Restricting Vapes Drives Young Adults Back To Cigarettes

This article examines new and existing research showing that restricting flavored e-cigarettes and vaping products can reduce vaping but may push young adults and other users back to combustible cigarettes, with evidence from U.S. studies and research reporting large illegal markets where bans are loosely enforced.

File this under unintended consequences: limiting access to less harmful nicotine alternatives appears to send some users straight back to cigarettes. Two studies and an international report suggest that bans on flavors or broad sales restrictions reduce vaping but increase traditional smoking among certain groups.

The first study, published in Nicotine & Tobacco Research in 2021, found troubling shifts in behavior among young adult vape users. “Young adult e-cigarette users indicate low support for e-cigarette sales restrictions (both for flavored products and complete restrictions). Moreover, if vape product sales were restricted to tobacco flavors, 39.1% of users reported being likely to continue using e-cigarettes but 33.2% were likely to switch to cigarettes. If vape product sales were entirely restricted, e-cigarette users were equally likely to switch to cigarettes versus not (~40%).”

A more recent study from researchers at the University of Missouri and the Yale School of Public Health looked at state-level flavored e-cigarette restrictions and found a similar pattern among young adults. The work reports that restricting flavored products led to a decrease in vaping but also to an increase in cigarette smoking compared to states without such restrictions. “We should always be cognizant that any policy will have unintended effects, especially in the public health space. In this case, our study finds flavored e-cigarette restrictions have the unintended effect of sizably increasing cigarette use,” Pesko said. “This is not good from a public health perspective because cigarettes are far more dangerous products. It’s the equivalence (sic) of steering a ship away from a storm straight into a whirlpool.”

That quote captures the policy dilemma: a rule aimed at protecting public health can steer people toward clearly worse outcomes if alternatives vanish. Policymakers often focus on reducing use of a particular product, but behavior substitution matters; when safer substitutes are removed, demand does not always disappear, it shifts.

There’s also international evidence that prohibition fuels black markets and keeps flavors available through informal channels. A report from researchers studying Chinese policy effects notes strong persistence in flavored e-cigarette use despite bans, and it attributes that persistence to loose enforcement and illicit supply chains. “Despite the predicted decrease in e-cigarette choices, the predicted choice share of flavored e-cigarettes when they are illegal but loosely enforced is 53% of the predicted share when legal. This large illegal share is consistent with anecdotal evidence and with the evidence from our 2023 background survey that flavored e-cigarettes remain popular after the ban although fewer vapers reported getting their e-cigarettes from specialty or general retailers.”

Calling that dynamic a polite way to describe a black market is fair; prohibition rarely eliminates demand and often creates alternative distribution routes. That outcome raises questions about whether well-meaning regulations do more harm than good when they push consumers toward riskier behavior or unregulated sources.

Historical context matters. Over past decades, cigarette smoking fell dramatically for many reasons unrelated to flavored alternatives being available or not. Social norms, public smoking restrictions, education, and taxation all played a role in reducing smoking rates long before flavored e-cigarette rules entered the picture. The modern debate is whether removing potentially less harmful options is a sensible trade-off when the likely result can be increased cigarette consumption and illicit markets.

Regulators aiming to protect youth should weigh the evidence that broad product bans can shift behavior toward more dangerous outcomes for adults trying to quit smoking. Vapes and e-cigarettes are considered by many researchers to be less harmful than combustible tobacco, and shutting down access to those alternatives without clear, enforceable strategies to prevent youth uptake risks reversing public-health gains. It remains, as President Reagan so famously said: Government is the problem.