|motivation||post hoc(?), TOTC|
|used by||CtFK, CDC, Bloomberg|
US harm reduction opponents found their stride/framing in attacking defining flavours in e-cigarettes. The presumption being that those attract only non-smokers, or were even "invented" just to addict youths en masse (often paired with tobacco-industry conflation). This rationale primarily rests on flavour descriptors however, and is a clear case of simplistic reasoning.
Albeit the origin can be attributed to opinion papers/reports which 'negligently' confound access-usage in teens with causation. Ad nauseam assertions are meant to distract from other surveyed initiation reasons. (It's largely gadget appeal, btw. Easily solved through clear purpose communication, as proven by the UK). Obviously detailed consequence discussions of ban proposals are vehemently opposed.
It's a modal scope syllogism(?), that necessitates refuting the disassociative effects of vaping flavours (substitution of subconscious cigarette perfumation). Or even proclamations that adults wouldn't even use or universally prefer them. (Insinuating ex-smokers have also been tricked into using e-cigs). Which leads to the suspicion among vapers that the intent is fostering dual use and relapse to smoking. Or to instigate a real home-mixery/EVALI-type situation.
Recap: The origin concern absolutey does have merit. There's no indication that teens are more prone to liking palatability than adults however. Which is what the hysteria and framing campaigns insinuate. (It's actually labels and branding which are put forth as substantiation.)
Even from a quick glance, some argument variances might be attributable on who advocates for flavour bans:
Misquotable report, causal confounding
An oft-cited opinion piece by Dr. B.A.King (who also promulgated the EVALI misnomer) explains the origin of the e-cigarette flavour opposition. It's titelized "Flavours a Major Driver of Youth E-Cigarette Epidemic" for optimum misquoting, parrots the "epidemic" FUD, and miscondenses an already-slanted 2016 report in just two paragraphs:
[...] can harm adolescent brain development and prime the brain for addiction to other drugs.³ The increase in youth e-cigarette use has been driven by multiple factors, including ad vertising, high nicotine content, and the availability of flavors that appeal to youths.³ Youths report that flavors are a primary reason they use e-cigarettes, and most youth e-cigarette users first initiate use with flavored products⁴. Among youth e-cigarette users in 2019, 70% reported using flavored varieties, making e-cigarettes the most common flavored tobacco product used among youths.¹ [...] nihp/docs/AJPH/OSH/Comment-Flavours-a-Mmajor...pdf
It casually glances over more common initiation reasons, and confounds the access-driven preferences for causality. Just like his 2016 surgeon general report did through selective quoting and origin paper confirmation bias.
- Objectivity and Evidence in the 2016 Surgeon General’s Report on E-Cigarettes
- Experts re-analyse the data on which the Surgeon General’s report was based
The dominant thought process behind the US flavour prohibition is that sweets are only meant for/consumed by kids. Culminating into the claim that teenagers are like 3 year olds, and lose their mind when hearing "gummy bears", "mango" or "unicorn poop". If the conclusion is drawn from labels/descriptors, it's detectable from typical phrases like:
- "kid-friendly" flavours (sometimes still quoted even)
- "appeal to", "are marketed to", and "can only be meant for" (some influence by pharma-rationale)
- Never expliciting that it's about the naming or descriptivenes, but also avoid disclosing specific taste attributes, and eschew mentioning nutmeg/spinach/fried chicken and other fringe flavours.
- In the US-borne arguments, teens are oftentimes portrayed/propped up as inept or even daft. (But then again, they're American teens..)
- And over time this line of reasoning devolved into any non-tobbaco(-ish) aromas must be appealing to youths, and youths alone.
- Usually advocate for complete bans, not for sales restrained to strict adult-only stores. (Albeit a point could be made that lackluster enforcement [in the US] necessitates a ban. Only that this point is never made.)
- Often paired with unverified claims that "adults prefer/only use 'tobacco' flavours anyway". (Soule et al - dual use selection bias / redefinitional)
Interestingly such advocates are vaguely cognisant of other teen uptake causes (predisposed, experimentation, gadget appeal, marketing/packaging, peer pressure), but choose to ignore/cerrypick surveys for quick fixes. Notably absent are distinct thought processes on probable consquences, intended or not. (Narrow focus on middle/upper-class adolescents.)
genuine tobacco control
"Tobacco" signals higher toxicity, and attributes product involvment from the tobacco industry. Name-based deterrant is fairly plausible. But not unless accurate descriptions like RY4/RY8 were also prohibited.
- Less common now, but these advocates at least acknowledge the derogation on the smoking cessation aspect, and instability/high concentration of ATFs.
- Plausible rationale of less lifestyle/health-perceptive liquid labels.
- Some TC might be subject to projection bias on how much a "tobacco" ascription steers disinclination.
- Argument is usually that the reduction in nicotine use initiation outweighs the relapse effect.
Though the chain of reasoning is partly resting on the assumption that any teen and adult usage were completely isolated from another.
pharma-driven rationale (on-ramp)
Artifical flavours can't replicate the burnt/smoke/ash attributes of tobacco. Yet come close to the plant-like taste.
