12.6.11 Effects of flavoured tobacco products on smoking initiation and cessation

Last updated: October 2023
Suggested citation: Winnall, WR. 12.6.11 Effects of flavoured tobacco products on smoking initiation and cessation. In Greenhalgh EM, Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2024. Available from https://www.tobaccoinaustralia.org.au/chapter-12-tobacco-products/12-6-11-effects-of-flavoured-tobacco-products-on-smoking-initiation-and-cessation   


Flavoured tobacco products are commonly associated with initiation and subsequent use of tobacco products. Results from the Longitudinal Population Assessment of Tobacco and Health (PATH) Study showed that 71.9% of youth in the U.S. (aged 12 to 17) and 57.6% of young adults (aged 18 to 24) used flavoured products upon initiation of smoking.1 These flavoured products include menthol and mint among others. An analysis of this study that included only non-menthol/mint flavours showed that the use of these flavoured products at initiation was associated with subsequent use over 12 months.1 This was true of flavoured cigarettes as well as cigars (little cigars and cigarillos), waterpipe tobacco and smokeless tobacco.1 More information about flavoured cigarettes and the uptake of smoking can be found in Section 5.13.2.

Unlike initiation, there is considerably less research regarding the effects of flavoured tobacco products on cessation. One study of cigarillo users found that people who had strong flavour preferences were more likely to indicate that they would stop smoking if flavoured cigarillos were banned.2 As tobacco products with a characterising flavour were banned by the European Union in 2016, the cessation activity of their users has been studied using EUREST-PLUS ITC surveys. This study found that 62.2% of flavoured product users transferred to unflavoured products, 8.6% quit completely and 11% moved to alternative products that were flavoured.3 Future research directly comparing cessation behaviours in users of flavoured products compared to unflavoured are necessary to determine the effects of flavoured products on cessation.                                                                 


1. Villanti AC, Johnson AL, Glasser AM, Rose SW, Ambrose BK, et al. Association of flavored tobacco use with tobacco initiation and subsequent use among us youth and adults, 2013-2015. JAMA Network Open, 2019; 2(10):e1913804. Available from: https://www.ncbi.nlm.nih.gov/pubmed/31642927

2. Pike Moore S, Osborn C, Koopman Gonzalez S, Quisenberry A, Klein EG, et al. Flavour loyalty may predict cessation or substitution following a cigarillo flavour ban among young adults in the USA. Tobacco Control, 2022; 31(Suppl 3):s206-s13. Available from: https://www.ncbi.nlm.nih.gov/pubmed/36328462

3. Zatonski M, Herbec A, Zatonski W, Janik-Koncewicz K, Driezen P, et al. Cessation behaviours among smokers of menthol and flavoured cigarettes following the implementation of the eu tobacco products directive: Findings from the EUREST-PLUS ITC europe surveys. European Journal of Public Health, 2020; 30(Suppl_3):iii34-iii7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/32918816