Abstract

E-cigarette flavor preference may differ among smokers using e-cigarettes, but little information is available on preferences by menthol cigarette status. Using nationally representative data for US adults from the 2018–2019 Tobacco Use Supplement to the Current Population Survey, we analyzed e-cigarette flavor preference by menthol cigarette status and e-cigarette device type for dual-cigarette and e-cigarette users and e-cigarette users who had recently quit smoking by trying to switch to e-cigarettes (“switchers”). Approximately half (52.2%) of dual users of menthol cigarettes and e-cigarettes reported using menthol/mint-flavored e-cigarettes as did 41.4% of “switchers” who had smoked menthol cigarettes; exclusive menthol/mint flavor use was 13.1% for dual users and 21.3% for “switchers.” A similar proportion (45.1%) of dual users who smoked nonmenthol cigarettes used tobacco-flavored e-cigarettes, but only 26.7% of “switchers” who had smoked nonmenthol cigarettes used tobacco-flavored e-cigarettes. Approximately 60% of dual users and “switchers” used fruit/other flavors, regardless of menthol cigarette use. By device type, 63.9% of dual users of cartridge-based e-cigarettes and menthol cigarettes used menthol/mint-flavored e-cigarettes. Approximately 75% of dual users and 85% of “switchers” who used tank or mod systems used fruit/other flavors. Menthol cigarette smokers may be particularly likely to use menthol/mint e-cigarettes, and a majority of dual users and “switchers” used fruit/other flavors. These results can inform policy measures concerning flavored electronic nicotine delivery system products.

Highlights

  • Flavor use and preference among electronic nicotine delivery system (ENDS) users is an important public health issue with implications for tobacco use and harm [1,2,3,4]. Certain flavors such as tobacco and menthol may differentially appeal to adult cigarette smokers trying to transition from combustible tobacco use, whereas young ENDS users may tend to prefer sweeter flavors such as candy or fruit [5,6,7,8,9,10,11]

  • Administration (FDA) issued a final guidance document that stated that the agency would prioritize regulatory enforcement against cartridge-based ENDS with flavors other than tobacco or menthol [12]

  • We analyze e-cigarette flavor preference by menthol cigarette smoking status among US adults using data from the 2018–2019 Tobacco Use Supplement to the Current Population Survey (TUS-CPS). We examine this flavor preference among dualcigarette and e-cigarette users and recent former cigarette smokers who report switching to e-cigarettes to try to quit smoking

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Summary

Introduction

Flavor use and preference among electronic nicotine delivery system (ENDS) users is an important public health issue with implications for tobacco use and harm [1,2,3,4]. Certain flavors such as tobacco and menthol may differentially appeal to adult cigarette smokers trying to transition from combustible tobacco use, whereas young ENDS users may tend to prefer sweeter flavors such as candy or fruit [5,6,7,8,9,10,11]. This guidance sought to protect population health by striking a balance between maintaining e-cigarettes as an alternative for adult combusted tobacco users while dissuading youth use

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