Characteristics Associated With Ice Flavor Use Among Middle and High School Students Currently Using E-cigarettes: National Youth Tobacco Survey, 2023

Introduction:
This text presents the findings of a study examining the characteristics associated with ice flavor e-cigarette use among middle and high school students currently using e-cigarettes. The study uses data from the 2023 National Youth Tobacco Survey (NYTS) to analyze the differences in sociodemographic characteristics and tobacco use behaviors between youth who use ice flavors and those who do not.

Key Points:

* The study found that 57.9% of middle and high school students who currently use e-cigarettes reported using ice flavors.
* Youth who currently used e-cigarettes were more likely to use ice flavors if they used e-cigarettes on ≥20 of the past 30 days, used fruit, candy, or mint flavors, reported any nicotine dependence, or had mild/moderate or severe psychological distress.
* The study also found that those who were unaware of the device type used had lower odds of using ice flavors than those using prefilled/refillable pods or cartridges.
* After controlling for all other covariates, associations remained significant between ice flavor use and frequent e-cigarette use, use of selected flavor types (fruit, candy, mint), any nicotine dependence, and psychological distress.
* The study highlights the importance of monitoring youth e-cigarette use behaviors and the need for tobacco control strategies to prevent and reduce youth tobacco use.

Main Message:
The study demonstrates that ice flavor e-cigarette use among youth is associated with frequent e-cigarette use, use of selected flavor types, any nicotine dependence, and psychological distress. The findings suggest that the emergence of novel flavor categories and features of e-cigarettes warrant continued surveillance to provide an understanding of associated use patterns, especially among youth. The study emphasizes the need for effective tobacco control strategies to prevent and reduce youth tobacco use, including regulations on e-cigarette flavors and marketing tactics that appeal to youth.

Eunice Park-Lee, Hannah Cowan, Mo’Nique Gaines-Harris, Maria R Cooper, Michael D Sawdey, Karen A Cullen, Characteristics Associated With Ice Flavor Use Among Middle and High School Students Currently Using E-cigarettes: National Youth Tobacco Survey, 2023, Nicotine & Tobacco Research, Volume 27, Issue 6, June 2025, Pages 1137–1141, https://doi.org/10.1093/ntr/ntae216