Effects of non-tobacco flavors and nicotine on e-cigarette product appeal among young adult never, former, and current smokers.

Introduction:
This text provides an analysis of the effects of non-tobacco flavors and nicotine on the appeal of e-cigarette products among young adult never, former, and current smokers. The study aims to identify e-cigarette product characteristics that disproportionately appeal to never smokers relative to current or former smokers to inform regulatory policies that optimize health impact to the population as a whole.

Key Points:

* The study used a flavor (fruit, menthol, tobacco) × nicotine concentration (nicotine-containing vs. nicotine-free) within-participant fully crossed factorial design with a double-blind product appeal testing procedure.
* The study found that appeal ratings were significantly higher for fruit vs. tobacco flavored solutions in each smoking history group. The magnitude of difference in appeal ratings favoring fruit (vs. tobacco) solutions was significantly greater in never smokers compared to current smokers but was not different from former smokers.
* appeal was greater for menthol-flavored than tobacco-flavored solutions in each group. The magnitude of preference for menthol vs. tobacco was greater in never smokers as compared to former and current smokers.
* appeal was significantly lower for nicotine-containing (vs. nicotine-free) e-cigarette solutions in each group, and the relative magnitude of this effect was amplified in never smokers compared to former and current smokers.
* Menthol and fruit flavors suppressed nicotine’s appeal-reducing qualities among never smokers.
* The study controlled for potential confounds such as age, e-cigarette device type, e-cigarette dependence, and salivary cotinine.
* The study's sample included 100 young adult vapers, with 22 never smokers, 25 former smokers, and 53 current smokers.

Main Message:
The study provides experimental evidence that while most young adult e-cigarette users preferred fruit and menthol over tobacco flavors and found nicotine-containing solutions less appealing than nicotine-free solutions, these effects were amplified in never smokers relative to current and former smokers. The study suggests that regulations targeting non-tobacco flavors in e-cigarettes may vary by smoking history and have different impacts on never smokers compared to current or former smokers. The findings highlight the importance of considering smoking history in developing regulatory policies for e-cigarettes to optimize health impact to the population as a whole.

Leventhal aM, Goldenson NI, Barrington-Trimis JL, Pang RD, Kirkpatrick MG. Effects of non-tobacco flavors and nicotine on e-cigarette product appeal among young adult never, former, and current smokers. Drug and alcohol dependence. 2019;203:99-106. doi:10.1016/j.drugalcdep.2019.05.020