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expert reaction to study looking at first and subsequent use of flavoured tobacco products

Research, published in JAMA Network Open, reports an association between starting on flavoured tobacco products and continued use of tobacco when compared to starting on non-flavoured tobacco products.


Dr Emma Beard, Senior Research Associate, University College London, said:

“There is no circumstance where it would be better for you to continue to smoke rather than switching completely to e-cigarettes. The current study found that first use of flavoured e-cigarettes was associated with subsequent use among those aged 18+ but not among those aged 12-17. If it is the case that the majority of these were already cigarette users, this may support the provision of flavoured e-cigarettes to help smokers become smoke free. Of course, careful monitoring is necessary and there is a need for further studies looking at the impact of e-cigarette flavouring.”


Prof Peter Hajek, Director of the Tobacco Dependence Research Unit, Queen Mary University of London (QMUL), said:

“The question of whether flavoured e-cigarettes attract adolescents to smoking is currently highly topical.

“The report shows that young people who experiment with one type of tobacco product also experiment with other products, but experimentation is of little relevance. It is the habitual use, such as daily or ‘on most days’ that is of any concern.

“Somewhat misleadingly, the report labels use of e-cigarettes once in the past 30 days as ‘current use’, when ‘current smoking’ is normally understood as daily smoking. The Tables however include data on use on at least 6 days in the past month, and on daily use. These are highly reassuring. Only 3% of the youth sample smoke at least weekly and 1% smoke daily; 1% vape at least weekly and 0.3% vape daily.

“These figures do not support the claims that the US youth is in the grip of nicotine use epidemic. They also do not support the assertions that flavoured e-cigarette products, that seem important in helping adult smokers switch to vaping, need to be banned to protect youth.”


Association of Flavored Tobacco Use With Tobacco Initiation and Subsequent Use Among US Youth and Adults, 2013-2015’ by Villanti et al. was published in JAMA Network Open at 16:00 UK time on Wednesday 23 October. 

DOI: 10.1001/jamanetworkopen.2019.13804


Declared interests

Dr Emma Beard: “Emma does not receive any funding from tobacco companies or manufacturers of e-cigarettes”

Prof Peter Hajek: “No conflict of interest.”

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