https://tobaccocontrol.bmj.com/content/31/e1/e10 Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA]===
+*Non-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use.
+**Citation: Harlow AF, Fetterman JL, Ross CS, et alAssociation of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USATobacco Control 2022;31:e10-e17.
 ===2020: [https://pubmed.ncbi.nlm.nih.gov/32881666/ Investigation on the antibacterial activity of electronic cigarette liquids (ECLs): a proof of concept study]=== <!--T:18-->
@@ Line 103: / Line 113: @@
 <!--T:21-->
-**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.
+*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 [http://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html 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.
+=== 2015 [http://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking] ===
-**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.
+*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: [https://www.sciencedirect.com/science/article/pii/S0887233318307768?via%3Dihub High Content Screening in NHBE cells shows significantly reduced biological activity of flavoured e-liquids, when compared to cigarette smoke condensate]=== <!--T:22-->
@@ Line 115: / Line 126: @@
 *[https://sci-hub.st/10.1016/j.tiv.2019.03.018 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: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-019-0318-2?optIn=false Toxicity classification of e-cigarette flavouring compounds based on European Union regulation: analysis of findings from a recent study]=== <!--T:24-->
@@ Line 124: / Line 133: @@
 *[https://harmreductionjournal.biomedcentral.com/track/pdf/10.1186/s12954-019-0318-2.pdf 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: [https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0222152&fbclid=IwAR1Rqtl6D0eLtqU0-pqJ5vlSlLK2xlJk8rs0djo90oeUAwIdX9IgmYgByZY Effects of flavoring compounds used in electronic cigarette refill liquids on endothelial and vascular function]=== <!--T:26-->
@@ Line 132: / Line 140: @@
 *[https://storage.googleapis.com/plos-corpus-prod/10.1371/journal.pone.0222152/1/pone.0222152.pdf?X-Goog-Algorithm=GOOG4-RSA-SHA256&X-Goog-Credential=wombat-sa%40plos-prod.iam.gserviceaccount.com%2F20210106%2Fauto%2Fstorage%2Fgoog4_request&X-Goog-Date=20210106T115250Z&X-Goog-Expires=3600&X-Goog-SignedHeaders=host&X-Goog-Signature=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 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: [https://reason.org/wp-content/uploads/public-health-case-e-cigarette-flavors.pdf A QUESTION OF TASTE: THE PUBLIC HEALTH CASE FOR E-CIGARETTE FLAVORS]=== <!--T:28-->
@@ Line 149: / Line 156: @@
 **[https://sci-hub.se/10.1016/j.fct.2018.02.059# 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: [https://pubs.acs.org/doi/10.1021/acs.est.6b06030 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.
@@ Line 169: / Line 175: @@
 *[https://tobaccocontrol.bmj.com/content/tobaccocontrol/25/Suppl_2/ii67.full.pdf 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: [http://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/234-bo Medical journal misrepresents a case of hypersensitivity pneumonitis as popcorn lung disease caused by e-cigarette]=== <!--T:36-->
@@ Line 183: / Line 188: @@
 *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.”
 *[https://sci-hub.se/10.1016/j.yrtph.2015.05.018 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.
+*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: [https://www.mdpi.com/1660-4601/10/10/5146/htm Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour (Vapor) Extract on Cultured Myocardial Cells]=== <!--T:40-->
@@ Line 193: / Line 197: @@
 *[https://sci-hub.do/10.3390/ijerph10105146 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= <!--T:42-->
+===2024: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-024-01003-z Exploring the opinions and potential impact of unflavoured e-liquid on smoking cessation among people who smoke and smoking relapse among people who previously smoked and now use e-cigarettes: findings from a UK-based mixed methods study]===
+*"The findings highlight that people who smoke and vape could be impacted by flavour restrictions in a range of ways, some of which could have a potential adverse impact on harm reduction efforts in the UK (e.g., by making smoking more appealing than vaping)."
+**Citation: Khouja, J.N., Dyer, M.L., Havill, M.A. et al. Exploring the opinions and potential impact of unflavoured e-liquid on smoking cessation among people who smoke and smoking relapse among people who previously smoked and now use e-cigarettes: findings from a UK-based mixed methods study. Harm Reduct J 21, 90 (2024). https://doi.org/10.1186/s12954-024-01003-z
+===2024: [https://www.nber.org/papers/w32534 Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults]===
+*"The vast majority of youth e-cigarette users consume flavored e-cigarettes, raising concerns from public health advocates that flavors may drive youth initiation into and continued use of e-cigarettes...Our findings suggest that statewide comprehensive flavor bans may have generated an unintended consequence by encouraging substitution towards traditional smoking in some populations."
