As anticipated, the Connecticut Public Health Committee raised Senate Bill 367 recently, which would ban the sale of all flavored e-cigarettes except those that taste like tobacco. This legislation is no surprise: leadership in the Public Health Committee has made a flavor ban a top priority, and Gov. Ned Lamont has been a longtime advocate, even including it in his 2020 budget proposal. He has committed to signing it into law if the Legislature passes it.

When it comes to e-cigarette flavor bans, Connecticut has plenty of company, mostly here in the Northeast. Massachusetts, New Jersey, New York and Rhode Island have all banned the sale of these products; Maine cities Portland and Bangor have also done so. But prohibition never works as planned. Connecticut legislators should put aside their assumptions and evaluate the impact that a ban on flavored e-cigarette products would have on their constituents’ health, which will differ from their intent.

While the original objective of e-cigarettes has largely been forgotten, it’s worth remembering that these products came onto the market because there was a demand for a less harmful alternative to combustible cigarettes for those already addicted to nicotine. Chinese pharmacist Hon Lik is credited with their invention in 2003, which he began working toward after his father died of lung cancer.

When used as originally intended — as a harm reduction tool for current smokers — e-cigarettes have been a resounding success. While combustible cigarettes burn tobacco and release more than 7,000 chemicals into a smoker’s lungs, of which at least 250 are harmful or carcinogenic, e-cigarettes operate by heating a liquid that contains nicotine. According to Public Health England, the leading health agency in the United Kingdom, eliminating the burning process decreases the harm associated with combustible cigarettes by 95 percent. Virtually every public health agency, including the U.S. Food and Drug Administration, acknowledges that nicotine products exist on a continuum of risk, on which e-cigarettes are at the lower end near traditional nicotine replacement therapies. Meanwhile, Public Health England specifically endorses them as a smoking-cessation tool, and randomized controlled trials show that those who use e-cigarettes are able to sustain abstinence from combustibles at nearly twice the rate of traditional nicotine replacement.

Flavors are essential to the harm reduction benefits. In one study of 4,515 smokers who had switched to e-cigarettes, all participants called flavors “very important” to their decision to switch, and 40 percent reported that tobacco-only flavoring would have made their switch less likely. Another study found that smokers were more likely to switch completely from combustibles to e-cigarettes when they used flavored products.

As elsewhere, Connecticut legislators insist flavors are the root cause of the spike in teen vaping, even naming the campaign to prohibit their sale “Flavors Hook Kids.” Research suggests otherwise, with the U.S. Centers for Disease Control and Prevention finding in 2019 that 55.3 percent of teens who use e-cigarettes say they initially tried one out of “curiosity,” compared to 22.4 percent who cited flavors as their primary reason for initiation. There is no doubt we must keep these products out of youths’ hands, but in many ways, Connecticut is already doing so: the teen vaping rate here is below the national average, which fell 40 percent from 2020 to 2021 to 11 percent of high school students.

More can be done, but flavor bans are not the way to accomplish legislators’ objectives. These bans may even worsen health outcomes: a study of a flavor ban in San Francisco found the policy to be associated with an increase in combustible cigarette smoking compared to areas without a flavor ban. In Massachusetts, too, the flavor ban did not achieve its objective, instead simply driving the sale of flavored e-cigarettes across state lines to New Hampshire. In a region as densely compact as the Northeast, Connecticut could expect the same.

With nearly 12 percent of Connecticut adults addicted to combustible cigarettes, public policy should not sacrifice less harmful nicotine alternatives that could benefit more than 420,000 constituents to fulfill a campaign slogan. State legislators should weigh these costs and reject the e-cigarette flavor ban in Senate Bill 367.

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