Nicotine - Banning Flavors - Opposition: Difference between revisions

→‎What Does the Science Say? Do Flavors Have Any Value?: added paper on use in 3 states where flavours banned
(→‎What Does the Science Say? Do Flavors Have Any Value?: added paper on use in 3 states where flavours banned)
 
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=What Does the Science Say? Do Flavors Have Any Value?=
=What Does the Science Say? Do Flavors Have Any Value?=


=== 2023: [https://pubmed.ncbi.nlm.nih.gov/37292701/ The impact of flavored e-cigarette bans on e-cigarette use in three US states.] ===
* Note comments by [[Clive Bates]] [CB:]
* A pre-print examining the effect of flavor bans on adult e-cigarette use in 3 states (Washington, New Jersey, and New York), finding quite a bit of retailer noncompliance and consumer circumvention of the ban:
** Results: After the ban, 8.1% of respondents (N=1624) quit using e-cigarettes, those primarily [using] banned menthol or other flavors declined from 74.4% to 50.8, those using tobacco-flavored declined from 20.1% to 15.6%, and those using non-flavored increased from 5.4% to 25.4%... Of those primarily using banned flavors, 45.1% obtained e-cigarettes from in-state stores, 31.2% from out-of-state stores, 32% from friends, family, or others, 25.5% from Internet/mail sellers, 5.2% from illegal sellers, 4.2% mixed flavored e-liquids themselves, and 6.9% stocked up on e-cigarettes before the ban.
** Conclusions: Most respondents continued to use e-cigarettes with banned flavors post-ban. Compliance of local retailers with the ban was not high, and many respondents obtained banned-flavor e-cigarettes through legal channels. However, the significant increase in the use of non-flavored e-cigarettes post-ban suggests that these may serve as a viable alternative among those who used previously used banned or tobacco flavors.
* A strength of this paper is looking at the many different ways that consumers were able to circumvent the flavor ban. Some of those are likely less possible now (e.g. with the shipping ban on e-cigarettes), but it’s striking how many options there are.
* The big question of course, is did this drive people to smoking?  The study didn’t directly examine this, but makes a case for indirectly saying this isn’t a concern: only 8.3% of adult e-cigarette users quit post-ban, and these people were ''less'' likely to currently smoke – the implication being that if the ban drove anyone to smoke, it would be a small percentage. I’m not so sure though: I can’t tell if smoking status was collected at follow-up (post-ban) or only pre-ban (I get the sense it was only collected once, otherwise why not directly look at smoking status at follow-up?). Additionally, since smoking frequency and quantity weren’t collected, it can’t be ruled out whether dual users smoked more after the ban. ''[CB: '''OMG''' missing out on reporting smoking outcomes is quite a weakness]''
* It is also puzzling the very high (at least post-ban) percentage who report using non-flavored e-cigarettes. Non-flavored products are essentially negligible: e.g. FDA’s recent publication on US sales data finds that flavors that could not be classified (i.e. not tobacco, menthol, mint, fruit, candy, sweet, or ambiguous/ concept” flavors) accounted for <0.1% of sales. The data in the current study are self-reported and I wonder how many who report using “non-flavored” are actually using tobacco flavor (which is often treated as the ‘default’ flavor). This would complicate things, because tobacco-flavored and non-flavored use went in opposite directions after the ban. ''[CB: that would hardly be a surprise, given the muddled language about flavours used in the expert community]''
* On a related note, it’s also puzzling why tobacco flavor becomes less common post-ban – even with the rampant circumvention of the ban, I’d expect use to increase since it’s the only remaining available option (except for possibly non-flavored). This might be an effect of the type of people who quit using e-cigarettes after the ban: it seems to be the more casual or experimental users who stopped using e-cigarettes, leaving a greater proportion of heavier users who also smoke more frequently and more often use tobacco-flavored e-cigarettes.
* Yang Y, Lindblom EN, Ward KD, Salloum RG. medRxiv. 2023 May 21:2023.05.19.23290249. doi: 10.1101/2023.05.19.23290249. Preprint. PMID: 37292701 Free PMC article.


===2020, Feb 26 - Article: [https://news.psu.edu/story/609549/2020/02/26/research/research-suggests-adults-not-just-teens-electronic-cigarette Research suggests adults, not just teens, like electronic cigarette flavors]===
===2020, Feb 26 - Article: [https://news.psu.edu/story/609549/2020/02/26/research/research-suggests-adults-not-just-teens-electronic-cigarette Research suggests adults, not just teens, like electronic cigarette flavors]===