Tim Tai, Senior Photographer

Seven states have banned flavored e-cigarettes. A recent Yale-led study found that these policies push smokers toward traditional cigarettes, a more lethal habit. 

In a study published on Tuesday, Oct. 31, that funded by the Tobacco Center for Regulatory Science through grants from the National Institutes of Health and the U.S. Food and Drug Administration, researchers from Yale, the University of Missouri and Georgetown University analyzed retail sales from 2018 to 2023 and found that restricting flavored e-cigarettes increased conventional cigarette sales. As research has shown that traditional cigarettes are more dangerous than electronic cigarettes, current regulations against flavored electronic cigarettes may pose a public health threat, according to the new study. The research also notes that traditional cigarette sales have increased disproportionately for brands most often used by underage youth. 

“As smoking’s health harms increase with the intensity of use, evidence that e-cigarette flavor restrictions yield an additional 15 cigarettes purchased for every 1 less 0.7mL e-cigarette pod sold suggests that these policies’ public health costs may outweigh their benefits,” Abigail Friedman, an assistant professor at the Yale School of Public Health, wrote to the News.

Both e-cigarettes and traditional cigarettes contain nicotine, which is an addictive substance, according to the NIH National Institute on Drug Abuse. But only traditional cigarettes have tar, which contains particles that can cause cancer and reduce the lung’s ability to absorb oxygen. 

Tar also damages the small hairs, or cilia, that help protect people’s lungs from dirt and infection, according to Alex C. Liber, an assistant professor at Georgetown University’s School of Medicine. He said that the saying “people smoke for the nicotine and die from the tar” is famous in the field. 

“The cigarette is the most dangerous consumer product ever created by man,” Liber told the News. “E-cigarettes are not as dangerous, at least based on the evidence we have.”

Liber also expressed concerns about the Food and Drug Administration establishing policies that indirectly encourage smokers to use traditional cigarettes instead of e-cigarettes. 

The Hill reported last week that the Biden Administration is looking to propose a ban on menthol and flavored cigarettes, saying that the FDA sent the rule to the White House for review in mid-October. 

The FDA has implemented a Premarket Tobacco Approval Process, requiring all tobacco products to be approved by the FDA before they are marketed. 

“I personally think e-cigarettes are over-regulated to the point that it is detrimental to public health,” Michael Pesko, professor of economics at the University of Missouri, told the News. “It’s odd that a lot of places don’t allow menthol e-cigarettes but they do allow menthol cigarettes to be sold. It’s unusual that we would regulate the less harmful product more.”

Friedman, Liber and Pesko said they hope that the FDA will take this new study into consideration when designing future regulation for electronic cigarette products. 

James McKinney, an FDA spokesman, told the News “the FDA does not comment on specific studies.” 

According to their website, The Tobacco Center Regulatory Science program “helps inform and assess FDA’s ongoing and potential regulatory activities.”

“This is high quality evidence that e-cigarettes as commercial products with flavors have the positive effect of reducing combustible use that would otherwise be occurring,” Pesko told the News. “[The FDA] hasn’t approved any flavored e-cigarettes yet. That might be a little short sighted.”

In 2022, 173.5 billion cigarettes were sold to retailers in the United States.