Restrictions on flavoured vaping products were associated with a 9.6 per cent increase in cigarette sales in Canada, according to new research that raises questions about the potential unintended consequences of tighter vape regulations.
The working paper, which analysed sales data from 5,918 gas and convenience stores across Canada between 2018 and 2023, found that restrictions almost eliminated sales of flavoured non-menthol and menthol nicotine vaping products (NVPs), while sales of tobacco/unflavoured products increased by 123.4 per cent.
Overall nicotine vaping product unit sales fell by 29.5 per cent, although this was not statistically significant, while cigarette sales increased by 9.6 per cent. The researchers estimated that the increase equated to around 5.5 additional cigarettes per person per month based on pre-restriction sales levels.
The authors say the resulting increase in nicotine absorbed from cigarettes was of a similar magnitude to the reduction in nicotine absorbed from NVPs.
The findings are particularly relevant to the UK, where the government is considering restrictions on how vape flavours can be named and described, rather than banning the flavours themselves.
They also follow an August Opinium survey of 6,000 UK adults commissioned by Elfbar, which found that proposed restrictions on vape flavour names could result in more than half a million adult vapers returning to or increasing their smoking.
Researchers from the University of Missouri and Yale University said the results suggest flavour restrictions can lead to some consumers switching away from vaping and towards combustible tobacco. However, they cautioned that their analysis measures product sales rather than individual consumption and cannot establish whether changes reflected the number of consumers or their consumption frequency.
The study also found that the increase in cigarette sales became more pronounced around 10 months after flavour restrictions were introduced, while the decline in overall NVP sales became apparent after about six months.
The study also found little evidence that consumers responded to flavour restrictions by moving to vape shops or online purchasing. Google searches related to NVP shopping fell by 21.7 per cent, while searches for “Vape Shop” fell by 17 per cent, although the latter result was not statistically significant.
The researchers conclude that the Canadian experience demonstrates a substitution effect between vaping products and cigarettes, warning that restrictions on flavoured NVPs can have unintended consequences.
The findings are consistent with previous research from the US, according to the authors, but the Canadian analysis is significant because Canada has a more restrictive tobacco-control environment than the US.
Canada had already banned menthol cigarettes nationwide, restricted flavoured cigars, introduced plain packaging for combustible tobacco and capped NVP nicotine concentrations at 20mg/ml during the study period. The researchers therefore argue that the emergence of substitution towards cigarettes in Canada suggests the effect may not be unique to the US.
The authors said policymakers should therefore “proceed with caution” when considering restrictions on NVP flavours, arguing that the potential increase in cigarette consumption could outweigh public-health benefits from reducing vaping.