It seemed to make sense: restrict flavored vaping products in order to lower the number of
young people smoking. Thing is, it doesn’t work. Thing is also, it does just the opposite of
what it is intended to do.
The results of a recently released study show a "high rate of substitution" between vapes and cigarettes, meaning the restrictive – some say unconstitutional -- policies designed to prevent underage use are actually doing exactly the opposite of what they were intended to do.
Laws restricting flavored nicotine vaping products have been shown to be associated with higher, not lower, cigarette purchases. So says the new paper, which looked at retail sales across 44 states.
Those results lead to the same conclusion that others have reached over the last several years: for every less than .7-milliliter nicotine pod sold in jurisdictions with these restrictive policies, people purchased 15 more cigarettes. Say the study’s authors, "That tradeoff equates to over a pack more cigarettes per pod for the size of current leading products" like Vuse Alto, which uses 1.8-milliliter pods.
“The substitution effect identified by this study underlines the folly of trying to protect public health by deterring the use of electronic nicotine delivery systems (ENDS), which are far less hazardous than combustible cigarettes,” commented reason.com.
"We find that ENDS flavor policies reduce flavored ENDS sales as intended, but also increase cigarette sales across age groups," said Yale public health researcher Abigail Friedman and her colleagues. "As cigarettes are much more lethal than ENDS, the high rate of substitution estimated here suggests that, on net, any population health benefits of ENDS flavor policies are likely small or even negative."
The study looked at 15 state and 279 local flavor restrictions that were put in place between January 7, 2018 and March 26, 2023. Included were full-on bans on ENDS flavors besides tobacco and laws that curbed sales of these items to specialty stores like vape shops and tobacconists. The information was drawn from IRI (Information Resources Incorporated), which analyzed checkout figures from retailers including convenience stores, supermarkets, drug stores, discount stores, and gas stations.
"ENDS sales fall and cigarette sales rise as a greater percentage of state residents are subject to policies restricting flavored ENDS sales," the report’s authors noted. "Effects are in the same direction for policies prohibiting all ENDS sales (i.e., flavored and unflavored), consistent with substitution." Aside from Friedman, the authors were Alex C. Liber, Georgetown University - Cancer Prevention and Control Program; Alyssa Crippen, Yale School of Public Health; and Michael Pesko, University of Missouri - Department of Economics.
The effects, they added, turned out to be "larger in the long run; that is, for policies in effect a year or longer. Separating ENDS flavor prohibitions from less restrictive policies limiting flavored ENDS sales to particular types of retailers reveals that both policies yield reductions in ENDS sales and increases in cigarette sales once in effect for at least a year."
Five Key Findings
The report itself identifies five key findings. The first is that ENDS sales fall and cigarette sales rise as a greater percentage of state residents are subject to policies restricting flavored ENDS sales. “Effects are in the same direction for policies prohibiting all ENDS sales (i.e., flavored and unflavored), consistent with substitution.”
Second, ENDS flavor policies’ relationships to ENDS and cigarette sales are larger over the long-run; that is, for policies in effect a year or longer. “Indeed, when allowing differential effects over time, the relationship between ENDS flavor policies and cigarette sales is positive and significant in the long-run but not the short-run.”
Third, 71% of the increase in cigarette sales associated with ENDS flavor restrictions comes from tobacco-flavored cigarettes. “Alongside the inclusion of controls for restrictions on menthol cigarette sales, this finding indicates that the observed substitution response to ENDS flavor policies cannot be attributed to menthol cigarettes’ availability, nor fully counteracted by menthol cigarette sales prohibitions.”
Fourth, ENDS flavor restrictions’ relationship to cigarette sales holds across cigarette product age profiles, including for brands disproportionately used by underage youth.
Lastly, separating ENDS flavor prohibitions from less restrictive policies limiting flavored ENDS sales to particular types of retailers reveals that both policies yield reductions in ENDS sales and increases in cigarette sales once in effect for at least a year. “These findings are consistent with flavored ENDS policies encouraging substitution from ENDS towards combustible cigarettes, aligning with results from 16 of 18 other studies assessing cigarette use following adoptions of minimum legal sales age laws for ENDS, ENDS tax rate increases, and advertising restrictions.
In other words, the report concluded, “policies making ENDS more expensive, less accessible, or less appealing appear to incentivize substitution towards cigarettes.”
The only question that remains is this: are politicians and activists who claim they want to help young people really listening?