As flavored e-cigarettes have grown in popularity among young people in recent years, researchers want to know what predicts who is most likely to use them. The tobacco industry has long marketed flavored tobacco products to vulnerable groups, including young adults and women. A new study from the University of Maryland School of Public Health shows that young adults ages 18-24, women, and those who have never smoked cigarettes were the groups mostly likely to use e-cigarettes that come in fruit and candy flavors.
“Around the globe, tobacco use is changing. The industry now reaches young people with new flavors and new gadgets,” says behavioral and community health professor Dr. Dina Borzekowski, a co-author of the study. “We know that when trying out e-cigarettes, youth start off with flavors. Public health interventionists need to know more about those using flavors to better affect policies around e-cig marketing and distribution.”
E-cigarettes come in traditional tobacco and menthol flavors (TM) as well a multitude of non-tobacco and non-menthol (NTM) flavors like fruit, candy, desserts and chocolate. Data from the Department of Health and Human Services (DHHS) show that more than a quarter of students in grades six through 12 and a third of all young adults have ever used e-cigarettes. According to this new study published in the journal Drug and Alcohol Dependence, eight percent of U.S. young adults used e-cigarettes in the past month. Of these users, about 69 percent chose NTM flavors; fruit and candy flavors were the most popular. Young women with a high school diploma/GED and higher are more likely to choose NTM flavors such as fruit and candy compared to TM flavors. Past marijuana use, a non-cigarette smoker status, and a diminished harm perception of e-cigarettes also predicted the use of sweet e-cigarette flavors.
“At the same time that fruit and candy flavored e-cigarettes are rising in popularity, there is an unclear media portrayal of the negative health consequences of vaping,” explains lead researcher Dr. Julia Chen.
Dr. Chen and colleagues express concern that the study findings are particularly alarming since NTM e-cigarette flavors can increase nicotine addiction and lead to further e-cigarette and traditional tobacco product use by enhancing the rewarding and reinforcing properties associated with vaping. Essentially, e-cigarettes could be a gateway drug to using other tobacco products, yet are perceived as being less harmful than traditional cigarettes.
The researchers advocate for the development of public health and media initiatives for preventing and reducing flavored e-cigarette use among this group. “With the knowledge from this study, we can target the most high-risk groups with public health programs and mass media campaigns showing the harmful effects of flavored e-cigarettes and flavored tobacco products,” adds Dr. Julia Chen. “We can also provide cessation aids to those who develop a nicotine dependence.” The research team also calls for more regulations and restrictions on the tobacco industry’s marketing tactics for selling and promoting flavored e-cigarettes.
The paper, “Prospective Predictors of Flavored E-Cigarette Use: A One-Year Longitudinal Study of Young Adults in the U.S,” was published in Drug and Alcohol Dependence. The study was led by Dr. Julia Chen a May graduate of the University of Maryland School of Public Health’s PhD program. She is currently a post-doctoral fellow at the NIH-National Institute on Minority Health and Health Disparities. Co-authors include Drs. Kerry Green, Amelia Arria, and Dina Borzekowski of the University of Maryland School of Public Health.
Dr. Julia Chen will present this paper this November at the American Public Health Association’s Annual Meeting.