E-cigarette device power moderates the effects of non-tobacco flavors and nicotine on product appeal in young adults.

Introduction:
This article is a summary of a laboratory study investigating the effects of non-tobacco flavors and nicotine content on e-cigarette product appeal in young adult e-cigarette users, with a focus on how device power moderates these effects. The study's primary outcomes paper reported that fruit and menthol flavored e-cigarette solutions increased appeal, nicotine reduced appeal, and non-tobacco flavored solutions attenuated the appeal-reducing effects of nicotine. This summary will highlight the key points of the study design and major findings, as well as the main message regarding the potential implications for e-cigarette regulation.

Key Points:

* The study used a flavor (fruit, menthol, tobacco) × nicotine concentration (nicotine-containing [6mg/mL] vs. nicotine-free) within-participant double-blind factorial design.
* Participants were instructed to abstain from using nicotine/tobacco products for 2-hours prior to the study visit and provided written informed consent.
* The appeal testing procedure involved 36 experimental trials with 2-puff cycles per product, followed by appeal ratings with 1-minute inter-trial intervals.
* The primary outcomes were that higher device power amplified the appeal-reducing effects of nicotine-containing solutions and allowed non-tobacco flavors to mask nicotine's appeal-reducing effects.
* Power did not significantly moderate the effects of fruit (vs. tobacco) flavors on appeal but attenuated menthol (vs. tobacco) flavor effects on appeal.
* Smoking history did not moderate the moderating effects of device power.

Main Message:
The study provides evidence that e-cigarette device power moderates the main and interactive effects of non-tobacco flavors and nicotine on product appeal in young adults. The findings suggest that increasing device power amplifies the appeal-reducing effects of nicotine-containing solutions and allows non-tobacco flavors to mask nicotine's appeal-reducing effects. These results have potential implications for e-cigarette regulation, particularly in the absence of certain nicotine and flavor regulations. Restrictions on high powered devices could indirectly impact young adult vaping by altering the effects of flavors and nicotine on user appeal, potentially reducing the appeal of all e-cigarette products among young adults. however, given the nuanced effects of how power interacted with flavor and nicotine, it cannot be concluded that restrictions on high powered devices would invariably reduce the appeal of all e-cigarette products among young adults. Therefore, further research is needed to fully understand the potential impact of regulating e-cigarette device power on young adult vaping.

Leventhal aM, Mason TB, Kirkpatrick MG, anderson MK, Levine MD. E-cigarette device power moderates the effects of non-tobacco flavors and nicotine on product appeal in young adults. addictive behaviors. 2020;107:106403. doi:10.1016/j.addbeh.2020.106403