Use of Flavored E-Cigarettes and the Type of E-Cigarette Devices Used among Adults and Youth in the US-Results from Wave 3 of the Population Assessment of Tobacco and Health Study (2015-2016).

Liane M Schneller,Scott Mcintosh,Maansi Bansal-Travers,Maciej L Goniewicz,Deborah Ossip,Richard J O’Connor

doi:10.3390/ijerph16162991

Abstract

The United States (U.S.) Food and Drug Administration has expressed concern about flavored e-cigarettes (e.g., JUUL brand) because they are appealing to youth who may be unaware that the product is addictive. The Population Assessment of Tobacco and Health Study Wave 3 provided data on flavor categories, type of e-cigarette product, and smoking status among past 30-day youth and adult e-cigarette users in the US. Most past 30-day youth and adult users reported using only one flavor category, with fruit (53% youth, 31% adult) being the most commonly reported category. Adults were far more likely to report using tobacco flavor alone, compared to any other individual flavor category or flavor category combinations (OR: 21.08, 95%CI: 5.92, 75.12). Whereas, youth were more likely to report using multiple flavor categories (OR: 2.03, 95%CI: 1.55, 2.65), with the most reported pairing being fruit and candy (36%). The variety of flavors on the market appeals to consumers of all ages. Although most past 30-day e-cigarette users reported only one flavor category, non-tobacco flavors were far more common among youth. Differences in flavor preferences among adult versus youth vapers may have implications for the role of flavors in both the initiation of youth vaping and adult vaping for smoking cessation.

Highlights

The United States (U.S.) Food and Drug Administration (FDA) was given the authority to regulate all tobacco products, including electronic cigarettes (e-cigarettes), following the passing of the Deeming rule in August 2016 [1]
The adult and youth vaping populations did not differ in gender or race/ethnicity
Nicotine levels could provide public health implications as some adult smokers use e-cigarettes as a cessation tool [5], while many youth are misinformed and unaware of the nicotine concentration of e-cigarettes [36]. These findings build upon previous research [11,25,26,27], and reinforce the FDA concerns about the role of flavors in youth vaping appeal, as many youth are unaware of the addictiveness of e-cigarettes [36]

Summary

Introduction

The United States (U.S.) Food and Drug Administration (FDA) was given the authority to regulate all tobacco products, including electronic cigarettes (e-cigarettes), following the passing of the Deeming rule in August 2016 [1]. Per these regulations, the FDA has the authority to regulate the presence of ‘characterizing flavors’ in e-cigarettes, as was done with cigarettes through the Family Smoking. Consumers must be 18 years or older to purchase e-cigarette products in most states, but underage sales are occurring in retailers and online [9]. The FDA is investigating policies that would allow e-cigarettes to be available and attractive for adults trying to transition from cigarette smoking, but less accessible and appealing to youth and young adult nonsmokers [9]

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Conclusion