+**Citation: Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults, Henry Saffer, Selen Ozdogan, Michael Grossman, Daniel L. Dench, and Dhaval M. Dave, NBER Working Paper No. 32534, June 2024, JEL No. H07,I12,I18,J13
+===2024: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntae151/7697906?login=false The Impact of New Jersey’s 2020 E-cigarette Flavor Ban on E-cigarette, Cigarette, and Cigar Sales in New Jersey]===
+*"Flavored e-cigarette sales were declining prior to the ban but the pace of the decline accelerated following federal and state restrictions on flavored e-cigarette sales, then slowed by the second half of 2020, with a brief period of increased cigarette and cigar sales immediately following the ban."
+**Citation: Mary Hrywna, Arjun Teotia, Erin Miller Lo, Daniel P Giovenco, Cristine D Delnevo, The Impact of New Jersey’s 2020 E-cigarette Flavor Ban on E-cigarette, Cigarette, and Cigar Sales in New Jersey, Nicotine & Tobacco Research, 2024;, ntae151, https://doi.org/10.1093/ntr/ntae151
+===2023: [https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4586701 E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales]===
+*"Over 375 US localities and 7 states have adopted permanent restrictions on sales of flavored electronic nicotine delivery systems (“ENDS”). These policies’ effects on combustible cigarette use, a more harmful habit, remain unclear. Matching new flavor policy data to retail sales data, we find a tradeoff of 12 additional cigarettes for every 1 less 0.7 mL ENDS pod sold due to ENDS flavor restrictions. Further, cigarette sales increase even among brands disproportionately used by underage youth. Thus, any public health benefits of reducing ENDS sales via flavor restrictions may be offset by public health costs from increased cigarette sales."
+**Citation: Friedman, Abigail and Liber, Alex C. and Crippen, Alyssa and Pesko, Michael, E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales (September 26, 2023). Available at SSRN: https://ssrn.com/abstract=4586701 or http://dx.doi.org/10.2139/ssrn.4586701
+===2023: [https://academic.oup.com/ntr/advance-article/doi/10.1093/ntr/ntad258/7492743 Responses to real-world and hypothetical e-cigarette flavor bans among US young adults who use flavored e-cigarettes]===
+*"Young adults who vape flavored e-cigarettes have mixed responses to e-cigarette flavor bans. Under both real-world and hypothetical e-cigarette flavor bans, most who use flavored e-cigarettes continue vaping. Under a real-world ban, the second most common response among those who exclusively vape is to switch to smoking; under a hypothetical federal ban, it is to quit all tobacco."
+*Citation: Jamie Tam, Evelyn Jimenez-Mendoza, John Buckell, Jody Sindelar, Rafael Meza, Responses to Real-World and Hypothetical E-Cigarette Flavor Bans Among US Young Adults Who Use Flavored E-Cigarettes, Nicotine & Tobacco Research, 2023;, ntad258, https://doi.org/10.1093/ntr/ntad258
+===2022: [https://www.sciencedirect.com/science/article/abs/pii/S0091743522001116 Effect of flavored E-cigarette bans in the United States: What does the evidence show?]===
+*However, in this paper, we propose an evidence-based version of this model based on several years' worth of longitudinal and econometric research, which suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking. From this analysis, we propose a re-evaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults.
+**Citation: Siegel M, Katchmar A. Effect of flavored E-cigarette bans in the United States: What does the evidence show? Prev Med. 2022 Dec;165(Pt B):107063. doi: 10.1016/j.ypmed.2022.107063. Epub 2022 Apr 20. PMID: 35452711.
+===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287473/ Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas]===
+*Results from this study highlight heterogeneity in young adult e-cigarette users’ reactions to existing flavored e-cigarette sales restrictions and hypothetical restrictions. Some reduced e-cigarette use, but many reported intentions to continue e-cigarette use, by using tank-based e-cigarettes, available flavors, or flavors accessed through alternative sources. More concerning, some switched to cigarettes. Similarly, in response to future restrictions of all flavored e-liquids, young adult e-cigarette users largely indicated that they would either quit vaping – the ideal scenario – or switch to cigarettes – the least desirable scenario. Another major concern highlighted was access to flavored e-cigarettes despite restrictions (e.g., online, across state lines). Collectively, findings suggest that implications of flavored e-cigarette sales restrictions are complex, with the potential for both reductions in e-cigarette use and unintended consequences among young adults, including continued use of flavored e-cigarettes or switching to cigarettes, and retail and consumer circumvention of restrictions.
