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Farsalinos on Flavors

In an open letter to New York City Councilman Costa Constantinides (Democrat from the Borough of Queens), Dr. Konstantinos Farsalinos has made a compelling case for preserving flavor variety in the e-liquids used in electronic cigarettes. The open letter has been published on the website ecigarette-research, while the study itself is available at the US National Library of Medicine. Councilman Constantinides has proposed a city ordinance banning flavor variety, based on the unsubstantiated claim that it will be a factor in attracting youth to vaping, and on the additional claim, also unsupported, that the result will be higher smoking rates among young people.

Farsalinos cites a study he headed, finding that flavor variety is a major factor in the success of vaping as an aid to smoking cessation. The study surveyed 4618 "dedicated users" of electronic cigarettes, 91% of them former smokers using the devices to quit smoking, while the others were continuing to smoke sometimes, having reduced their smoking by 500% by the use of e-cigs (from 20 cigarettes per day to 4 per day).

A total of 48.5% reported that a lack of flavor variability would increase their craving for cigarettes, while 39.7% said that the availability of only one flavor would make it more difficult for them to quit or reduce smoking.

Almost 70% changed flavors within the day or from day to day, and the number of flavors used was independently correlated (that is, regardless of the subjects'  statements) with the success of their quit attempts.

Interestingly, flavor variety seems to be linked with the tendency of vapers to distance themselves gradually from the smoking experience, since users near the initiation of vaping-to-quit prefer tobacco flavors, but often move to fruit flavors and sweet flavors as the length of their cessation efforts increases.

Considerable confusion results from the court-mandated falsehood that e-cigarettes are not intended to help with smoking cessation, even though everybody, especially vapers, knows that is their primary purpose. Constantinides has been quoted to the effect that "the e-cigarette industry has openly admitted that they are not in the tobacco cessation business." As Farsalinos notes, the councilman has simply misunderstood; in fact e-cigarette companies are prohibited by law from making this obviously true claim, and must imply it by using euphemisms such as "tobacco alternative".

Of course another complication is the issue of whether flavor variety does in fact attract youths, and whether that is the intent of flavor marketing. Both of these propositions are routinely put forward by e-cig detractors, yet they are both totally unsubstantiated. Even the National Youth Tobacco Survey conducted by the Center for Disease Control has not been able to confirm these propositions; indeed the question the NYTS asks about flavored tobacco products lumps e-cigarettes together with everything else, and even so, there are fewer responses indicating preference for flavors. As Farsalinos points out, this NYTS study is flawed by imprecise use of language, testing only experimentation (ever experimentation and past-30-days experimentation) but then calling such experimentation "current use". Farsalinos suggests that youth uptake of nicotine can be more effectively prevented by outlawing sale to minors, a measure which will not harm the large population of former smokers who are vaping to quit.