Banning flavors and lowering nicotine levels in electronic cigarettes is a strategy that could backfire, a new study suggests.

Without those draws, many people would vape less and smoke more tobacco cigarettes, researchers claim.

“Some regulations on e-cigarettes, like making safer batteries, would benefit the general public,” said study author Lauren Pacek. She’s an assistant professor of psychiatry and behavioral sciences at Duke University School of Medicine in Durham, N.C.

But others, like reducing nicotine, might prompt adults to cut down or quit e-cigarettes and smoke more tobacco cigarettes, Pacek said.

The U.S. Food and Drug Administration has taken steps in the past year to try to make e-cigarettes less appealing to youth, following a huge surge in teen use of the devices.

For this new study, which was funded by the U.S. National Institutes of Health, Pacek and her team surveyed 240 young adults aged 18 to 29 who used both e-cigarettes and tobacco cigarettes.

In the online survey, participants were asked what they would do if the sale of flavored e-cigarettes were limited; if e-cigarettes didn’t contain nicotine, and if they couldn’t adjust the amount of nicotine or the temperature of the vapor.

If nicotine was not in e-cigarettes, 47% of the participants said they wouldn’t use them as often and would smoke more tobacco cigarettes.

If the ability to customize e-cigarettes was no longer available, 22% said they would use e-cigarettes less and smoke tobacco cigarettes more. About 17% said if e-cigarette flavors were limited to tobacco and menthol, they would do the same.

Pacek said that the FDA is now looking at reducing the level of nicotine in tobacco cigarettes to a very low level. Nicotine cannot be eliminated entirely, because that’s beyond the FDA’s authority, she explained.

“The level would be so low that smokers cannot smoke enough cigarettes to get the amount of nicotine that they’re craving,” she said.

Pacek has taken part in large trials in which people used low-nicotine cigarettes. Contrary to what you might expect, people actually smoked fewer cigarettes, she said.


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