+**Citation: Romm KF, Henriksen L, Huang J, Le D, Clausen M, Duan Z, Fuss C, Bennett B, Berg CJ. Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas. Prev Med Rep. 2022 Jul 9;28:101901. doi: 10.1016/j.pmedr.2022.101901. PMID: 35855926; PMCID: PMC9287473.
+===2022: [https://academic.oup.com/ntr/article/24/9/1332/6550857 The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review]===
+*"E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers."
+**Citation: Mari S Gades, Aleksandra Alcheva, Amy L Riegelman, Dorothy K Hatsukami, The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review, Nicotine & Tobacco Research, Volume 24, Issue 9, September 2022, Pages 1332–1343, https://doi.org/10.1093/ntr/ntac073
+***Acknowledgment: This work was supported by the National Institute of Drug Abuse (T32 DA007097 and R36 DA050000 to MSG); and the National Institutes of Health (P01 CA217806 to DKH).
+===2022: PREPRINT: [https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1 A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults]===
+*"We demonstrated the value of this decision aid using data from various sources to estimate the impact of a flavour ban in three populations: the general UK population, low-socioeconomic position UK population, and the general US population. All three examples suggested a negative net population impact of a ban. These reports were then presented to the all-party parliamentary group for vaping."
+*[https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1.full.pdf PDF of full paper]
+**Citation: A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults Mark J Gibson, Marcus R Munafò, Angela S. Attwood, Martin J. Dockrell, Michelle A. Havill, Jasmine N Khouja medRxiv 2022.11.14.22282288; doi: https://doi.org/10.1101/2022.11.14.22282288
+===2022: [https://pubmed.ncbi.nlm.nih.gov/36328469/ Removal of mango-flavoured Juul pods created opportunity for adulterated mango Juul-compatible pods with altered chemical constituents]===
+*"Adulterated Juul-compatible products may expose e-cigarette consumers to more chemical constituents at higher concentrations than previously found in the original product, despite similarity in product design."
+**Citation: Dell LG, Page MK, Leigh NJ, Goniewicz ML. Removal of mango-flavoured Juul pods created opportunity for adulterated mango Juul-compatible pods with altered chemical constituents. Tob Control. 2022 Nov;31(Suppl 3):s230-s233. doi: 10.1136/tc-2022-057476. PMID: 36328469; PMCID: PMC9664127.
 ===2021: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8145156/ A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California]===
 *San Francisco’s ban on flavored tobacco product sales was associated with increased smoking among minor 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 flavored tobacco use among those who vaped. This raises concerns that reducing access to flavored electronic nicotine delivery systems may motivate youths who would otherwise vape to substitute smoking. Indeed, analyses of how minimum legal sales ages for electronic nicotine delivery systems are associated with youth smoking also suggest such substitution.
 *Citation: Friedman AS. A Difference-in-Differences Analysis of Youth Smoking and a Ban on Sales of Flavored Tobacco Products in San Francisco, California. JAMA Pediatr. 2021;175(8):863-865. doi:10.1001/jamapediatrics.2021.0922
 ===2021: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntab154/6332852?redirectedFrom=fulltext Reactions to sales restrictions on flavored vape products or all vape products among young adults in the US]=== <!--T:43-->
@@ Line 209: / Line 252: @@
 *Free version of full study or PDF not available
 *Citation: Heather Posner, MPH, Katelyn F Romm, PhD, Lisa Henriksen, PhD, Debra Bernat, PhD, Carla J Berg, PhD, MBA, Reactions to Sales Restrictions on Flavored Vape Products or All Vape Products Among Young Adults in the United States, Nicotine & Tobacco Research, 2021;, ntab154, doi: 10.1093/ntr/ntab154
 ===2021: [https://f1000research.com/articles/10-619/v1 Vaping liquid flavour preferences, oral nicotine pouch and cannabis use: A survey of participants in the 2019 Oceania Vape Expo (version 1; peer review: awaiting peer review)]===
@@ Line 215: / Line 257: @@
 *[https://f1000research.com/articles/10-619/v1/pdf?article_uuid=853423ae-6086-4c13-a7bc-87b28d81a4a6 PDF Version]
 *Citation: Glover M, Phillips CV, Selket K and Jeffares Y. Vaping liquid flavour preferences, oral nicotine pouch and cannabis use: A survey of participants in the 2019 Oceania Vape Expo [version 1; peer review: awaiting peer review]. F1000Research 2021, 10:619 doi:10.12688/f1000research.54582.1
-*Acknowledgement: This study was conducted by the Centre of Research Excellence: Indigenous Sovereignty & Smoking as part a wider programme of research aimed at building scientific knowledge on how to reduce tobacco-related harms among Indigenous peoples. The funding for that programme of work was obtained following submission of a researcher-initiated application for funding from the Foundation for a Smoke-Free World. The Foundation had no involvement in the conception, design, analysis or writing of the study results, nor did they have any input into the decision to publish. That is, this study was not commissioned by the Foundation.
