Adults' favorability toward prohibiting flavors in all tobacco products in the United States

Prev Med. 2019 Dec:129:105862. doi: 10.1016/j.ypmed.2019.105862. Epub 2019 Oct 23.


In November 2018, US Food and Drug Administration announced its intent to prohibit menthol in combustible tobacco products, prohibit flavored cigars, and prohibit flavored e-cigarettes unless they are sold in age-restricted, in-person locations. This study assessed adult attitudes toward prohibiting flavors in all tobacco products, including e-cigarettes. Data were from the 2016 Summer Styles survey of 4203 US adults aged ≥18 years. Respondents were asked whether they favored or opposed prohibiting flavors (e.g., menthol, spicy, sweet, or fruity flavor) in all tobacco products. Prevalence and correlates of favorability were assessed using weighted percentages and adjusted prevalence ratios (aPR) respectively. Assessed correlates were: sex, age, race/ethnicity, income, US Census region, marital status, children <18 years living in the home, perceptions toward e-cigarette advertising, and current (past 30-day) tobacco product use. Overall, 47.3% of adults reported favorable attitudes toward prohibiting flavors in all tobacco products. By tobacco product use status, prevalence was 52.0%, 48.4%, and 34.8% among never, former, and current users, respectively (p < .05). Among current tobacco product users, favorability was more likely among adults who believed e-cigarette ads exposure makes youth think about smoking (aPR = 1.82; 95% CI = 1.20-2.78) and those with any children aged <18 years in their household (aPR = 1.38; 95% CI = 1.05-1.82). To conclude, nearly half of adults favored prohibiting flavors in all tobacco products, including e-cigarettes. Prohibiting flavors in tobacco products could benefit public health by reducing both individual-level and population-level harms, including tobacco use initiation especially among youth.

Keywords: Flavored tobacco; Opinion; Policy; Tobacco control.

MeSH terms

  • Advertising / trends
  • Electronic Nicotine Delivery Systems / statistics & numerical data*
  • Female
  • Flavoring Agents / adverse effects*
  • Humans
  • Male
  • Menthol / adverse effects*
  • Middle Aged
  • Public Opinion*
  • Smokers / statistics & numerical data
  • Surveys and Questionnaires
  • Tobacco Products* / legislation & jurisprudence
  • Tobacco Products* / statistics & numerical data
  • United States
  • United States Food and Drug Administration


  • Flavoring Agents
  • Menthol