Titled, “Changes in Flavor Preference in a Cohort of Long-Term Electronic Cigarette Users,” the current study assessed changes in patterns of use in relation to flavours, self-reported adverse reactions, and evaluated users’ anticipated reactions to possible FDA flavour-related regulatory scenarios.
The researchers analysed data compiled from 383 adult participants, who completed two online e-cigarette surveys between 2012 and 2014 (baseline survey) and again between 2017 and 2019 (follow-up survey). In both surveys, participants had to answer the following question: “Thinking about your preferred liquid, what is the name of this liquid flavour?” and then asked to list all flavors used in the past 30 days. Participants were also asked to report any adverse events (open-ended description) with the associated flavour.
“Participants’ age averaged 44 ± 12 years; 86% were exclusive e-cigarette users, and 13% reported “poly-use” (i.e., e-cigarette and other tobacco product use). E-cigarette flavor preference migration occurred in all demographic groups: only 36-44% maintained a preference for their original flavor,” reported the researchers.
Preference for tobacco and mint flavours decreased over time
50% of the participants reported that they would “find a way” to buy their preferred flavour or add flavouring agents themselves, if non-tobacco flavours were banned.
“Preference for tobacco and menthol or mint decreased over time (40% baseline vs. 22% follow-up); preference for fruit remained stable (23% baseline and follow-up), but chocolate/candy or other sweets preference significantly increased (16% baseline vs. 29% follow-up), and other flavors increased slightly. Migration to sweet flavors was more noticeable in younger adults (18-45 yr); exclusive e-cigarette users preferred sweet flavors more commonly than poly-users did (31% vs. 19%).”
With regards to flavour-associated adverse reactions, 26 (6.9%) participants reported respiratory irritations. As for restrictions, 50% of the participants reported that they would “find a way” to buy their preferred flavour or add flavouring agents themselves, if non-tobacco flavours were banned.
Vapers tend to migrate from tobacco to sweeter flavours
“Flavor migration toward sweet flavors occurred in long-term e-cigarette users, a trend most pronounced in younger and exclusive e-cigarette users. The anticipated maintenance of access to flavors despite regulation suggests an element of e-cigarette-related dependence that requires further evaluation. This information could help clinicians understand the health impacts of e-cigarette flavors, develop appropriate strategies for smoking cessation, and inform the U.S. Food and Drug Administration to plan future regulation of e-cigarette flavors,” concluded the study.