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Relative increases in direct-to-consumer menthol ads following 2020 FDA guidance on flavoured e-cigarettes
  1. Elizabeth K Do1,2,
  2. Katie O’Connor1,
  3. Megan C Diaz1,
  4. Barbara A Schillo1,
  5. Jennifer M Kreslake1,3,
  6. Elizabeth C Hair1,3
  1. 1 Schroeder Institute, Truth Initiative, Washington, DC, USA
  2. 2 Epidemiology, The George Washington University Milken Institute of Public Health, Washington, DC, USA
  3. 3 Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
  1. Correspondence to Dr Elizabeth K Do, Schroeder Institute, Truth Initiative, Washington, DC 20001, USA; edo{at}


Objective To examine potential changes in email and direct mail advertisements for flavoured e-cigarettes following the 2020 Food and Drug Administration (FDA) flavour guidance.

Methods Digital copies of e-cigarette advertisements were obtained from Mintel Comperemedia (November 2019–May 2020) and coded for the presence of flavours. Χ2 tests were used to determine changes in the prevalence of email and direct mail advertisements for e-cigarettes with menthol, non-menthol and no flavours.

Results Following FDA guidance, the relative proportion of menthol-flavoured e-cigarette advertisements sent via email significantly increased from 22.5% to 52.2%. No changes were found for e-cigarette advertisements mentioning no flavours, nor non-menthol-flavoured e-cigarettes, sent via email or direct mail.

Conclusions The 2020 FDA flavour guidance was followed by an increased proportion of direct-to-consumer email advertisements of menthol-flavoured e-cigarette products.

  • advertising and promotion
  • electronic nicotine delivery devices
  • surveillance and monitoring

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  • Contributors EKD and JMK designed the study. EKD and KO performed the qualitative coding of advertisements. EKD, KO and JMK wrote the initial draft of the manuscript. MCD aided EKD in the analysis and interpretation of the results. EKD, KO, MCD, JMK, ECH and BS contributed to the writing and editing of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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