-<br>
 ===2021: Testimony in Netherlands pertaining to a potential flavour / flavor ban: [https://www.clivebates.com/documents/NLFlavoursResponseJan2021.pdf Regulation of e-cigarette flavours – a response]=== <!--T:45-->
@@ Line 224: / Line 264: @@
 *Covers 12 key points
+===2021: [https://www.sciencedirect.com/science/article/pii/S0306460321003373 Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors: Findings from the 2020 ITC Smoking and Vaping Survey in Canada, England and the United States]===
+*Conclusion: "At this time, it is not yet clear exactly how NVP flavor bans will play out as they are implemented across national and sub-national jurisdictions. However, by extrapolating from this study, and the other limited studies available, it appears that the outcomes will be mixed and complex. While our study suggests most vapers are opposed to a ban, and some vapers indicated that such a ban would lead to unintended consequences (e.g., taking up cigarette smoking again, or turning to illicit channels), many vapers said that they would be willing to vape available flavors. Thus, it is important for policy makers to weigh the potential for public health consequences, as well as possible benefits."
+**Citation: Gravely S, Smith DM, Liber AC, Cummings KM, East KA, Hammond D, Hyland A, O'Connor RJ, Kasza KA, Quah ACK, Loewen R, Martin N, Meng G, Ouimet J, Thompson ME, Boudreau C, McNeill A, Sweanor DT, Fong GT. Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors: Findings from the 2020 ITC Smoking and Vaping Survey in Canada, England and the United States. Addict Behav. 2022 Feb;125:107152. doi: 10.1016/j.addbeh.2021.107152. Epub 2021 Oct 14. PMID: 34695685; PMCID: PMC9094050.
+***Acknowledgment: This study was supported by grants from the US National Cancer Institute (P01 CA200512), the Canadian Institutes of Health Research (FDN-148477), the National Health and Medical Research Council of Australia (APP 1106451). GTF was supported by a Senior Investigator Award from the Ontario Institute for Cancer Research (IA-004) and the Canadian Cancer Society 2020 O. Harold Warwick Prize. AH and RJO are supported by a Tobacco Centers of Regulatory Science US National Cancer Institute grant (U54 CA238110). AL is supported by the Center for the Assessment of Tobacco Regulations (U54CA229974). AM is a National Institute for Health Research (NIHR) Senior Investigator. These funders/supporting agencies had no role in the study design, collection, analysis or interpretation of the data, writing the manuscript, or the decision to submit the paper for publication. Declarations of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. KMC has served as paid expert witness in litigation filed against cigarette manufacturers. GTF and DH have served as expert witnesses on behalf of governments in litigation involving the tobacco industry. AM is a UK National Institute for Health Research (NIHR) Senior Investigator. The views expressed in this article are those of the authors and not necessarily those of the NIHR, or the UK Department of Health and Social Care.
