Electronic nicotine delivery systems (ENDS) flavours and devices used by adults before and after the 2020 US FDa ENDS enforcement priority: findings from the 2018 and 2020 US ITC Smoking and Vaping Surveys.

Introduction:
This article presents the findings of a study that examines changes in electronic nicotine delivery systems (ENDS) flavors and devices used by adults before and after the 2020 US Food and Drug administration (FDa) enforcement priority. The study aims to fill a research gap by analyzing data from the International Tobacco Control Four Country Smoking and Vaping Survey to investigate changes in the usual use of flavored ENDS among adult current smokers and ex-smokers before and after the policy shift.

Key Points:

* The study found that between 2018 and the early phase of the FDa's 2020 enforcement priority, the prevalence of menthol/mint and fruit/other-flavored cartridges increased among adults.
* half of adults who were using flavored cartridges in 2018 (prior to enforcement) switched to flavors and/or devices exempt from the enforcement priority, but there was no shift to disposables.
* The findings indicate that ENDS devices and flavors used by adult current and former smokers are varied and may change over time and with available product offerings.
* The study controlled for time-in-sample, sex, age group, income, education, smoking status, and time-in-sample.
* The sample included 919 US frequent ENDS users in 2018 and 689 in 2020, with 360 eligible respondents who had complete ENDS flavor and device data at both time points.
* The study assessed ENDS flavors, devices, and flavor-device combinations used most often, as well as the location of last purchase of fruit/other-flavored cartridges in 2018 and 2020.
* Supplemental analyses examined changes in smoking and vaping between surveys.

Main Message:
The study suggests that more comprehensive restrictions on ENDS flavors and devices may be necessary to limit youth use, but policies should also consider the potential impact on adults who vape as a method of quitting smoking or remaining abstinent. The findings highlight the need for further research to understand the impact of FDa regulatory actions on smoking and vaping behaviors among both youth and adults. additionally, the study emphasizes the importance of considering the varied devices and flavors used by adult current and former smokers when developing regulatory policies.

Gravely S, Meng G, hammond D, et al. Electronic nicotine delivery systems (ENDS) flavours and devices used by adults before and after the 2020 US FDa ENDS enforcement priority: findings from the 2018 and 2020 US ITC Smoking and Vaping Surveys. Tobacco control. 2022;31:s167-s175. doi:10.1136/tobaccocontrol-2022-057445