E-cigarettes are often marketed by the tobacco and nicotine industries as a safer alternative to smoking – but in reality, they are attracting a new generation of users, particularly youth, with flavoured products, flashy packaging and misleading health claims.
This year’s World No Tobacco Day spotlights the manipulative tactics employed by the industries to lure young people into addiction and advocates for stronger policies to protect public health.
“One of the main concerns is that e-cigarettes attract new users, particularly young people who might never have smoked in the first place, because they are told these products are relatively harmless – but that simply isn’t true,” explains Reinskje Talhout, a senior scientist at the Netherlands’ National Institute for Public Health and the Environment (RIVM) and head of the WHO Collaborating Centre for Tobacco Product Regulation and Control.
“Cigarettes are the most toxic and deadly products on the market, so saying e-cigarettes are less harmful doesn’t mean much,” warns Reinskje. “It’s misleading to call them safe.”
Flavours are fuelling the uptake
“All tobacco and nicotine products are harmful, no matter how good they taste or how appealing they look. If e-cigarettes are truly meant to help people quit smoking, as the industry tries to convince us, then why do they come in thousands of flavours and flashy, youth-friendly designs?” asks Reinskje.
Flavouring agents are among the most commonly used additives in tobacco and nicotine products – designed to enhance their appeal and mask the harshness of nicotine and tobacco. From fruity and candy-like options to minty or cooling agents, flavours mask the bitter and irritating qualities of nicotine and tobacco, making these products more palatable and appealing – especially to first-time users – and making it harder for those who have decided to quit.
“The taste of tobacco and nicotine is quite harsh,” explains Reinskje, “so especially for starters, that can be off-putting. Flavours help smooth the experience and make it easier to use these products. That’s why they’re so effective in facilitating uptake, particularly among young people.”
In a 2021 assessment, researchers found nearly 20 000 e-liquids and 250 unique flavour varieties on the market in the Netherlands. Most were sweet or minty – very few were tobacco flavoured.
As Reinskje notes, “That shows how flavourings are being used as a core marketing and product design strategy – not just to improve taste, but to create an entirely different user experience that appeals to youth”.
Following recommendations from RIVM, in 2023 the government of the Netherlands implemented a comprehensive ban on e-cigarette flavours that are not tobacco, to prevent trapping young people into nicotine addiction and discourage non-users from taking up nicotine and tobacco products.
More than flavour: the risk of additives
There are multiple additives in tobacco and nicotine products, going far beyond taste enhancement. Some additives are explicitly banned in the European Union due to the misleading associations they create – such as those suggesting vitality or health benefits.
“You’ll find vitamins, amino acids, even elements of the coffee bean being added,” says Reinskje. “These additives are quite dangerous because they can lower people’s perception of the risks involved. As of April this year, these compounds will be forbidden in the Netherlands.”
“Some additives pose direct health risks by being carcinogenic or toxic, while others go even further by altering the body’s absorption of nicotine,” explains Reinskje. “Cooling agents such as menthol, for example, trigger a cooling response in the throat, making it easier to inhale and encouraging deeper, more frequent use. Unlike a cigarette, which has a natural endpoint, an e-cigarette can be used continuously – leading to greater exposure to nicotine and harmful emissions and increasing the potential for dependence.”
Regulations lag behind industry tactics
WHO has raised the alarm on how electronic nicotine delivery systems, including e-cigarettes, have been allowed onto the market with limited regulation in many countries. These products are aggressively marketed to youth using bright packaging and colours, toy-like designs, influencer partnerships and thousands of enticing flavours.
As of 2022, in the WHO European Region, only 4 countries ban all flavours in e-cigarettes, while another 4 allow or restrict specific flavours. Just 11 countries prohibit all forms of advertising, promotion and sponsorship of e-cigarettes, compared to 36 with partial bans and 6 with no regulations. These gaps leave young people particularly vulnerable to targeted e-cigarette marketing.
To protect youth and public health, countries must take decisive action to prevent uptake of nicotine and tobacco products, and counter nicotine addiction as part of a comprehensive approach to tobacco control. Removing the appeal of these products through stricter regulations is essential to protecting current and future generations from harm.