Legal restrictions on the flavors of nicotine vaping products are associated with increased cigarette purchases, according to a new paper that analyzes retail sales data from 44 states. For each fewer 0.7-milliliter nicotine pod sold in jurisdictions with such policies, the analysis found, consumers bought 15 more cigarettes. "That tradeoff," the authors note, "equates to over a pack more cigarettes per pod for the size of current leading products" such as the Vuse Alto, which uses 1.8-milliliter pods.
The substitution effect identified by this study underlines the folly of trying to protect public health by deterring the use of electronic nicotine delivery systems (ENDS), which are far less hazardous than combustible cigarettes. "We find that ENDS flavor policies reduce flavored ENDS sales as intended, but also increase cigarette sales across age groups," Yale public health researcher Abigail Friedman and her collaborators report. "As cigarettes are much more lethal than ENDS, the high rate of substitution estimated here suggests that, on net, any population health benefits of ENDS flavor policies are likely small or even negative."
