154. Vaping Flavors Associated With Vaping Dependence Symptoms Among Adolescents: A Pilot Study Using Vape Factor Fast Find (VF3)

Abstract

Health risks associated with vaping depend on the vaporized substance, of which thousands of different vaping liquids, oils, and waxes are commercially available. Some vaping materials contain nicotine and others contain psychoactive ingredients such as tetrahydrocannabinol. Most vaping materials contain flavorings which may range from strawberries and cream to bubble gum. The presence of nicotine, THC, and various flavorings in vaping materials may present differential risk for developing symptoms of dependence. This study prototyped a new survey instrument –Vape Factor Fast Find (VF3) –designed to record the specific materials vaped by adolescents. We assessed the association between specific vaping materials and symptoms of vaping dependence. Our study population was an online convenience sample of 225 youth ages 16-18 who used vaping devices. Participants were invited to participate through postings in online gaming sites. Participants completed a 12-minute survey of vaping and smoking behaviors and selected their specific brand and model of vaping device from a list of 613 devices using a rapid-indexing cascading list. They selected their specific brand and flavor of vaping liquid from a list of more than 3000 liquids using a similar method. Participants completed the 10-question Penn State Vaping Dependence Scale. We calculated the average completion time for the VF3 questions and reported the most frequently used devices and liquids. We assessed the association between the count of vaping dependence symptoms and specific vaping products using poisson regression, adjusting for tobacco smoking behavior, age, sex, race/ethnicity, the nicotine content of the vaping liquid, and vaping frequency. We used a jackknife procedure to assess this association with specific vaping flavors one-by-one. As a contrast, we used broad vaping liquid flavor categories such as those from the PATH Study to assess the association with dependence symptoms. The Boston University Medical Center IRB approved all study procedures. The study sample was aged 17.5±0.7 (mean±sd), 50% female, 10.5% Black, 17.8% Hispanic, 2.3% Asian, and 60.3% non-Hispanic White. 78.4% of participants found their vaping device in 25.6±26.3 seconds (median±IQR) and 71.6% found their vaping liquid brand and flavor in 22.7±18.3 seconds. Top device brands were Snow Wolf, BLU, and JUUL. Top vaping liquid brands were 180 Vape, The Flavor Apprentice, and Blackbeard Vapor. The materials vaped most frequently were liquids containing nicotine (46.2% of participants), liquids without nicotine (29.8%) and marijuana (15.6%). Vaping liquid flavors that were associated with increased vaping dependence symptoms included Ice Cream (rate ratio 2.53, 95% confidence interval 1.43-4.50), Spice (e.g., clove) (1.72, 1.20-2.45), Sugar (1.61, 0.81-3.19), Vanilla (1.58, 1.21-2.06), and Cake (1.48, 1.00-2.19). The broad flavor category “Candy, Desserts or Sweets” did not reveal an association with dependence symptoms, rate ratio 1.04 (0.91-1.20). Scientists require precise information about the vaping devices and materials used by adolescents to assess the health impacts of vaping. In this pilot study, the Vape Factor Fast Find (VF3) method showed promise as an efficient means of collecting precise information to avoid misclassification of the vaping exposures in future research studies.