- Which makes them prevalent for dual-use, but less effective so for smoking disassociation. (Which is precisely why there are no nicotine gums with tobacco-ish flavours.)
- Hence pharma and commercial public health groups likely assume relapse capabilities to those complex flavour additives; perhaps even accustomizatiton/on-ramp effects for experimental teen use. (→ SF flavour ban: more smokey smoke)
- It seems (SFP) they're largely using much terser assertions of e.g. "appeal to youths" against other flavourings.
- Appeal to groupthink (WHOs: see, these LMICs have already done our bidding!)
- And cessation aid claims should necessitate pharmaceutical regulations.
Interestingly the reasoning is often the implication that non-NRT nicotine inherently should be tied (or assumed to be) to tobacco-esque aromas. The advocacy against non-NRT cessation also diminishes the thrive for other quitting options. Thus it's easy to assume the primary motivator is revenue protecting (and let's be honest, quarterly reports likely focus more on cancer therapies than NRT).
tobacco industry (vertical migration)
Big/commercial tobacco companies obviously have a vested interest in having a prevalence of vaguely cigarette-reminiscent flavours.
- For Altria/Juul it was an easy cop-out after the backslash to their marketing and purposeful sales continuation to adolescents. (They can easily weather a temporary ban, until smaller competitors are eradicated).
- For tobacco companies, the dual-use and relapse attributes of tobacco-ish aromas benefits their heated tobacco products (also somewhat muted flavours). Whose market establishment just so coincides with the heated up lobbying for flavour bans.
- And they have the research capabilities to further adulterate combustible cigarette perfumation to align with SNPs.
Proxy advocates seemingly prefer to equate/say just "tobacco flavours", avoiding disclosure of realistic differences.
regulatory scope affirmation
Albeit regulators employ similar phrasing/pretenses, it's fair to assume the motivator is slightly different.
- Since e-cigs being regulated as "tobacco" products are fairly weak legs to stand on, the restraint onto ATFs for e-cigs might just be an attempt at substantiating their jurisdiction.
- As well as effort minimization (= BigT/vendor consolidation seems to be main driver behind US FDA approach).
- Most plausible detection phrase is "flavoured tobacco products".
- Seems to be driver behind FDA and EU Commission.
- It becomes fairly apparent when actual tobacco with defining flavours gets market approval alongside anti-vaping FUD.
political populism / actionism
Just sounds convincing / easily communicable for goodwill. Polls over science. Differentiation woes due to the "e-cigarette" moniker. And US media influence. Or simply not sticking around for the consequences.
Alternatively: advocating for "tobacco" restrictions is the closest politicians can get away with to just mandating poop flavours (valid ex-smoker penalty in their mind), whilst retaining a veneer of believability.
- SF flavour ban organizers applauding themselves for talking-point framing: https://www.foundationpublic.com/legislative-and-issue-ad
While based on self-reporting, surveys (NYTS'19) reveal some of the rationales behind teens picking up vaping.
Curiosity and peer pressure are often externally imposed, and curiosity/tricks pretty much equate to gadget appeal. Whereas flavours can both be motive and fallout excuse. And less harm indicates alertness and use as quitting aid. Anyway, coarse surveys are not fit for interpolation, but a better indicator still than simplistic reasoning. NYTS'21 indicates even less use urges from aroma ingredients.
Synthetic tobacco-like flavours notably do stifle smoking disassociation. Duh. Same reason tobacco-ish NRT aren't a commercial or medical success, nor would whiskey-reminiscent soda be a treatment for recovering alcoholics.
- Li et al 2021 (?)
- E-Cigarette Flavors, Devices, and Brands Used by Youths Before and After Partial Flavor Restrictions in the United States: Canada, England, and the United States, 2017‒2020
- Flavored e-cigarette use: Characterizing youth, young adult, and adult users
- The Impact of Flavor Descriptors on Nonsmoking Teens’ and Adult Smokers’ Interest in Electronic Cigarettes
- A Randomized Trial of E-Cigarettes versus Nicotine-Replacement Therapy
- The case for flavours in tobacco harm reduction, to save lives
- Responses to potential nicotine vaping product flavor restrictions among regular vapers using non-tobacco flavors: Findings from the 2020 ITC Smoking and Vaping Survey in Canada, England and the United States While bans on the sale of non-tobacco flavored NVPs may in theory help prevent some youth from taking up vaping, the evidence to support this claim is lacking at this time. Moreover, there may be unintended consequences[…]
- The myth of vape flavors designed for kids is believable because it is intuitive…
- Effect of flavored E-cigarette bans in the United States: What does the evidence show?
- Tobacco control leaders call for a balanced assessment of the risks and benefits of nicotine vaping
- Clive Bates: The case against banning flavours in vaping and other smoke-free products
- E-cigarette addiction and harm perception: Does initiation flavor choice matter?
- The Impact of Flavor Descriptors on Nonsmoking Teens’ and Adult Smokers’ Interest in Electronic Cigarettes