Trump move on flavored e-cigarettes may hit adults trying to quit

The Trump administration’s looming ban on flavored e-cigarette sales is aimed at stopping kids from vaping, but it could have unintended consequences for adults who use those products to quit smoking tobacco.

The Trump administration argues flavors such as cherry and mint are fueling a youth vaping “epidemic” and must be removed from the market.

But experts say flavored vapes have also helped some adults wean themselves off of cigarettes, one of the leading causes of death in the U.S.

{mosads}“A lot of ex-smokers will go back to smoking,” said Dr. Michael Siegel, a professor and tobacco control expert at Boston University.

“They’re addicted to nicotine. If their products are taken off the shelf, most won’t be able to quit cold turkey. There will be no way for them to get their products, so they’ll go back to smoking,” he added.

Tobacco-flavored e-cigarettes can still be sold after the ban takes effect, but the most popular flavors, such as menthol, mint and mango, will all be removed from the market.

Department of Health and Human Services Secretary Alex Azar said the new regulations would be issued in “several weeks.”

President Trump made the announcement this week, citing rising youth vaping rates and a spate of vaping-related illnesses that have killed six people and sickened hundreds. “We can’t allow people to get sick. And we can’t have our kids be so affected,” he said.

That frustrates experts who think the administration is conflating commercially sold e-cigarettes, which are regulated by the government, with the illicit black market products that are linked to the illnesses.

While federal health officials say they have not identified a common product or cause behind the illnesses, most states point to illicit THC vapes that are sold on the black market and may contain ingredients that are harmful if inhaled into the lungs, such as vitamin E.

“Banning flavored e-cigarettes is not going to do anything about these deaths,” Siegel said.

When e-cigarettes came to the U.S. market 12 years ago, they presented smokers with a less harmful alternative to cigarettes, without the tar or toxic gases associated with burning tobacco.

E-cigarettes still contain nicotine, the addictive drug found in cigarettes, and the long-term effects of vaping are still unknown. 

While there are debates about whether vaping is an effective tool to help people quit cigarettes, experts argue it is almost certainly better than smoking, which kills 480,000 per year, per the Centers for Disease Control and Prevention.

But public health officials became alarmed when government surveys showed teenagers vaping at increasing rates.

About 28 percent of youth surveyed said they had recently used e-cigarettes in 2019, according to preliminary data released by the Food and Drug Administration (FDA) this week.

The move to ban flavors could reduce youth vaping rates, experts say, but it could also mean adults who vape might begin using more cigarettes.  

“The availability of flavors and wide variety of flavors are important for people who are using e-cigarettes as a way to transition off combustible cigarette products,” said Lauren Pacek, an assistant professor in psychiatry and behavioral sciences at Duke University.

A study published in the Substance Use & Misuse journal that Pacek co-authored found that 17 percent of  240 young adults who both vaped and smoked said they would increase their use of regular cigarettes if flavors were limited to tobacco and menthol.

“I think there’s a potential for a flavor ban to deter use in adolescents, but there may be unintended consequences among other populations,” Pacek said.

Raymond Niaura, a professor at New York University, a psychologist, and an expert on tobacco dependence and treatment, said evidence shows flavors are an important factor for smokers who switch to vape products.

“A lot of people who want to switch away from tobacco don’t want to be reminded of the taste and smell of smoking cigarettes,” he said.

Banning the sale of flavored e-cigarettes runs the risk that illicit versions will pop up on the black market, he said.

That could lead to more illnesses in addition to those that have been linked to black-market THC vapes.

Critics also pointed out the irony of banning the sale of menthol vape flavors while letting menthol cigarettes stay on the market.

The FDA proposed last year banning menthol in cigarettes, but it’s not clear if that will move forward. A spokesperson did not offer a comment.

But anti-smoking advocates who also want the FDA to ban menthol cigarettes said that’s not enough of a reason to let menthol vapes stay.

“The fact that FDA hasn’t banned menthol cigarettes shouldn’t be an excuse for leaving menthol and mint e-cigarettes on the market,” said Vince Willmore, vice president of communications for the Campaign for Tobacco-Free Kids.

“We need a comprehensive ban on all flavored e-cigarettes, including mint and menthol, because the evidence shows that these flavors are popular with youth, and if you leave some flavors on the market, kids will migrate to them,” he added.

Azar acknowledged this week the “promise” e-cigarettes offer people who are trying to quit smoking. But he indicated tobacco-flavored e-cigarettes could also be pulled if kids started using those too.

“There is some public health need for alternative nicotine delivery devices to be available for adults to get off of combustible tobacco,” Azar, sitting next to Trump, said in the Oval Office on Wednesday.

“But with now 5 million children regularly using e-cigarettes, we can’t allow the benefits to adults from that to come at the expense of our children,” he added.