Local policies have reduced the availability and youth and adult use of products like flavored e-cigarettes and menthol cigarettes compared to areas without restrictions, the Truth Initiative reported after the first comprehensive quality review that looked at the outcomes of flavor and menthol tobacco restrictions. The research, which was conducted in partnership with the Research Triangle Institute, was published in Nicotine and Tobacco Research.

“Flavors—including menthol—have an important role in attracting youth and young adults to tobacco products because they are easier to start and more difficult to quit,” the organization said. “More than four out of five young adults aged 18–24 who have ever used tobacco reported that their first product was flavored.”

According to Truth Initiative, 338 U.S. jurisdictions restrict flavored tobacco in some form. Currently, 139 prohibit flavors such as fruit, candy, and other desserts, but not menthol, whereas 199 prohibit all flavors across all products. Local policies restricting flavors correlated to decreased youth use of flavored tobacco products, according to 4 of the 16 studies that Rogers et al. analyzed for its review.

The researchers examined reviews of implemented flavored product sales laws, including U.S. product sales restrictions and the evidence for their effectiveness on outcomes. in the hopes of offering justification for nations and states to adopt and implement flavored and menthol tobacco product sales restriction policies.

The authors called on state and local legislation to fill the gaps in incomplete federal policies, writing that “until comprehensive national policies are in place, U.S. jurisdictions must continue their efforts to create and implement policies restricting the sale of flavored and menthol tobacco products to protect the most vulnerable from the deadly toll of tobacco-related disease and death.”

In its position statement about the use of e-cigarettes and vaping, ONS calls for the U.S. Food and Drug Administration to regulate e-cigarettes, vaping liquids, and other tobacco products to protect underage users from adverse health effects and potential nicotine addiction. Nurses must advocate for regulation and encourage Congress to pass legislation recognizing the danger that flavored nicotine products pose to children and take an active role in supporting tobacco control policies and legislation.