BACKGROUND: The appeal of e-cigarettes is concerning as vaping is harmful to health. Flavored e-cigarettes are particularly appealing, especially to youth. To protect youth, the Dutch government implemented a ban on flavored e-cigarettes, limiting products to tobacco flavors and unflavored options only. This study assesses the impact of the flavor ban on e-cigarette use, aiming to inform policy makers about the effectiveness of such regulations.
METHODS: In September 2024, nine months following the ban's implementation, we conducted a retrospective cross-sectional survey. Participants included 548 adolescents and young adults (ages 13-24) and 457 adults (25+ years), all of whom used e-cigarettes at least monthly prior to the ban.
RESULTS: As a result of the ban, 39.5% ± 1.7% of respondents reported reduced vaping, and 22.4% ± 1.4% reported quitting. These outcomes did not differ between the two age groups (p = 0.48 and p = 0.06, respectively). The use of flavorless e-cigarettes among younger users increased (from 1.9% to 3.7%, p = 0.01), but there was no shift to tobacco flavors. The use of now-banned flavors declined from 91.4% ± 0.9% before the ban to 47.0% ± 1.6% after (p <0.01). Among those continuing to use banned flavors, the majority (35.6% ± 2.2%) purchased them abroad. The use of related products (e.g., nicotine pouches/snus) remained stable pre to post-ban, while the use of other products (e.g., cigarettes) decreased, suggesting no major substitution of e-cigarettes with alternative products.
CONCLUSIONS: We conclude that the e-cigarette flavor ban effectively reduced e-cigarette use, potentially benefiting public health. To enhance policy effectiveness, we recommend international adoption of similar flavor bans or other strategies to restrict cross-border purchasing.