Candy Flavorings in Tobacco

An analysis finds that chemicals used to flavor candy and popular drinks are also being used in tobacco products, often at much higher levels. Tobacco products with cherry, grape, and apple flavors contain the same flavorings used in Jolly Rancher candies, Life Savers, and Kool-Aid. To the Editor: Flavored tobacco products are marketed worldwide (see the Supplementary Appendix, available with the full text of this letter at NEJM.org). A 2007 World Health Organization (WHO) report 1 states, “In view of the little research that has been conducted on flavoured tobacco, the WHO Study Group on Tobacco Product Regulation . . . urges health authorities to consider public health initiatives to reduce the marketing and use of flavoured tobacco products.” In the United States, the Food and Drug Administration reports, “Almost 90 percent of adult smokers start smoking as teenagers. . . . flavored cigarettes are a gateway for many children and . . .