A systematic review of consumer preference for e-cigarette attributes: Flavor, nicotine strength, and type.

Samane Zare,Yuqing Zheng,Mehdi Nemati,Estelle Cormet-Boyaka

doi:10.1371/journal.pone.0194145

Abstract

ObjectiveSystematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type.MethodA systematic search of peer-reviewed articles resulted in a pool of 12,933 articles. We included only articles that meet all the selection criteria: (1) peer-reviewed, (2) written in English, and (3) addressed consumer preference for one or more of the e-cigarette attributes including flavor, strength, and type.Results66 articles met the inclusion criteria for this review. Consumers preferred flavored e-cigarettes, and such preference varied with age groups and smoking status. We also found that several flavors were associated with decreased harm perception while tobacco flavor was associated with increased harm perception. In addition, some flavor chemicals and sweeteners used in e-cigarettes could be of toxicological concern. Finally, consumer preference for nicotine strength and types depended on smoking status, e-cigarette use history, and gender.ConclusionAdolescents could consider flavor the most important factor trying e-cigarettes and were more likely to initiate vaping through flavored e-cigarettes. Young adults overall preferred sweet, menthol, and cherry flavors, while non-smokers in particular preferred coffee and menthol flavors. Adults in general also preferred sweet flavors (though smokers like tobacco flavor the most) and disliked flavors that elicit bitterness or harshness. In terms of whether flavored e-cigarettes assisted quitting smoking, we found inconclusive evidence. E-cigarette users likely initiated use with a cigarette like product and transitioned to an advanced system with more features. Non-smokers and inexperienced e-cigarettes users tended to prefer no nicotine or low nicotine e-cigarettes while smokers and experienced e-cigarettes users preferred medium and high nicotine e-cigarettes. Weak evidence exists regarding a positive interaction between menthol flavor and nicotine strength.

Highlights

Electronic cigarettes (e-cigarettes) have been increasingly popular among youth [1] and adults [2, 3]
Consumer preference for nicotine strength and types depended on smoking status, e-cigarette use history, and gender
The U.S Food and Drug Administration (FDA) has authority to regulate tobacco products, such as setting standards for cigarette nicotine and tar levels, banning flavored cigarettes except for menthol, and requiring cigarettes be sold in packs of at least twenty

Summary

Introduction

Electronic cigarettes (e-cigarettes) have been increasingly popular among youth [1] and adults [2, 3]. Unlike e-cigarettes, cigarettes have been the subject of heavy tobacco control policies that target specific product attributes. The U.S Food and Drug Administration (FDA) has authority to regulate tobacco products, such as setting standards for cigarette nicotine and tar levels, banning flavored cigarettes except for menthol, and requiring cigarettes be sold in packs of at least twenty. Beginning in mid-2016, FDA extended their regulatory authority to e-cigarettes and has worked to level the playing field with cigarettes. One example is a mandatory nicotine and tobacco warning statement on e-cigarette product packages targeting a start date in 2018. They extended the deadline to 2022 for the vaping industry to comply with new FDA guidelines [5]

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Conclusion