Beyond Smoke: What is the role of flavours in e-cigarette usage?

E-cigarettes are widely known to be a harm-reduced substitute for traditional tobacco cigarettes in terms of the way they mimic the act of smoking - often being a key element to their appeal to former smokers. However, another lesser-discussed aspect that attracts smokers wanting to quit and switch to e-cigarettes is their variety of flavours.

In a report titled "The Case for Flavours in Tobacco Harm Reduction To Save Lives," Dr Konstantinos Farsalinos, an expert in public health, shares that 'flavourings are essential in the acceptability and appeal of e-cigarettes when used as substitutes for smoking' as they 'offer a better taste to users' when compared to regular cigarettes - and certainly when compared to flavourless e-cigarettes. In fact, an online survey shows that only 1% of vapers who participated were using flavourless liquids in their e-cigarettes.

With an incredibly diverse range of e-liquid flavours on the market, the base liquid mostly contains 'humectants, [such as] vegetable glycerol and propylene glycol, water, and […] nicotine' while the flavouring is either natural, nature-identical or artificial. These are food-approved additions that can mostly be found in the food-flavouring industry. Despite this, there is rising discord among governments and authorities regarding the inclusion of flavours in e-liquids.

It is vital to strictly regulate and constantly research the safety of flavours in e-liquids. For example, Dr Konstantinos' report highlights the case of diacetyl and acetyl propionyl - naturally found and synthetically used in certain foods - which can be safely ingested but cause concerns when inhaled. Yet, for the risk of improper use of flavouring due to limited research or insufficient regulations, it is not proportional to remove the flavour element from e-cigarettes entirely.

In addition to its general appeal and widespread use among former smokers, it is also seen as a catalyst and bridge for change. Data from the 2018–2019 Tobacco Use Supplement-Current Population Survey (TUS-CPS) observed that smokers incorporating non-tobacco flavours in their e-cigarettes exhibited a higher likelihood of attempting to quit and achieving successful cessation in comparison to individuals exclusively relying on non-flavoured or tobacco-flavoured products. Similarly, Dr Konstantinos' report shares how a 'longitudinal study of people buying an e-cigarette found that non-tobacco flavour users were 30% more likely to report smoking abstinence compared to those using tobacco flavour.'

With these results, it is clear that more effort needs to be put into research and regulations protecting, understanding and promoting the safe use of flavoured e-liquids as a method of smoking cessation rather than moving in the opposite direction.

To learn more about e-cigarette usage, flavours and the risk of bans, read Dr. Konstantinos' full report here.

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