What Is The Role of Flavours in Harm Reduction, and How Should Countries Respond? China and Beyond

A recent report by Dr Konstantinos Farsalinos, titled ‘The Case for Flavours in Tobacco Harm Reduction To Save Lives’, provides a hard-hitting picture of the role of flavours in tobacco harm reduction. This report highlights the irreplaceable role that flavours play in encouraging smokers to switch from traditional combustible cigarettes to less harmful alternatives, like e-cigarettes. Such findings contradict the recent and ongoing decisions of various countries, such as China, to ban flavoured e-cigarettes.

Flavour Ban in China

The Chinese government enacted a ban on flavoured e-cigarettes in 2022, following discussions that it was the element of flavour that made vapes particularly attractive to the youth. Therefore, citing an effort to curb youth vaping, China only allows tobacco-flavoured e-cigarettes. Other countries also share similar reasons for their anti-flavouring policies.

The Implications of a Flavours Ban on Harm Reduction

Despite its good intentions, the ban on flavoured e-cigarettes in China has significant negative implications for harm reduction. While the government focuses solely on reducing use among the youth, Dr Farsalinos’ report finds that adult smokers are more likely to switch to e-cigarettes when they have access to a variety of flavours and are therefore able to find a satisfying alternative to cigarettes. According to the report, flavours are a crucial factor in the appeal and acceptability of e-cigarettes among adult smokers seeking to quit smoking. A flavour ban can result in smokers continuing with or reverting to traditional, combustible cigarettes that cause much greater harm. Essentially, a ban on flavoured e-cigarettes reduces the efficiency of vapes as a harm-reduction tool.

Black Market for Flavours

Dr Farsalinos also warns that a ban on flavours may increase the use of illicit and unregulated products. These products often lack quality control and include unsafe or unknown ingredients, contributing to their health risk. The emergence of black market products has already been seen in other countries where there are stringent regulations on alternative tobacco and nicotine products. This increases concerns about the flavours used not being monitored and deemed safe. For example, while many worry about flavouring agents such as diacetyl in e-liquids, despite its monitored and reduced use, regulating such agents becomes almost impossible when they appear in the black market as an alternative.

Risk-Proportionate Policy

Instead, flavourings must be recognised and appropriately regulated with rigorous safety standards, high-quality ingredients and reliable research. While concern for the youth is never invalid, the response must be in risk-proportionate policies that limit access for that particular demographic rather than removing access entirely. Dr. Farsalinos’s report also strongly advocates for regulatory frameworks that support the availability of flavoured e-cigarettes, while implementing safeguards to prevent youth access. In this manner, governments can create policies catering to multiple factions of society while simultaneously promoting public health.