Tobacco-flavoured? Presence of descriptors and additives on Chinese e-cigarette packaging after a flavour ban

Background Flavoured e-cigarettes are attractive to youth, and flavour descriptors on packaging can increase product appeal and reduce perceived risk. In October 2022, China banned non-tobacco-flavoured e-cigarettes and published a list of 101 permitted additives. We examined e-cigarette packs for the prevalence of flavour descriptors and additives approximately 6 months after the ban implementation. Methods Using a systematic protocol, we purchased 143 unique e-cigarette packs from six major Chinese cities in April–May 2023. Trained, native Chinese speakers coded flavour descriptors on packs (tobacco, non-tobacco, concept or none). Additive presence was determined from ingredient lists on the packs. Permitted additives were reviewed for flavouring properties. Prevalence of flavour descriptors and additives by flavour category was examined. Results Of 143 packs, 84 were manufactured after full enforcement of the flavour ban and included an ingredient list. Of these, 19% displayed tobacco descriptors, 48% concept descriptors and 33% both concept and tobacco descriptors. Forty-two per cent listed at least one permitted additive capable of imparting non-tobacco flavour (tobacco: 44%; concept: 30%; tobacco-plus-concept: 57%). Ethyl maltol (12%) and coffee extract (11%) were the most common additives, appearing in package ingredient lists in about one-third of tobacco-flavoured (31%) and tobacco-plus-concept descriptor (32%) packs. No packs featured a non-tobacco characterising flavour descriptor or listed any unpermitted additives. Conclusions Concept descriptors and flavouring additives are commonly listed on Chinese tobacco-flavoured e-cigarette packs, sustaining product appeal and undermining the flavour ban. Stricter regulations, such as a ban on concept descriptors, tighter additive restrictions and strengthened enforcement, could better protect public health.