{
  "abstract": "Introduction The appeal of e-cigarettes is concerning as vaping is harmful to health. Flavoured e-cigarettes are particularly appealing, including to youth. Therefore, the Dutch government implemented a ban that limits e-cigarette products to tobacco flavours and unflavoured options only. This study aimed to evaluate the impact of the ban on e-cigarette use in pre-ban users.Methods We conducted a retrospective cross-sectional online survey, 9 months following the ban’s implementation. A research agency with a certified participant pool recruited 548 adolescents and young adults (ages 13–24) and 457 adults (25+ years), all of whom used e-cigarettes pre-ban.Results As a result of the ban, 40% (95% CI 36% to 43%) of respondents reduced vaping, including 22% (95% CI 20% to 25%) who quit entirely, with no differences between the two age groups. Most consumers (73%) who quit vaping due to the ban did not use a substitution product. Six per cent of all participants started cigarette smoking and attributed this initiation to the e-cigarette flavour ban. Yet, overall prevalence of cigarette, cigar(illo) and waterpipe smoking declined post-ban, by 8 percentage points (ppt), 3% ppt and 5% ppt, respectively, indicating that more users quit than started using potential substitution products. The use of non-tobacco flavours in e-cigarettes declined by 44 ppt. Among those continuing to use banned flavours, the largest group (36%) purchased them in physical shops abroad.Conclusion The e-cigarette flavour ban effectively reduced e-cigarette use among pre-ban users, potentially benefiting public health. To enhance policy impact, we recommend international adoption of similar measures or other strategies to restrict cross-border purchasing.",
  "authors": [
    {
      "affiliations": [
        "Centre for Health Protection, Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven, The Netherlands",
        "Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands"
      ],
      "name": "Ina M Hellmich"
    },
    {
      "affiliations": [
        "Centre for Health Protection, Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven, The Netherlands"
      ],
      "name": "Anne Havermans"
    },
    {
      "affiliations": [
        "Centre for Health Protection, Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven, The Netherlands"
      ],
      "name": "Charlotte G G M Pauwels"
    },
    {
      "affiliations": [
        "Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands"
      ],
      "name": "Sanne Boesveldt"
    },
    {
      "affiliations": [
        "Centre for Health Protection, Rijksinstituut voor Volksgezondheid en Milieu, Bilthoven, The Netherlands"
      ],
      "name": "Reinskje Talhout"
    }
  ],
  "title": "Reduced vaping and smoking prevalence among people using e-cigarettes after implementation of an e-cigarette flavour ban in the Netherlands",
  "uid": "32202c22-702c-5d43-8647-0c708a57bb5a"
}