Effects of electronic cigarette e-liquid flavouring on cigarette craving.

Introduction:
This text is a summary of a research article examining the impact of e-cigarette flavoring on cigarette cravings among adult daily smokers. The study compares the use of nicotine-containing fruit/sweet-flavored e-liquids with unflavored e-liquids over a one-week period. The primary outcomes measured are average, peak, and cue-elicited cigarette cravings, while secondary outcomes include smoking lapse occurrence, enjoyment of the e-cigarette, ease of transitioning from smoking to using an e-cigarette, intentions to continue using an e-cigarette, intentions and motivation to quit smoking, and return to smoking and continuation of e-cigarette use.

Key points:

* The study is an experimental design with an independent groups design, randomizing e-liquid flavoring (flavored vs unflavored) using a random number generator.
* Participants were daily smokers, not currently attempting to quit smoking or using e-cigarettes, and were randomized to use either flavored or unflavored e-cigarettes for one week.
* The primary outcomes measured were average, peak, and cue-elicited cigarette cravings, while secondary outcomes included smoking lapse occurrence, enjoyment of the e-cigarette, ease of transitioning from smoking to using an e-cigarette, intentions to continue using an e-cigarette, intentions and motivation to quit smoking, and return to smoking and continuation of e-cigarette use.
* The study found no clear evidence that nicotine-containing fruit/sweet-flavored and unflavored e-liquids had different effects on cigarette cravings after one week of use.
* Additionally, there was no clear evidence of a difference in secondary outcomes between the two groups.
* During the study, 94% of participants continued to use their e-cigarette and 27% continued to abstain from smoking.
* Exploratory analyses suggested that e-liquid flavoring might have a medium-sized effect on peak sweet food craving, with scores 9% higher in the flavored condition.

Main message:
The study found no clear evidence that nicotine-containing fruit/sweet-flavored and unflavored e-liquids had different effects on cigarette cravings after one week of use. Therefore, during an initial switch from smoking to using e-cigarettes, there may be little impact of a fruit/sweet-flavored e-liquid restriction on cigarette craving if smokers choose to use unflavored products. However, further research is needed to establish if differences emerge over longer periods of exposure, among smokers attempting to quit, and whether there are any effects on smoking cessation outcomes.

Dyer ML, Khouja JN, Jackson AR, et al. Effects of electronic cigarette e-liquid flavouring on cigarette craving. Tobacco control. 2023;32:e3-e9. doi:10.1136/tobaccocontrol-2021-056769