Device and liquid characteristics used with sweet, menthol/mint, and tobacco ENDS liquid flavors: The population-based VAPER study.

Introduction:
This text provides an analysis of the relationship between device and liquid characteristics of electronic nicotine delivery systems (ENDS) and the flavors used by adult frequent ENDS users in the U.S. The study aims to understand how these characteristics and combinations may affect user behavior and health, and how regulations on specific device or liquid characteristics may impact ENDS users.

Key Points:

* The study analyzes data from the Vaping and Patterns of E-cigarette Use Research (V APER) study, which is a longitudinal cohort study of ENDS use patterns and behaviors among adult (age 21 +) U.S. ENDS users who use ENDS at least 5 days per week.
* The study focuses on three primary flavor groups: tobacco, menthol/mint, and sweet.
* The sample had only four users of disposable devices with a freebase liquid, seven users of disposable pod/cartridge devices with a freebase liquid, and 26 users of a tank device with a nicotine salt.
* The study found that most participants (76.2%) used sweet flavors, and those using sweet flavors used lower nicotine concentrations, voltages, and resistances and higher wattages than those using tobacco.
* Participants using sweet flavors were also more likely than those using menthol/mint or tobacco to report using ENDS because they enjoy the flavor.
* Participants using menthol/mint flavors used higher nicotine concentrations (44 mg/mL) than tobacco flavor users (37.2 mg/mL).
* Those using refillable devices with disposable pods/cartridges and salt nicotine liquids are far less likely to use sweet flavors than those using other device-liquid groupings.

Main Message:
The findings highlight the importance of understanding the specific device and liquid characteristics and combinations used by frequent adult ENDS users. Regulatory agencies must consider how regulations on flavor, nicotine concentration, or wattage may affect frequent adult ENDS users’ behaviors. For example, regulations limiting the availability of sweet flavors may push users towards menthol/mint or tobacco flavors, which are more often used with lower wattages and may have different health implications. Further research is needed to understand the exact health implications of different device/liquid characteristic combinations and how regulation of each of these characteristics might affect user behavior and health.

Crespi E, Hardesty JJ, Nian Q, et al. Device and liquid characteristics used with sweet, menthol/mint, and tobacco ENDS liquid flavors: The population-based VAPER study. Addictive behaviors. 2023;144:107727. doi:10.1016/j.addbeh.2023.107727