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Preferred flavors and reasons for e-cigarette use and discontinued use among never, current, and former smokers

  • Original Article
  • Published:
International Journal of Public Health

Abstract

Objectives

To compare e-cigarette flavors preferred and reasons for use and discontinued use across never, current, and former e-cigarette users and cigarette smokers.

Methods

We recruited 1567 participants aged 18–34 years through Facebook ads targeting tobacco users and nonusers in August 2014 to complete an online survey. We assessed tobacco use, preferred flavors, and reasons for e-cigarette use and discontinued use.

Results

Our sample was 49 % male, 87 % White; 56 % current cigarette smokers; and 53 % e-cigarette users. Current e-cigarette users used an average of 20.9 days in the past 30 (SD = 11.7) and 55.2 puffs/day (SD = 37.3). Compared to never and current smokers, former smokers used e-cigarettes more frequently (p’s <0.001). Among users and nonusers, the most preferred was fruit flavors, and the most commonly reported reason for e-cigarette use was “they might be less harmful than cigarettes”. The most endorsed reason for discontinued e-cigarette use was “using other tobacco products instead”. Never, current, and former smokers had distinct reasons for e-cigarette use and discontinued use and differed in flavor preferences.

Conclusions

Regulating marketing and flavors may impact e-cigarette uptake by young adults.

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References

  • Benowitz NL, Goniewicz ML (2013) The regulatory challenge of electronic cigarettes. JAMA 310(7):685–686

    Article  CAS  PubMed  Google Scholar 

  • Berg CJ, Barr DB, Stratton E, Escoffery C, Kegler MC (2014) Attitudes toward e-cigarettes, reasons for initiating e-cigarette use, and changes in smoking behavior after initiation: a pilot longitudinal study of regular cigarette smokers. Open J Prev Med 4(10):789–800

    Article  PubMed  PubMed Central  Google Scholar 

  • Berg CJ, Escoffery C, Bundy L, Haardoerfer R, Zheng P, Kegler MC (2015a) Cigarette users interest in using or switching to electronic nicotine delivery systems (ENDS) or smokeless tobacco for harm reduction, cessation, or novelty. Nicotine Tob Res 17(2):245–255

    Article  PubMed  PubMed Central  Google Scholar 

  • Berg CJ, Stratton E, Schauer GL, Lewis M, Wang Y, Windle M, Kegler MC (2015b) Perceived harm, addictiveness, and social acceptability of tobacco products and marijuana among young adults: marijuana, hookah, and electronic cigarettes win. Subst Use Misuse 50(1):79–89

    Article  PubMed  PubMed Central  Google Scholar 

  • Bombard JM, Pederson LL, Nelson DE, Malarcher AM (2007) Are smokers only using cigarettes? Exploring current polytobacco use among an adult population. Addict Behav 32(10):2411–2419

    Article  PubMed  Google Scholar 

  • Bullen C, McRobbie H, Thornley S, Glover M, Lin R, Laugesen M (2010) Effect of an electronic nicotine delivery device (e cigarette) on desire to smoke and withdrawal, user preferences and nicotine delivery: randomised cross-over trial. Tob Control 19(2):98–103

    Article  CAS  PubMed  Google Scholar 

  • Bullen C, Howe C, Laugesen M, McRobbie H, Parag V, Williman J, Walker N (2013) Electronic cigarettes for smoking cessation: a randomised controlled trial. Lancet 382(9905):1629–1637

    Article  PubMed  Google Scholar 

  • Cahn Z, Siegel M (2011) Electronic cigarettes as a harm reduction strategy for tobacco control: a step forward or a repeat of past mistakes? J Public Health Policy 32(1):16–31

    Article  PubMed  Google Scholar 

  • Callahan-Lyon P (2014) Electronic cigarettes: human health effects. Tob Control 23(Suppl 2):ii36–ii40