 ===2020: [https://sci-hub.st/https://onlinelibrary.wiley.com/doi/10.1111/add.15235# Association of vaping‐related lung injuries with rates of e‐cigarette and cannabis use across US states]=== <!--T:47-->
@@ Line 231: / Line 275: @@
 *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: [https://www.sciencedirect.com/science/article/pii/S2352853220300134 The impact of a comprehensive tobacco product flavor ban in San Francisco among young adults]=== <!--T:49-->
@@ Line 243: / Line 285: @@
 *[https://sci-hub.st/10.1016/j.abrep.2020.100273 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: [https://www.realclearpolicy.com/articles/2020/10/01/yale_study_on_lung_disease_forecasts_dire_consequences_for_flavor_bans_579308.html Yale Study on Lung Disease Forecasts Dire Consequences for Flavor Bans]=== <!--T:51-->
@@ Line 252: / Line 292: @@
 *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:  [https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.201906-472OC Changes in Flavor Preference in a Cohort of Long-Term Electronic Cigarette Users]=== <!--T:53-->
@@ Line 263: / Line 302: @@
 *[https://www.atsjournals.org/doi/pdf/10.1513/AnnalsATS.201906-472OC 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: [https://www.detroitnews.com/story/opinion/2019/09/16/opinion-vape-flavor-ban-doesnt-help-kids-hurts-adults/2291817001/ Vape flavor ban doesn't help kids, hurts adults]=== <!--T:55-->
@@ Line 274: / Line 311: @@
 *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: [https://www.wwlp.com/news/state-politics/flavor-ban-will-feed-illegal-tobacco-sales-stores-say/ Flavor ban will feed illegal tobacco sales, stores say]=== <!--T:57-->
@@ Line 282: / Line 318: @@
 *“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: [https://www.sun-sentinel.com/opinion/commentary/fl-op-com-minton-e-cigarette-ban-ineffective-dangerous-20190923-svobcmjbdjeptduwlqdx6blcii-story.html E-cigarette flavor ban — ineffective and dangerous]=== <!--T:59-->
@@ Line 291: / Line 326: @@
 *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: [https://www.kqed.org/science/1950849/vapers-turn-to-home-brew-as-flavored-nicotine-bans-mount Vapers Turn to Home Brew as Flavored Nicotine Bans Mount]=== <!--T:61-->
@@ Line 302: / Line 336: @@
 *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: [https://www.theatlantic.com/ideas/archive/2019/10/danger-vaping-bans/600451/ The Vaping Overreaction Politicians who ban flavors should brace for a surge in cigarette smoking and the use of questionable bootleg vaping products.]=== <!--T:63-->
@@ Line 311: / Line 344: @@
 *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: [https://www.tandfonline.com/doi/abs/10.1080/10826084.2019.1626435?journalCode=isum20 Young adult dual combusted cigarette and e-cigarette users’ anticipated responses to hypothetical e-cigarette market restrictions]=== <!--T:65-->
@@ Line 320: / Line 352: @@
 *[https://sci-hub.se/10.1080/10826084.2019.1626435 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: [https://www.regulations.gov/document?D=FDA-2017-N-6565-22941 Patterns of flavored e-cigarette use among adults vapers in the United States: an internet survey]=== <!--T:67-->
@@ Line 331: / Line 361: @@
 *[https://www.regulations.gov/contentStreamer?documentId=FDA-2017-N-6565-22941&attachmentNumber=1&contentType=pdf 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: [https://tobaccocontrol.bmj.com/content/28/2/168 Should flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experiment]=== <!--T:69-->
@@ Line 339: / Line 368: @@
 *[https://tobaccocontrol.bmj.com/content/tobaccocontrol/28/2/168.full.pdf 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).
-<br>
 =Relapse Prevention or Long Term Abstinence= <!--T:71-->
 ===2020: [https://harmreductionjournal.biomedcentral.com/articles/10.1186/s12954-020-00418-8 Reported patterns of vaping to support long-term abstinence from smoking: a cross-sectional survey of a convenience sample of vapers]=== <!--T:72-->
@@ Line 358: / Line 382: @@
 *[https://sci-hub.st/10.1186/s12954-020-00418-8# 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: [https://www.insidesources.com/e-cigarette-flavor-bans-will-drive-more-people-back-to-smoking/ E-Cigarette Flavor Bans Will Drive More People Back to Smoking]=== <!--T:74-->
@@ Line 369: / Line 390: @@
 *Citation: Michael Siegel, February 19, 2019, Inside Sources
-<br>
 =Smoking Cessation= <!--T:76-->
 ===2021: [https://academic.oup.com/ntr/article-abstract/23/9/1490/6149939 How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys]=== <!--T:77-->
@@ Line 380: / Line 397: @@
 *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: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7275248/ Associations of Flavored e-Cigarette Uptake With Subsequent Smoking Initiation and Cessation]=== <!--T:79-->
@@ Line 390: / Line 405: @@
