By Jacob Okie Weiss

Regardless of how they vote in the referendum on the ban of flavored tobacco products in the coming weeks, Denverites should be aware of the health effects increased access to these products have on youth nicotine use.

To recap: Denver’s Referendum 310 will decide whether to keep or repeal a ban on flavored tobacco products, including nicotine vapes. If a majority of Denverites vote “yes,” the city will continue to ban these products. The Denver City Council passed the ban on Dec. 16 in an 11-1 vote, and Mayor Mike Johnston signed it into law. In March, opponents of the ban, including local business owners and representatives from Philip Morris USA, Inc. — one of the world’s largest producers of tobacco products — submitted enough signatures to put the referendum on the ballot this year.

Access to flavored tobacco products and vapes increase youth nicotine use in several ways.

First, flavored tobacco products are especially attractive to young, first-time users. A national survey showed 81% of youth and 86% of young adults who have ever used tobacco reported their first product was flavored.

Second, studies show individuals who start using nicotine younger are more likely to become lifelong users, with 83% of all current smokers reporting they began between the ages of 14-25.

Finally, vaping increases the risk of using cigarettes and other dangerous behaviors. Recent evidence shows young people who vape are seven times more likely to start smoking cigarettes in the following year, four times more likely to drink alcohol, five times more likely to use marijuana and four times more likely to misuse prescription drugs.

Colorado has made great progress in decreasing youth tobacco use, with only 8.7% of high schools in 2023 reporting they used an e-cigarette in the past month, down from 27% in 2017. This decrease was partly due to the passage of prop EE in 2020, which raised taxes on tobacco and created a new tax on vape products. Now, Denverites have another opportunity to protect the health of our young people by voting to maintain the ban on flavored tobacco products.

Jacob Okie Weiss, MD, is an addiction medicine fellow at the University of Colorado Department of Family Medicine.