Besides facing significant opposition from the tobacco industry and retailers leading up to the final days of the 2019-20 Legislative Session, the flavour ban was also met with concern by public health experts who predicted that it would drive teens back to smoking regular cigarettes.
Similarly, the city’s chief economist, Ted Egan, whose office is charged with analyzing the economic impact of legislations in San Francisco, had confirmed that the ban would only lead to increased smoking rates. And sadly, data keep confirming this.
Higher smoking rates in cities with flavour bans
A recent study published in JAMA Pediatrics, found that following San Francisco’s flavour ban, teenagers in the city’s high schools were more likely to take up smoking than teenagers in US school districts where no flavour bans were imposed. While prior to the ban, smoking rates in San Francisco were similar to that of many cities across the country.
“To understand this conceptually, think about youth preferences between tobacco products,” said study author Abigail Friedman, an assistant professor in the Department of Health Policy and Management at the Yale School of Public Health, in a statement. “Among youths who vape, some likely prefer ENDS to combustible products because of the flavors.”
“For these individuals as well as would-be vapers with similar preferences, banning flavors may remove their primary motivation for choosing vaping over smoking,” she continued. “Thus, some of them will respond to a ban on flavors by choosing to use combustible products instead of ENDS.”
Teen responses to possible restrictions
In line with these findings, a 2019 online survey of 240 young U.S. adults aged 18 to 29, asking participants about any changes in tobacco use behaviour had illustrated this clearly.
The survey had asked hypothetical questions about flavour bans and nicotine limits, to which about 47% said they would increase their use of traditional cigarettes. About 22% said that if regulations limited the customizability of devices, they would vape less and smoke more tobacco cigarettes, and 17% percent said that if e-liquid flavours were to be limited to tobacco and menthol flavours, they would vape less and smoke more traditional cigarettes.
The study’s lead author and an assistant professor in psychiatry and behavioral sciences at Duke, Lauren Pacek, Ph.D., had highlighted that although the survey was small and not designed to predict e-cigarette use across the U.S., the data suggest that when considering changes to e-cig regulations, lawmakers must consider their potential downstream effects.
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