 *[https://sci-hub.st/10.1001/jamanetworkopen.2020.3826# 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: [https://www.sciencedirect.com/science/article/abs/pii/S0306460318311821 The role of flavors in vaping initiation and satisfaction among U.S. adults]=== <!--T:81-->
@@ Line 401: / Line 413: @@
 *[https://sci-hub.st/10.1016/j.addbeh.2019.106077# 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: [https://pubmed.ncbi.nlm.nih.gov/31477072/ Vaping patterns, nicotine dependence and reasons for vaping among American Indian dual users of cigarettes and electronic cigarettes]=== <!--T:83-->
@@ Line 412: / Line 421: @@
 *[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6721166/pdf/12889_2019_Article_7523.pdf 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: [https://www.youtube.com/watch?v=WqTdqLZQUCo Video: Can Flavors Help People Who Smoke Quit Smoking?]=== <!--T:85-->
@@ Line 421: / Line 427: @@
 *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: [https://docs.google.com/document/d/18yNyRhNe0liQ_uP3tSEcaLV9JB-gLyMEnCuE8aLBtPc/edit?usp=sharing Flavors make vaping more palatable, help cigarette smokers kick the habit]=== <!--T:87-->
@@ Line 432: / Line 436: @@
 *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: [https://web.archive.org/web/20191129093506/https://www.chieftain.com/opinion/20191128/banning-flavored-e-cigarettes-has-consequences Banning flavored e-cigarettes has consequences]=== <!--T:89-->
@@ Line 443: / Line 445: @@
 *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
-<br>
 ===2018: [https://academic.oup.com/ntr/article-abstract/20/8/977/4061315?redirectedFrom=fulltext Advice From Former-Smoking E-Cigarette Users to Current Smokers on How to Use E-Cigarettes as Part of an Attempt to Quit Smoking]=== <!--T:91-->
@@ Line 452: / Line 452: @@
 *[https://sci-hub.do/10.1093/ntr/ntx176# 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.
 ===2018: [https://bmjopen.bmj.com/content/8/3/e018329.full Motivation and main flavour of use, use with nicotine and dual use of electronic cigarettes in Barcelona, Spain: a cross-sectional study ]===
 *The most prevalent motivation for using e-cigarettes was to reduce tobacco smoking 48%, followed by quitting smoking 39.2%, and to use e-cigarettes in places where tobacco smoking was prohibited 10.2%.
 *Citation: Bunch K, Fu M, Ballbè M, et alMotivation and main flavour of use, use with nicotine and dual use of electronic cigarettes in Barcelona, Spain: a cross-sectional studyBMJ Open 2018;8:e018329. doi: 10.1136/bmjopen-2017-018329
-*Acknowledgement: The project was cofunded by the Instituto de Salud Carlos III, Subdirección General de Evaluación, Government of Spain (PI15/00291). The project was also cofunded by ISCIII-Subdirección General de Evaluación and by FEDER funds/European Regional Development Fund (ERDF)—a way to build Europe—in 2015 and Ministry of Universities and Research, Government of Catalonia (grant 2017SGR608).
 ===2017: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800112/ Differences between Dual Users and Switchers Center around Vaping Behavior and Its Experiences Rather than Beliefs and Attitudes]=== <!--T:93-->
@@ Line 470: / Line 466: @@
 *[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800112/pdf/ijerph-15-00012.pdf 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: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808473/ Preferred Flavors and Reasons for E-cigarette Use and Discontinued Use Among Never, Current, and Former Smokers]=== <!--T:95-->
@@ Line 483: / Line 477: @@
 *[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808473/pdf/nihms739529.pdf 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: [https://www.mdpi.com/1660-4601/10/12/7272/htm Impact of Flavour Variability on Electronic Cigarette Use Experience: An Internet Survey]=== <!--T:97-->
@@ Line 497: / Line 488: @@
 *[https://sci-hub.st/10.3390/ijerph10127272# 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: [https://nyaspubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1749-6632.2000.tb06686.x Tobacco Dependence: Global Public Health Potential for New Medications Development and Indications]=== <!--T:99-->
@@ Line 508: / Line 496: @@
 *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)= <!--T:101-->
 ===2021: [https://thr.ams3.cdn.digitaloceanspaces.com/strapi/0cbd3b34cef86dad0032528c324d2f7b.pdf THE CASE FOR FLAVOURS IN TOBACCO HARM REDUCTION, TO SAVE LIVES]===
@@ Line 518: / Line 504: @@
 *[https://www.youtube.com/watch?v=BwlJVEBk1o8&t=121s Webinar]
 **This webinar discussed the above flavors report and took place on 15 December 2021, and featured Dr Konstantinos Farsalinos, Dr Delon Human, Dr Kgosi Letlape, Prof Heino Stöver, and Charles A. Gardner, PhD.
 ===2020: [https://pubmed.ncbi.nlm.nih.gov/33748862/ Choice and variety-seeking of e-liquids and flavour (flavor) categories by New Zealand smokers using an electronic cigarette: a longitudinal study]=== <!--T:102-->
@@ Line 526: / Line 511: @@
 *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.