  • Caponnetto P, Campagna D, Cibella F, Morjaria JB, Caruso M, Russo C, Polosa R (2013) EffiCiency and Safety of an eLectronic cigAreTte (ECLAT) as tobacco cigarettes substitute: a prospective 12-month randomized control design study. PLoS One 8(6):e66317

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Carpenter CM, Wayne GF, Pauly JL, Koh HK, Connolly GN (2005) New cigarette brands with flavors that appeal to youth: tobacco marketing strategies. Health Aff (Millwood) 24(6):1601–1610

    Article  Google Scholar 

  • Chen IL (2013) FDA summary of adverse events on electronic cigarettes. Nicotine Tob Res 15(2):615–616

    Article  PubMed  Google Scholar 

  • DiFranza JR, Richards JW, Paulman PM, Wolf-Gillespie N, Fletcher C, Jaffe RD, Murray D (1991) RJR Nabisco’s cartoon camel promotes camel cigarettes to children. JAMA 266(22):3149–3153

    Article  CAS  PubMed  Google Scholar 

  • Enofe NC, Berg CJ, Nehl E (2014) Alternative tobacco product use among college students: who is at highest risk? Am J Health Behav 38(2):180–189

    Article  PubMed  PubMed Central  Google Scholar 

  • Etter JF (2010) Electronic cigarettes: a survey of users. BMC Public Health 10:231

    Article  PubMed  PubMed Central  Google Scholar 

  • Etter JF, Bullen C (2014) A longitudinal study of electronic cigarette users. Addict Behav 39(2):491–494

    Article  PubMed  Google Scholar 

  • Farsalinos KE, Polosa R (2014) Safety evaluation and risk assessment of electronic cigarettes as tobacco cigarette substitutes: a systematic review. Ther Adv Drug Saf 5(2):67–86

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gartner CE, Hall WD, Chapman S, Freeman B (2007) Should the health community promote smokeless tobacco (snus) as a harm reduction measure? PLoS Med 4(7):e185

    Article  PubMed  PubMed Central  Google Scholar 

  • Gray N, Henningfield JE, Benowitz NL, Connolly GN, Dresler C, Fagerstrom K, Jarvis MJ, Boyle P (2005) Toward a comprehensive long term nicotine policy. Tob Control 14(3):161–165

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Heatherton TF, Kozlowski LT, Frecker RC, Rickert W, Robinson J (1989) Measuring the heaviness of smoking: using self-reported time to the first cigarette of the day and number of cigarettes smoked per day. Br J Addict 84(7):791–799

    Article  CAS  PubMed  Google Scholar 

  • Hersey JC, Ng SW, Nonnemaker JM, Mowery P, Thomas KY, Vilsaint MC, Allen JA, Haviland ML (2006) Are menthol cigarettes a starter product for youth? Nicotine Tob Res 8(3):403–413

    Article  PubMed  Google Scholar 

  • Hua M, Alfi M, Talbot P (2013) Health-related effects reported by electronic cigarette users in online forums. J Med Internet Res 15(4):e59

    Article  PubMed  PubMed Central  Google Scholar 

  • King BA, Alam S, Promoff G, Arrazola R, Dube SR (2013) Awareness and ever-use of electronic cigarettes among US adults, 2010–2011. Nicotine Tob Res 15(9):1623–1627

    Article  PubMed  PubMed Central  Google Scholar 

  • King BA, Patel R, Dube SR (2015) Trends in Awareness and use of electronic cigarettes among US adults, 2010–2013. Nicotine Tob Res 17(2):219–227

    Article  PubMed  PubMed Central  Google Scholar 

  • Klein SM, Giovino GA, Barker DC, Tworek C, Cummings KM, O’Connor J (2008) Use of flavored cigarettes among older adolescent and adult smokers: United States, 2004–2005. Nicotine Tob Res 10(7):1209–1214

    Article  PubMed  Google Scholar 

  • Lovato C, Linn G, Stead LF, Best A (2003). Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database Syst Rev 4:CD003439

