A decision aid for policymakers to estimate the impact of e-cigarette flavour restrictions on population smoking and e-cigarette use prevalence among youth versus smoking prevalence among adults

Background Policy decisions should be evidence-based, but the magnitude of intended and unintended impacts cannot always be easily estimated from the available data. For example, banning flavours in electronic cigarettes (e-cigarettes) to reduce appeal to non-smoking young people could have the intended impact by reducing youth vaping but could have negative consequences for adult smokers and vapers.

Methods We developed a decision aid to help policymakers make informed decisions on the potential net impact of a ban on e-cigarette flavours. We estimated the number of non-smoking youth who would be deterred from ever vaping and subsequently ever smoking, and the number of smokers and ex-smokers who would be deterred from quitting or encouraged to relapse, to determine whether the benefits to youth outweigh the costs to existing smokers and vapers. This aid then outputs a report with the results graphically depicted to aid interpretability.

Results We demonstrated the value of this decision aid using data from various sources to estimate the impact of a flavour ban in three populations: the general UK population, low-socioeconomic position UK population, and the general US population. All three examples suggested a negative net population impact of a ban. These reports were then presented to the all-party parliamentary group for vaping.

Conclusions We demonstrate how decision aids can be used to help policymakers arrive at evidence-based decisions efficiently and can be used to quickly obtain up-to-date estimates as new data becomes available.