 *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.
-<br>
 ===2018: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022703/ Changing patterns of first e-cigarette flavor used and current flavors used by 20,836 adult frequent e-cigarette users in the USA]=== <!--T:104-->
@@ Line 536: / Line 518: @@
 *[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6022703/pdf/12954_2018_Article_238.pdf 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: [https://academic.oup.com/ntr/article-abstract/17/10/1255/1028251?redirectedFrom=fulltext The Impact of Flavor Descriptors on Nonsmoking Teens’ and Adult Smokers’ Interest in Electronic Cigarettes]=== <!--T:106-->
@@ Line 551: / Line 530: @@
 *[https://www.casaa.org/wp-content/uploads/Shiffman-on-flavors-1255-62.pdf 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: [https://www.sciencedirect.com/science/article/abs/pii/S1054139X12004090 Adolescent Males' Awareness of and Willingness to Try Electronic Cigarettes]=== <!--T:108-->
@@ Line 565: / Line 541: @@
 *[https://sci-hub.st/10.1016/j.jadohealth.2012.09.014# 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= <!--T:110-->
 ===2020: [https://cei.org/issue_analysis/perverse-psychology/ Report Summary: Perverse Psychology How Anti-Vaping Campaigners Created the Youth Vaping “Epidemic”]=== <!--T:111-->
@@ Line 578: / Line 551: @@
 *Teen vaping did not escalate despite the increased anti-vaping messaging. Adolescents’ curiosity and subsequent experimentation with vaping rose because of anti-vaping messaging.
 *[https://cei.org/sites/default/files/Michelle%20Minton%20-%20Perverse%20Psychology.pdf PDF of Full report]
 ===2020: [https://www.nber.org/papers/w26811 Paper: Intended and Unintended Effects of Banning Menthol Cigarettes]=== <!--T:113-->
@@ Line 587: / Line 558: @@
 *Menthol bans shifted smokers’ cigarette purchases away from grocery stores and gas stations to First Nations reserves (where the menthol bans do not bind).
 *[https://sci-hub.st/10.3386/w26811# PDF Full Paper]
 ===2020: [https://www.youtube.com/watch?v=O4_l-klxqCQ Video: Vaping: what people are getting wrong]=== <!--T:115-->
@@ Line 595: / Line 564: @@
 *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: [https://www.clivebates.com/the-us-vaping-flavour-ban-twenty-things-you-should-know/ The US vaping flavour (flavor) ban: twenty things you should know]=== <!--T:117-->
@@ Line 603: / Line 570: @@
 *A well researched article that touches on many of the myths and fears about youth use of flavored vapor products.
 *[https://www.clivebates.com/documents/Flavours20Nov2019.pdf PDF Version]
 ===2017: Blog: [http://mommavape.blogspot.com/2017/12/paint-me-green-and-hear-me-roar.html Confessions of an e-liquid mixologist]=== <!--T:119-->
@@ Line 611: / Line 576: @@
 *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= <!--T:121-->
 ===2020: Article: [https://vaping360.com/learn/popcorn-lung-diacetyl/ Does Diacetyl in Vaping Cause Popcorn Lung?]=== <!--T:122-->
@@ Line 622: / Line 583: @@
 <!--T:123-->
 *While almost anything is possible, there’s simply no evidence that vaping causes popcorn lung.
 ===2019: Cancer Research UK: [https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/does-vaping-cause-popcorn-lung Does vaping cause popcorn lung?]=== <!--T:124-->
@@ Line 629: / Line 588: @@
 <!--T:125-->
 *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: [https://www.cmaj.ca/content/re-vape-related-popcorn-lung-debunked-years-ago RE: Vape related "Popcorn Lung" debunked years ago]=== <!--T:126-->
@@ Line 636: / Line 593: @@
 <!--T:127-->
 *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: [http://www.ecigarette-research.org/research/index.php/research/2018/262-flavors Paper: E-cigarette flavors and aldehyde emissions: another failure to verify findings from a previous study]=== <!--T:128-->
@@ Line 645: / Line 600: @@
 *2017: [https://sci-hub.se/10.1016/j.fct.2018.02.059 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.
