The E-Cigarette Flavor Debate - Promoting Adolescent and Adult Welfare.

Introduction:
This text from the New England Journal of Medicine discusses the controversy around e-cigarette flavors and the challenges policymakers face when trying to balance the interests of adolescents and adult smokers. The authors propose a potential solution to address the concerns of both groups while minimizing harm. Readers will learn about the study design, major findings, and the main message of this perspective.

Key Points:

* The debate over e-cigarette flavors focuses on reducing adolescent vaping and harnessing vaping's potential to help smokers quit (NEJM.org).
* Some policies, like banning non-tobacco flavors, may reduce vaping among adolescents but could also hinder smoking cessation among adults (NEJM.org).
* Restricting the sale of flavored tobacco products to adult-only retail outlets is one measure taken to address young people's access without banning them entirely (NEJM.org).
* The authors propose moving all nonmedicinal nicotine products (including cigarettes, cigars, smokeless-tobacco products, and e-cigarettes) to adult-only retail outlets (NEJM.org).
* This policy offers benefits such as reducing incidental exposure to nicotine and tobacco products for children and adults, mitigating health disparities, and protecting against adolescents' exposure to future products (NEJM.org).
* Limiting sales to adult-only venues would face political challenges, given the distinct winners and losers, but has clear public health benefits for adolescents and adults (NEJM.org).
* The text also discusses related measures to increase retailers' incentives to prevent sales to underage customers, such as ID card scanners at store entrances, more effective compliance checks, and severe penalties for noncompliance (NEJM.org).

Main Message:
The main message of this text is that limiting the sale of all nonmedicinal nicotine products to age-restricted outlets offers the opportunity to protect adolescents while also assisting adults trying to overcome a fatal addiction to cigarettes. The authors emphasize that efforts to enable vaping as a pathway to smoking cessation do not have to come at the expense of young people who could be enticed by flavored products. By implementing policies that balance the interests of both groups, it is possible to reduce young people's exposure and access to tobacco and nicotine products, as well as temptation for adults.

Friedman AS, Warner KE. The E-Cigarette Flavor Debate - Promoting Adolescent and Adult Welfare. The New England journal of medicine. 2022;386(17):1581-1583. doi:10.1056/NEJMp2119107