Cooling e-cigarette flavors and the association with e-cigarette use among a sample of high school students.

Introduction
E-liquid flavor is typically presented by flavor category (e.g. menthol, mint, fruit, dessert).
Cooling sensations produced by flavor additives such as menthol enhance appeal of e-cigarettes
among youth, but not all e-liquids that produce cooling sensations are labeled as menthol.
Sensory experiences produced by flavors may allow for a new way to capture ecigarette
flavor use. This study aims to examine use of flavors that produce cooling sensations
among youth and its association with e-cigarette use behaviors.
Methods
A 2019 survey of high school students (n = 4875) examined use of e-cigarette flavors that
produced cooling sensations (cooling flavors) among past 30-day e-cigarette users. E-cigarette
use behaviors (flavor use, nicotine use, frequency of use) were examined between
those who did and did not use cooling flavors. A binary logistic regression was used to
examine associations between vaping frequency, nicotine (vs. non-nicotine) use, and vaping
cooling flavors while controlling for demographics, number of flavors vaped in the past
month, and vaping age of onset.
Results
51.6% (n = 473/916) of the analytic sample endorsed vaping cooling flavors. There were no
demographic differences by vaping cooling flavors. Vaping cooling flavors was associated
with vaping more frequently (AOR:1.04,95% CI:1.03,1.05) and vaping nicotine
(AOR:2.37,95% CI:1.53,3.67).

Davis DR, Morean ME, Bold KW, et al. Cooling e-cigarette flavors and the association with e-cigarette use among a sample of high school students. PloS one. 2021;16(9):1. doi:10.1371/journal.pone.0256844