Eliminate Flavored Products

The commercial tobacco industry uses flavors and marketing to entice kids and teens to their products. Research shows that flavors and advertising play a significant role in the appeal and initiation of tobacco and vapor products, especially among youth and young adults.⁵ These flavors are largely what has fueled the e-cigarette/vaping epidemic over the past decade. There are a variety of harmful flavored products on the market:

• E-cigarettes: nicotine vapor products that contain addictive nicotine and are known to cause lung damage. As of 2022, more than 2.5 million youth reported using e-cigarettes in some form and most use flavored e-cigarettes.^6,7
• Menthol cigarettes: menthol creates a cooling effect, reducing the harshness of cigarette smoke and making them easier to start and harder to quit. Current laws restrict any flavors in cigarettes, except for menthol. Dating back to the 1950’s, the tobacco industry has used predatory marketing practices to target the Black/African American community with menthol cigarettes, leading to higher use and death rates and contributing to significant health inequities.⁸
• Hookah: water pipes used to smoke specially made flavored tobacco. There is a dangerous misconception that hookah is a safe alternative, but there is a similar health risk to cigarette smoking because users are still ingesting harmful nicotine, tar, and heavy metals – often at a faster rate (i.e. more inhales over longer periods of time). A 1-hour hookah smoking session may expose the user to 100-200 times more smoke, up to 9 times more carbon monoxide, and 1.7 times more nicotine of a single cigarette.⁹ Highest use rates are found in college students, with use ranging from 22% to 40%.⁹
• Flavored cigars and cigarillos: little cigars that are often sold in many flavors. Similar to menthol cigarettes, current laws do not restrict the sale of flavored cigars or cigarillos, despite the same long-term health risks, like COPD and cancer. One large cigar has the same amount of nicotine as a pack of cigarettes.¹⁰
• Smokeless tobacco: not burned and is either dissolved, chewed, or spit – available in a variety of flavors, often appealing to youth. Smokeless tobacco use can lead to nicotine addiction and cause mouth, throat, stomach, and esophageal cancers.¹¹

Did you know? In 2020, a Health Impact Review by the Washington State Board of Health found very strong evidence that prohibiting the sale of flavored vapor products would decrease the use of ALL tobacco products by adolescents and young adults.

Minty, menthol flavors are added to dull the harsh smoke/vapor from nicotine-containing products and to make them easier to start using. Mentholated products can also be even more addictive, making them harder to quit. Menthol cigarettes are the only flavored cigarettes that were not banned in the 2009 Tobacco Control Act. Nearly 100,000 Washingtonians who smoke use menthol cigarettes.

Since 2009, many advocacy organizations and public health agencies across the U.S. have continued to push the FDA to prohibit all flavored tobacco products. The evidence is clear that flavors attract youth and menthol products cause more deaths, especially among Black Americans. The FDA failed to take meaningful actions and was sued in 2020 by the African American Tobacco Control Leadership Council for unreasonable delay in regulating menthol cigarettes. In 2022, the FDA proposed a rule to prohibit menthol flavor in cigarettes and a rule to prohibit all flavors in cigars. This federal rulemaking is behind schedule and still in progress.

Disproportionate Targeting of Black/African American Communities

Exposure to advertising and marketing significantly impacts whether or not someone will use a specific product. Since the 1950’s and continuing today, tobacco companies have advertised more heavily (especially with menthol products) in predominantly Black neighborhoods. The industry has used price promotions and discounts, and supported cultural events, such as using Black models or hip-hop icons.^13,14 The tobacco industry also funds some Black spokespeople and events that perpetuate inaccurate information and raise fears about proposals to end the sale of menthol cigarettes.¹⁵

The Washington State Department of Health created a campaign called ‘They Think They Know You,’ which raises awareness about the harms of menthol and how the commercial tobacco industry has taken advantage of the Black community.

The tobacco industry continues to create new products and push new variations into stores, often trying to evade federal and state regulations. Some products are marketed as ‘reduced risk’ or ‘healthier’ to try to increase the appeal to non-tobacco users and to youth. Flavors are commonly added to these emerging products. It’s important to stay in the loop on what’s being developed and marketed. The following are currently available:

• Disposable e-cigarettes: On the market because of loopholes in federal regulations on “closed-pod” systems that leave disposable and refillable e-cigarette devices out. As a result, the industry started developing and marketing more disposable e-cigarettes with synthetic nicotine, such as Puff Bar, Elf Bar, Hyde, and Breeze. Youth use of disposable e-cigarettes skyrocketed 1,000% between 2019-2020.¹⁷
• Synthetic nicotine: marketed as “tobacco-free nicotine”, this nicotine is created in a lab instead of coming from tobacco leaves. Marketing for some products tries to make them appear “healthier” and “safer” than tobacco. Synthetic nicotine is still a highly addictive substance that impacts brain development, memory, attention, and ability to learn. Tobacco companies created these products to exploit loopholes in federal and state regulations.
• Oral nicotine pouches: smokeless flavored products that contain a nicotine powder (e.g. Zyn, On! and Velo), as opposed to pouches with shredded tobacco leaf, like snus. Oral pouches often have high nicotine concentrations. The FDA does not consider this a smokeless tobacco product because there are no tobacco leaves, leaving them out of flavor regulations.
• Heat-not-burn or “heaters”: electronic devices (e.g. iQOS) that contain tobacco and are heated to a high temperature to produce ‘smoke’ that the user inhales. These products contain nicotine, flavors, and other chemicals.

Did you know that...

• youth who have used e-cigarettes were more likely to purchase those labeled "tobacco-free nicotine" and
• 73% of youth and young adults who use oral nicotine pouches also smoke cigarettes and 49% are using e-cigarettes.^18,19