Statewide prohibitions on flavored e-cigarettes have shown clear benefits in curbing vaping across adult age groups, according to new research. However, the study also reveals an unintended consequence: a deceleration in the reduction of traditional cigarette smoking following these bans.
Published on July 30 in JAMA Network Open, the study evaluated the effects of flavored vape bans introduced by several states — including Massachusetts, New Jersey, New York, Rhode Island, Maryland, and Utah — primarily enacted around 2020 to combat the rising epidemic of youth vaping.
These flavored products, often fruit or candy flavored, have been criticized for their appeal to children and teenagers.
Analyzing national survey data from 2019 to 2023, Levy and colleagues discovered the following key outcomes:
In states enforcing bans from 2020, e-cigarette use among young adults aged 18 to 24 declined by 6.7 percentage points by 2022 compared to states without bans.
By 2023, the decline persisted but at a reduced rate—a 1.2 percentage point decrease among adults aged 25 and older.
Among high school students, vaping dropped from 24.1% in 2019 to 14.0% in states with flavored vape restrictions, compared to a decline from 24.6% to 17.2% in states without such bans.
However, the study also uncovered a concerning trend: the pace of cigarette smoking decline slowed in states that implemented flavored vape bans.
For instance, by 2021, cigarette use among high school youth in those states was 1.8 percentage points higher than projected, while cigarette use among young adults was 3.7 percentage points above expectations.
Variations in outcomes were also noted between states.
Massachusetts exhibited the most significant decrease in vaping, likely due to stringent enforcement and pre-existing local bans. In contrast, states like Utah and Maryland showed more modest effects, possibly because their bans included exceptions—such as permitting menthol flavors or allowing specialty shops to continue selling certain flavored vapes.
The research was supported by the U.S. National Institute on Drug Abuse.
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