Nixing e-cigarettes because of flavor is nonsensical
In fact, cherry-flavored Jolly Ranchers helped me quit smoking a few years ago. While quitting made me crabby and resulted in some weight gain, I’ve shed some of the extra pounds and I’m in better health overall. I am lucky to be in the less than 10 percent of those who stay off cigarettes for the long term.
My own experience with flavors—as well as my background in the science of addiction—leads me to think it’s a bad idea to try to ban these flavors for e-cigarettes in particular. The increase in proposals for flavor bans in places like the Bay Area are antithetical to public health interests.
For former smokers, indeed, flavor variety is an attractive feature of e-cigarettes. The International Journal of Environmental Research and Public Health reports that limitations in flavor choices negatively impact user experience. About 40 percent of former and current adult smokers predict that removing their ability to choose flavors would make them less likely to remain abstinent or attempt to quit. In fact, data in this report suggest that current smokers tend toward the flavor of tobacco, while fruit and sweet flavors are the preferred flavorings for former smokers.
Other ways to quit can be worth trying, but e-cigarettes hold a lot of promise. While perhaps not intended as a smoking-cessation tool, smokers have adopted e-cigarettes as a way to transition off nicotine. The CDC recently reported that e-cigarettes are the most popular product for adults who quit smoking. While the vast majority of quit attempts are of the “cold turkey” variety, e-cigarettes beat out both nicotine replacement therapies like the patch or nicotine gum and prescribed drugs like Chantix and Zyban.
Moreover, some people have no desire to quit smoking. Maybe they like the nicotine, maybe they like the ritual or maybe they like the social benefits of smoking, although those benefits appear to be declining. For those people, e-cigarettes offer a safer alternative that doesn’t require them to give up the things they like about combustible cigarettes.
Getting smokers to switch to e-cigarettes is a good idea because overwhelming evidence indicates they are a safer (although not entirely safe) alternative to their combustible cousins.
A report commissioned by Public Health England emphatically states that e-cigarettes are at least 95 percent safer than traditional combustible cigarettes. Included in this estimate is the consideration that some flavors and constituents in e-cigarettes may pose a risk over long-term use. Contributors to this report collectively estimate that long-term health risks of e-cigarettes are about half the risk that accompanies smokeless tobacco and only slightly greater than long-term use of the patch or nicotine gum.
E-cigarettes aren’t a godsend, but they are better than the alternatives. Rather than trying to discourage their use by current smokers, public health officials and policymakers should treat them as a “harm reduction” tool. Just as current programs around the Bay Area provide clean syringes to injection drug users, distribute condoms in schools and encourage the use of pre-exposure prophylaxis for those who engage in risky sexual behavior, e-cigarettes deserve a chance to help public health.
Flavored e-cigarettes do need to be kept away from children and, just like alcohol, there are measures in place to restrict access to this vulnerable group. But banning e-cigarettes or severely limiting choices like flavor options would do nothing to advance the cause of public health.
Image by Elizabeth A.Cummings