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Flavour types used by youth and adult tobacco users in wave 2 of the Population Assessment of Tobacco and Health (PATH) Study 2014–2015
  1. Shyanika W Rose, Assistant Professor1,
  2. Amanda L Johnson2,
  3. Allison M Glasser1,
  4. Andrea C Villanti1,3,
  5. Bridget K Ambrose2,
  6. Kevin Conway4,
  7. K. Michael Cummings5,
  8. Cassandra A. Stanton6,7,
  9. Cristine Delnevo8,
  10. Olivia A Wackowski8,
  11. Kathryn C Edwards6,
  12. Shari P Feirman2,
  13. Maansi Bansal-Travers9,
  14. Jennifer Bernat2,
  15. Enver Holder-Hayes2,
  16. Victoria Green4,10,
  17. Marushka L Silveira4,10,
  18. Yitong Zhou1,
  19. Haneen Abudayyeh1,
  20. Andrew Hyland9
  1. 1 Truth Initiative Schroeder Institute, Washington, DC, USA
  2. 2 Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, Maryland, USA
  3. 3 Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
  4. 4 Division of Epidemiology, Services, and Prevention Branch, National Institute on Drug Abuse, Bethesda, Maryland, USA
  5. 5 Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
  6. 6 Westat Inc, Rockville, Maryland, USA
  7. 7 Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC, United States
  8. 8 Center for Tobacco Studies, School of Public Health, Rutgers University, Piscataway, New Jersey, USA
  9. 9 Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
  10. 10 Kelly Government Solutions, Rockville, Maryland, USA
  11. 11 Behavioral Science and Center for Health Equity Transformation, University of Kentucky, College of Medicine, Lexington, KY, United States
  1. Correspondence to Dr Shyanika W Rose, Behavioral Science and Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY 40508, USA; s.rose{at}


Background Most youth and young adult (YA) tobacco users use flavoured products; however, little is known about specific flavours used.

Methods We report flavour types among US tobacco users from the Population Assessment of Tobacco and Health Study, wave 2, 2014–2015. At wave 2, we examined (1) flavour use and type at past 30-day use; (2) new flavoured tobacco product use and type; (3) product-specific flavour patterns across youth (ages 12–17) (n=920), YA (18–24) (n=3726) and adult (25+) (n=10 346) past 30-day and new tobacco users and (4) concordance between self-coded and expert-coded brand flavour type among all adults (18+).

Results Prevalence of flavoured tobacco product use was highest among youth, followed by YA and adult 25+ any tobacco users. Within each age group, flavoured use was greatest among hookah, e-cigarette and snus users. Overall, menthol/mint, fruit and candy/sweet were the most prevalent flavour types at first and past 30-day use across age groups. For past 30-day use, all flavour types except menthol/mint exhibited an inverse age gradient, with more prevalent use among youth and YAs, followed by adults 25+. Prevalence of menthol/mint use was high (over 50% youth, YAs; 76% adults 25+) and exhibited a positive age gradient overall, though the reverse for cigarettes. Brand-categorised and self-reported flavour use measures among adults 18+ were moderately to substantially concordant across most products.

Conclusions Common flavours like menthol/mint, fruit and candy/sweet enhance appeal to young tobacco users. Information on flavour types used by product and age can inform tobacco flavour regulations to addess flavour appeal especially among youth.

  • non-cigarette tobacco products
  • packaging and labelling
  • public policy
  • surveillance and monitoring

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  • Contributors SWR drafted the manuscript, ALJ and YZ conducted analyses, all authors contributed to study design, refined research questions and analyses, provided feedback and review of manuscript drafts, and approved the final draft.

  • Funding This manuscript was supported with Federal funds from the National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, Food and Drug Administration, Department of Health and Human Services, under a contract to Westat (Contract No. HHSN271201100027C).

  • Disclaimer The views and opinions expressed in this manuscript are those of the authors only and do not necessarily represent the views, official policy, or position of the US Department of Health and Human Services or any of its affiliated institutions or agencies.

  • Competing interests MC has received grant funding from Pfizer, Inc, to study the impact of a hospital-based tobacco cessation intervention. MC also receives funding as an expert witness in litigation filed against the tobacco industry. No competing interests were reported by the other authors of this paper.

  • Patient consent for publication No patients were included in the study, however, all survey participants aged 18+ provided informed consent. Youth participants provided assent; their parent/legal guardian provided consent.

  • Ethics approval The PATH Study was approved by Westat’s Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available in a public, open access repository.