  • McMillen R, Maduka J, Winickoff J (2012) Use of emerging tobacco products in the United States. J Environ Public Health 2012:989474

    Article  PubMed  PubMed Central  Google Scholar 

  • Pearson JL, Richardson A, Niaura R, Abrams D, Vallone D (2011) Electronic cigarette awareness, use, and risk perceptions among current and former smokers. Society for Research on Nicotine and Tobacco, Toronto

    Google Scholar 

  • Ramo DE, Prochaska JJ (2012) Broad reach and targeted recruitment using Facebook for an online survey of young adult substance use. J Med Internet Res 14(1):e28

    Article  PubMed  PubMed Central  Google Scholar 

  • Rath JM, Villanti AC, Abrams DB, Vallone DM (2012) Patterns of tobacco use and dual use in US young adults: the missing link between youth prevention and adult cessation. J Environ Public Health 2012:679134

    Article  PubMed  PubMed Central  Google Scholar 

  • Richardson A, Ganz O, Stalgaitis C, Abrams D, Vallone D (2013) Noncombustible tobacco product advertising: how companies are selling the new face of tobacco. Nicotine Tob Res. doi:10.1093/ntr/ntt200

    Google Scholar 

  • Riker CA, Lee K, Darville A, Hahn EJ (2012) E-cigarettes: promise or peril? Nurs Clin North Am 47(1):159–171

    Article  PubMed  Google Scholar 

  • Stepanov I, Jensen J, Hatsukami D, Hecht SS (2008) New and traditional smokeless tobacco: comparison of toxicant and carcinogen levels. Nicotine Tob Res 10(12):1773–1782

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Stratton K, Shetty P, Wallace RB, Bondurant S (2001) Clearing the smoke: assessing the science base for tobacco harm reduction. DC, National Academy Press, Washington

    Google Scholar 

  • Substance Abuse and Mental Health Services Administration (SAMHSA) (2013) Results from the 2012 national survey on drug use and health: summary of national findings, NSDUH series H-46, HHS publication no. (SMA) 13-4795. Substance Abuse and Mental Health Services Administration, Rockville

  • Villanti AC, Richardson A, Vallone DM, Rath JM (2013) Flavored tobacco product use among US young adults. Am J Prev Med 44(4):388–391

    Article  PubMed  Google Scholar 

  • Wakefield M, Flay B, Nichter M, Giovino G (2003) Role of the media in influencing trajectories of youth smoking. Addiction 98(Suppl 1):79–103

    Article  PubMed  Google Scholar 

  • Wayne GF, Connolly GN (2002) How cigarette design can affect youth initiation into smoking: camel cigarettes 1983–93. Tob Control 11(Suppl 1):I32–I39

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhu SH, Gamst A, Lee M, Cummins S, Yin L, Zoref L (2013) The use and perception of electronic cigarettes and snus among the US Population. PLoS One 8(10):e79332

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Zhu SH, Sun JY, Bonnevie E, Cummins SE, Gamst A, Yin L, Lee M (2014) Four hundred and sixty brands of e-cigarettes and counting: implications for product regulation. Tob Control 23(Suppl 3):iii3–iii9

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Authors and Affiliations

Authors

Corresponding author

Correspondence to Carla J. Berg.

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Conflict of interest

The authors declare no conflicts of interest.

Statement of ethical approval

The Emory University Institutional Review Board approved this study, IRB# 00073636.

Funding

This research was supported by the National Cancer Institute (1K07CA139114-01A1; PI: Berg) and the Georgia Cancer Coalition (PI: Berg).

Additional information

This article is part of the special issue “Electronic Cigarettes and Public Health”.

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Berg, C.J. Preferred flavors and reasons for e-cigarette use and discontinued use among never, current, and former smokers. Int J Public Health 61, 225–236 (2016). https://doi.org/10.1007/s00038-015-0764-x

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  • DOI: https://doi.org/10.1007/s00038-015-0764-x

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