 ===2017: [https://pubs.acs.org/doi/10.1021/acs.est.6b06030 Comment on “Flavoring Compounds Dominate Toxic Aldehyde Production during E Cigarette Vaping”]=== <!--T:130-->
@@ Line 653: / Line 606: @@
 *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: [http://www.ecigarette-research.org/research/index.php/whats-new/whatsnew-2015/234-bo Medical journal MISPRESENTS a case of hypersensitivity pneumonitis as popcorn lung disease caused by e-cigarette]=== <!--T:132-->
@@ Line 661: / Line 612: @@
 *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 [http://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking]=== <!--T:134-->
@@ Line 670: / Line 618: @@
 *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= <!--T:136-->
@@ Line 746: / Line 691: @@
-<br>
 =Further Reading=
+===2023: Yale School of Public Health: [https://ysph.yale.edu/news-article/tobacco-purchases-rise-following-restrictions-on-e-cigarette-sales/ Tobacco purchases rise following restrictions on e-cigarette sales]===
 ===2021: Policy Analyst Testimony: [https://www.cga.ct.gov/2021/PHdata/Tmy/2021SB-00326-R000208-Stroud,%20Lindsey,%20Policy%20Analyst-Taxpayers%20Protection%20Alliance-TMY.PDF Testimony before the Connecticut Public Health Committee Regarding Prohibiting the Sale of Flavored Tobacco and Vapor Products]===
 ===2021: Commentary: [https://www.myjournalcourier.com/opinion/article/Commentary-Lindsey-Stroud-Want-fewer-teen-16184278.php Want fewer teen smokers? Stop all the bans]===
@@ Line 775: / Line 720: @@
 =Other Resources=
 ===[https://docs.google.com/document/d/1CWfu0QLj347Ud07tb9NdNWESXZRqAzW9MX_VbU_NAss/edit?usp=sharing Document of pre-written tweets about flavors]===
 =Suggested Studies, Papers, Surveys, and Articles to Add to This Page= <!--T:153-->
 *If you prefer not to add information to this page yourself, drop the links here and one of our editors will do it for you
-===2023: [https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4586701 E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales]===
+===2024: [https://pubmed.ncbi.nlm.nih.gov/39787830/ The impact of non-tobacco e-cigarette flavoring on e-cigarette uptake, cigarette smoking reduction, and cessation: A secondary analysis of a nationwide clinical trial]===
-===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0378427423001091?via%3Dihub A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro]===
+===2024: [https://jamanetwork.com/journals/jama-health-forum/fullarticle/2828404 Flavored E-Cigarette Sales Restrictions and Young Adult Tobacco Use]===
-===2022: PREPRINT: [https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1 A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults]===
-*[https://www.medrxiv.org/content/10.1101/2022.11.14.22282288v1.full.pdf PDF of full paper]
-===2022: [https://pubmed.ncbi.nlm.nih.gov/36328469/ Removal of mango-flavoured Juul pods created opportunity for adulterated mango Juul-compatible pods with altered chemical constituents]===
-===2022: [https://pubmed.ncbi.nlm.nih.gov/36250607/ Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey]===
-*E-cigarette use is positively associated with both making a quit attempt and quit success, and those using flavored e-cigarettes are more likely to successfully quit smoking, with no statistically significant differences between the use of menthol or mint-flavored e-cigarettes versus the use of other nontobacco flavored products.
-===2022: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14166-w E-cigarette addiction and harm perception: Does initiation flavor choice matter?]===
-===2022: [https://tobaccocontrol.bmj.com/content/31/e1/e10 Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA]===
-*Non-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use.
-===2022: [https://www.sciencedirect.com/science/article/abs/pii/S0091743522001116 Effect of flavored E-cigarette bans in the United States: What does the evidence show?]===
-*However, in this paper, we propose an evidence-based version of this model based on several years' worth of longitudinal and econometric research, which suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking. From this analysis, we propose a re-evaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults.
-===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287473/ Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas]===
-*Results from this study highlight heterogeneity in young adult e-cigarette users’ reactions to existing flavored e-cigarette sales restrictions and hypothetical restrictions. Some reduced e-cigarette use, but many reported intentions to continue e-cigarette use, by using tank-based e-cigarettes, available flavors, or flavors accessed through alternative sources. More concerning, some switched to cigarettes. Similarly, in response to future restrictions of all flavored e-liquids, young adult e-cigarette users largely indicated that they would either quit vaping – the ideal scenario – or switch to cigarettes – the least desirable scenario. Another major concern highlighted was access to flavored e-cigarettes despite restrictions (e.g., online, across state lines). Collectively, findings suggest that implications of flavored e-cigarette sales restrictions are complex, with the potential for both reductions in e-cigarette use and unintended consequences among young adults, including continued use of flavored e-cigarettes or switching to cigarettes, and retail and consumer circumvention of restrictions.
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