The political economy of flavored tobacco: comparative policy mapping of flavor restrictions for cigarettes and e-cigarettes

In the past five years, the market for flavored tobacco and nicotine products has become increasingly global, while policies have fragmented along national lines. Flavors attract new consumers, keep existing consumers addicted, and can worsen the negative health effects of smoking. Many of these concerns apply to newer products such as e-cigarettes, but with the added complexity for policymakers of differential risks for certain groups within the population. We conduct a comparative policy mapping of flavored cigarette and e-cigarette regulations in 200 national jurisdictions to build an original dataset of global flavor policy. We classify the policy combinations into four distinct approaches and generate several hypotheses to explain global policy variation. By comparing flavor restrictions across a large number of jurisdictions, we show that countries fall into four distinct groups. 41 countries restrict flavors in neither product, 16 restrict both, 40 restrict flavored e-cigarettes more than cigarettes, and 39 restrict flavored cigarettes more than e-cigarettes. In exploring several potential explanations for policy variation, we find that countries’ political systems, state capacity, and the role of states in the global tobacco economy correlate with different policies on flavor restrictions in cigarettes and e-cigarettes. Despite global calls to ban flavored tobacco and nicotine products, policymakers, tobacco control advocates, tobacco industry representatives and other relevant actors are divided as to how to regulate them, resulting in a patchwork of national policies. Comparing how countries regulate flavored cigarettes and flavored e-cigarettes highlights the barriers to adopting a global approach to a globalizing market: government capacity, governance type, and a country’s place within the global economy all contribute to countries taking different policy approaches despite a globalized product market and shared body of current scientific evidence.