Local Flavor Bans May Lead to Increase in Combustible Use


Lindsey Stroud

AVA Synopsis:

The study sought to assess the impact of flavor bans, specifically San Francisco’s flavored e-cigarette and tobacco product ban, and its effects on young adults, “focusing on the change in the use of menthol cigarettes, e-cigarettes, and cigars.”

The study used Amazon Mechanical Turk to formulate a “sample of San Francisco residents aged 18-34 who previously used tobacco products” [and] were surveyed about their tobacco use both before and after the ban.”

The participants “reported basic demographic information such as age, gender, race/ethnicity, educational attainment, employment status, and student status.” Further, participants were asked to report their attitudes toward San Francisco’s flavor ban.

The mean age of survey respondents was 27.2 years, and 93 percent reported having an associate degree or higher. The authors found that use of any tobacco products “decreased significantly after the flavor ban, and the prevalence of using any smoking products both cigarettes and cigars kept stable.”

The use of flavored vapor products “decreased significantly after the ban … within increases in the use of still permitted tobacco-flavored e-cigarettes.” The authors did find though, “a significant increase in cigarette smoking” in participants aged 18 to 24 years old. Among participants aged 25 to 34 years old, “there was a significant decrease in the exclusive use of e-cigarettes.” The authors also reported that nearly 21 percent of participants that reported exclusive e-cigarette use “quit all tobacco/nicotine use, including vaping, after the ban.” Only 4 percent of participants that reported flavored e-cigarette use and other tobacco product use, reported quitting tobacco products after the ban.

The authors note that only 8.1 percent of survey participants reported supporting San Francisco’s flavor ban, and 35 percent “agreed that the ban had been enforced completely in San Francisco.” A larger proportion of participants opposed the ban on flavored cigars, compared to the flavored e-cigarette ban.

The authors find that “a comprehensive ban on all flavors … will significantly reduce flavored tobacco product use … [and] will likely reduce e-cigarette use and cigar smoking but could also increase cigarette smoking.”


Some states and localities have already implemented bans on flavored tobacco products, including electronic cigarettes and tobacco cigarettes. Policymakers should take into consideration the effects of such bans on other tobacco product use, specifically those that are much more harmful than e-cigarettes and vapor products.


Objective: Flavors play an important role in the initiation and use of tobacco products. The FDA, states, and cities have been implementing or considering banning flavored e-cigarettes or any flavored tobacco products. This study empirically assessed the impact of one of the first comprehensive bans of all flavored tobacco products other than tobacco-flavored e-cigarettes among young adults in San Francisco, California.

Methods: Using Amazon Mechanical Turk, a sample of San Francisco residents aged 18–34 who previously used tobacco products (N = 247) were surveyed about their tobacco use both before and after the ban. Descriptive statistics and regression models were applied.

Results: The prevalence of overall flavored tobacco use decreased from 81% and 85% to 69% and 76% for 18–24 years and 25–34 years old, respectively. The prevalence of flavored e-cigarettes decreased from 57% and 56% to 45% and 48% for 18–24 years and 25–34 years old, respectively. The prevalence of cigars uses reduced as well. However, cigarette smoking increased, although not statistically significant among 25–34 years old. 66% of participants did not support the ban and 65% believed the ban had not been enforced completely. Most users reported being able to obtain flavored tobacco products in multiple ways despite the ban.

Conclusions: These findings suggest that comprehensive local flavor bans, by themselves, cannot sharply reduce the availability or use of flavored tobacco products among residents. Nevertheless, local bans can still significantly reduce overall e-cigarette use and cigar smoking but may increase cigarette smoking.

Further Reading:

Tobacco Truth, The War Against Tobacco Flavors Will Fail, 2019

Tobacco and Alcohol News Analysis and Commentary, My Testimony Today Regarding the Massachusetts Emergency Ban on the Sale of Electronic Cigarettes, 2019

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