Flavor Can Save Lives: The Neurobiological Rationale for Flavor in Reduced-Risk Nicotine Products

Flavor is more than just a preference (like or dislike) when it comes to changing behavior.

Youth use of flavored RRPs has decreased due to T21. Proper enforcement of age gating will decrease the levels of youth use even more moving forward.

Options and choices that align with a consumer’s flavor profile increase the likelihood of switching from smoking and staying switched. In the end, Flavor will save lives.

Currently, the most contentious debate in tobacco control and harm reduction is the role of flavored tobacco and nicotine products. Those against flavored products believe that they entice adults and minors to begin smoking and serve as a potential gateway to combustible cigarettes. Those who support flavored products assert that they are a viable reduced-risk product that helps current combustible cigarette smokers switch from a dangerous habit to less harmful behavior that still meets or exceeds sensory desires while greatly reducing health risks. Examples of reduced-risk products that use flavors include electronic nicotine delivery systems (ENDS, also known as vapes or e-cigarettes), heat-not-burn (HnB) products, and oral tobacco and nicotine products (snus, snuff, and nicotine pouches).

About a decade ago, scientific evidence demonstrating the importance of non-tobacco-flavored, reduced-risk products began to emerge. In 2015, researchers reported that 66 percent of those who independently chose to switch to novel ENDS products were able to completely stop smoking cigarettes. Most of the study participants attributed their success, which was verified by exhaled carbon monoxide readings, to the availability of non-tobacco- and non-menthol-flavored ENDS products. Unfortunately, around the same time, the underage use of vapes (both nicotine and non-nicotine) began to increase, which triggered an aggressive response from regulators and policymakers attempting to curb youth use via regulatory measures, educational campaigns, and laws limiting access to ENDS products. This led to the current situation in which no non-tobacco-flavored ENDS product has been approved for sale in the United States by the Food and Drug Administration (FDA).

The lack of approved, non-tobacco-flavored ENDS products is problematic because of the way in which flavor can be leveraged to help individuals more easily transition to reduced-risk tobacco and nicotine products. Most of us tend to think of flavor as a useful perception that brings pleasure (or disgust) as we ingest food and beverages. The reality, however, is that flavor perception is an essential function that not only keeps us healthy and alive but also dramatically influences many of our activities and behaviors, whether we realize it or not. To better understand the important role that flavor plays in our lives, this paper explains flavor perception from neuroscientific and psychological perspectives, describes how these influences consciously and subconsciously affect our behavior and thoughts, and explores how an understanding of these principles can be applied to influence smoking behavior and save the lives of millions of smokers across the globe.

With this understanding of the underlying science and influence of flavor, we can better appreciate how flavor factors into a rational approach to the regulation of reduced-risk products. Simply put, to reduce the nearly 500,000 smoking-related deaths that occur each year in the United States, the FDA Center for Tobacco Products (CTP) must take a scientifically driven approach that recognizes the neurobiological rationale for allowing a wide variety of flavored, reduced-risk products to be available to adults (while minimizing youth access). It is essential that the CTP approve non-tobacco-flavored, reduced-risk products.