Youth use of e-liquid flavours-a systematic review exploring patterns of use of e-liquid flavours and associations with continued vaping, tobacco smoking uptake or cessation.

Introduction:
This summary will provide an overview of a systematic review examining the use of e-liquid flavors by young people and its association with uptake or cessation of vaping and tobacco smoking, adverse effects, and subjective experiences. The review includes 58 studies and highlights the importance of flavors in the initiation and continuation of vaping, but finds insufficient evidence to support the claim that flavors are specifically associated with smoking uptake or cessation.

Key Points:

* The review includes 58 studies with a focus on young people's use of e-cigarette flavors.
* Most studies were cross-sectional survey designs, with a lack of clear definitions of key factors such as age, tobacco products, e-cigarettes, and flavors.
* Flavors are an important motivator for e-cigarette uptake, but the role of flavors in tobacco smoking uptake or cessation is unclear.
* There is insufficient evidence to suggest that specific e-liquid flavors are associated with adverse effects in young people.
* qualitative evidence shows interest and enjoyment in flavors, with experimentation and switching between flavors being common.
* There is no strong evidence of an association between flavored e-liquid use and subsequent uptake of tobacco smoking.
* The quality of evidence on use of e-cigarette flavors by young people is low overall.

Main Message:
The review highlights the importance of flavors in the initiation and continuation of vaping among young people, but the role of flavors in tobacco smoking uptake or cessation remains unclear. The quality of evidence on this topic is low, and there is a need for further research to inform policy decisions regarding the regulation of e-cigarette flavors. It is important to balance the potential benefits of e-cigarettes as a harm reduction tool for adult smokers with the need to protect young people from nicotine addiction and tobacco smoking.

Notley C, Gentry S, Cox S, et al. Youth use of e-liquid flavours-a systematic review exploring patterns of use of e-liquid flavours and associations with continued vaping, tobacco smoking uptake or cessation. addiction (abingdon, England). 2022;117(5):1258-1272. doi:10.1111/add.15723