Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review.

Introduction:
This summary will provide an overview of a systematic review examining the impact of non-menthol flavored e-cigarettes on e-cigarette perceptions and use among youth and adults. The review includes 51 articles published up to 2018.

Key Points:

* Non-menthol flavors in e-cigarettes decrease harm perceptions and increase willingness to try and initiation of e-cigarettes.
* among adults, e-cigarette flavors increase product appeal and are a primary reason for use.
* The role of flavored e-cigarettes on smoking cessation remains unclear.
* Most studies were cross-sectional and had limitations in study design and generalizability.
* qualitative data could have provided additional contextual information to the conclusions.

Main Message:
This review provides summary data on the role of non-menthol flavors in e-cigarette perceptions and use. Consistent evidence shows that flavors attract both youth and adults to use e-cigarettes. Given the clear findings that such flavors increase product appeal, willingness to try and initiation among youth, banning non-menthol flavors in e-cigarettes may reduce youth e-cigarette use. Longitudinal research is needed to examine any role flavors may play in quit behaviors among adults.

Meernik C, Baker hM, Kowitt SD, Ranney LM, Goldstein aO. Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review. BMJ open. 2019;9(10):1. doi:10.1136/bmjopen-2019-031598