E-Cigarette Flavors, Devices, and Brands Used by Youths Before and after Partial Flavor Restrictions in the United States: Canada, England, and the United States, 2017‒2020.

Introduction:
This text provides an analysis of the impact of US restrictions on e-cigarette flavors, implemented in February 2020, on the flavors, devices, and brands used by youth vapers in the US, Canada, and England. The study aims to identify any changes in the use of e-cigarette flavors, device types, and brands among past-30-day vapers in these countries before and after the policy implementation.

Key Points:

* The study uses data from the International Tobacco Control Policy Evaluation Project Youth Tobacco and Vaping Surveys conducted online with youths aged 16 to 19 years in the US, Canada, and England.
* The study examines the usual e-cigarette flavor, device, and brand reported by past-30-day vapers (n=59512) before (2017, 2018, 2019), during (February 2020), and after (august 2020) implementation of US flavor restrictions.
* The study finds that in august 2020, 78.7% of vapers in the US reported using a flavor prohibited in cartridges or pods, compared with 86.3% in Canada and 79.8% in England.
* Disposable e-cigarettes increased to a greater extent among vapers in the US (13.2% to 36.8%) versus Canada (7.7% to 14.2%) and England (10.8% to 16.4%).
* Puff Bar (disposable) emerged as the most popular brand in the US.
* Flavors are a primary reason for tobacco initiation and continued use, particularly among youths and young adults.
* Fruit is the most popular flavor among younger vapers, followed by mint or menthol, and candy or dessert flavors.
* an increasing number of jurisdictions are implementing restrictions on one-cigarette flavors, with the goal of reducing the appeal of vaping among young people.

Main Message:
The US restrictions on e-cigarette flavors implemented in February 2020 did not result in significant changes in the usual flavors used by youth vapers in the US. The study suggests that youths used brands and devices exempt from the restrictions, such as disposable e-cigarettes. The findings highlight the limitations of partial flavor restrictions and the need for more comprehensive policies to reduce the appeal of e-cigarettes among young people.

hammond D, Reid JL, Burkhalter R, et al. E-Cigarette Flavors, Devices, and Brands Used by Youths Before and after Partial Flavor Restrictions in the United States: Canada, England, and the United States, 2017‒2020. american journal of public health. 2022;112(7):1014-1024. doi:10.2105/aJPh.2022.306780