ENDS Flavors: Difference between revisions
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=Abuse Liability - All THR Products= <!--T:10--> | =Abuse Liability - All THR Products= <!--T:10--> | ||
===See Also: [https://safernicotine.wiki/mediawiki/index.php/Nicotine_-_Addiction/Dependence Nicotine - Addiction/Dependence]=== | |||
===2022: [https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-14166-w E-cigarette addiction and harm perception: Does initiation flavor choice matter?]=== | |||
*"Traditionally flavored e-cigarette initiation produces similar risk for addiction and harm perceptions as non-traditionally flavored initiation. These findings suggest that banning non-traditional flavors alone may be ineffective in curbing e-cigarette addiction and harm perception. Additional research is needed to better understand which e-cigarette product characteristics and behaviors may be associated with greater addiction and reduced harm perceptions." | |||
**Hung, M., Spencer, A., Hon, E.S. et al. E-cigarette addiction and harm perception: Does initiation flavor choice matter?. BMC Public Health 22, 1780 (2022). https://doi.org/10.1186/s12889-022-14166-w | |||
===2022: [https://academic.oup.com/ntr/article/24/9/1332/6550857 The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review]=== | |||
*"E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers." | |||
**Citation: Mari S Gades, Aleksandra Alcheva, Amy L Riegelman, Dorothy K Hatsukami, The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review, Nicotine & Tobacco Research, Volume 24, Issue 9, September 2022, Pages 1332–1343, https://doi.org/10.1093/ntr/ntac073 | |||
***Acknowledgment: This work was supported by the National Institute of Drug Abuse (T32 DA007097 and R36 DA050000 to MSG); and the National Institutes of Health (P01 CA217806 to DKH). | |||
===2020: [https://pubmed.ncbi.nlm.nih.gov/33176942/ Abuse liability assessment of the JUUL system in four flavors relative to combustible cigarette, nicotine gum and a comparator electronic nicotine delivery system among adult smokers]=== <!--T:11--> | ===2020: [https://pubmed.ncbi.nlm.nih.gov/33176942/ Abuse liability assessment of the JUUL system in four flavors relative to combustible cigarette, nicotine gum and a comparator electronic nicotine delivery system among adult smokers]=== <!--T:11--> | ||
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*mint-flavored nicotine gum was rated as more palatable than the original nicotine gum, but the improvement in flavor did not increase abuse liability in adults (22 – 50 years old) or young adults (18 –21 years old). Since the aversive taste of the original nicotine gum was an important impediment to compliance (Rose, 1996) and treatment initiation, the availability of nicotine gum in different flavors and the development of alternative oral nicotine replacement products with appealing flavors may improve compliance and expand the range of options for those attempting to quit smoking, without posing an increased risk of abuse. | *mint-flavored nicotine gum was rated as more palatable than the original nicotine gum, but the improvement in flavor did not increase abuse liability in adults (22 – 50 years old) or young adults (18 –21 years old). Since the aversive taste of the original nicotine gum was an important impediment to compliance (Rose, 1996) and treatment initiation, the availability of nicotine gum in different flavors and the development of alternative oral nicotine replacement products with appealing flavors may improve compliance and expand the range of options for those attempting to quit smoking, without posing an increased risk of abuse. | ||
*[https://sci-hub.se/10.1016/s0091-3057(02)00723-2 PDF Version] | *[https://sci-hub.se/10.1016/s0091-3057(02)00723-2 PDF Version] | ||
*Citation: Houtsmuller, E. J., Fant, R. V., Eissenberg, T. E., Henningfield, J. E., & Stitzer, M. L. (2002). Flavor improvement does not increase abuse liability of nicotine chewing gum. Pharmacology Biochemistry and Behavior, 72(3), 559–568. doi:10.1016/s0091-3057(02)00723-2 | *Citation: Houtsmuller, E. J., Fant, R. V., Eissenberg, T. E., Henningfield, J. E., & Stitzer, M. L. (2002). Flavor improvement does not increase abuse liability of nicotine chewing gum. Pharmacology Biochemistry and Behavior, 72(3), 559–568. doi:10.1016/s0091-3057(02)00723-2 | ||
=Marketing/Advertising/Packaging= | =Marketing/Advertising/Packaging= | ||
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===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0378427423001091 A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro]=== | ===2023: [https://www.sciencedirect.com/science/article/abs/pii/S0378427423001091 A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro]=== | ||
*"We show that the tested flavours do not increase overall toxicity levels in a flavour or concentration-dependent manner. In fact, we demonstrate that the toxicity of e-cigarette aerosols in vitro derived from all the analysed flavour variants were > 95% reduced when compared to cigarette smoke toxicity." | *"We show that the tested flavours do not increase overall toxicity levels in a flavour or concentration-dependent manner. In fact, we demonstrate that the toxicity of e-cigarette aerosols in vitro derived from all the analysed flavour variants were > 95% reduced when compared to cigarette smoke toxicity." | ||
*Citation: Bishop E, East N, Miazzi F, Fiebelkorn S, Breheny D, Gaca M, Thorne D. A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro. Toxicol Lett. 2023 May 1;380:1-11. doi: 10.1016/j.toxlet.2023.03.006. Epub 2023 Mar 17. PMID: 36935081. | **Citation: Bishop E, East N, Miazzi F, Fiebelkorn S, Breheny D, Gaca M, Thorne D. A contextualised e-cigarette testing strategy shows flavourings do not impact lung toxicity in vitro. Toxicol Lett. 2023 May 1;380:1-11. doi: 10.1016/j.toxlet.2023.03.006. Epub 2023 Mar 17. PMID: 36935081. | ||
===2022: [https://pubmed.ncbi.nlm.nih.gov/36250607/ Associations between e-cigarette use and e-cigarette flavors with cigarette smoking quit attempts and quit success: Evidence from a US large, nationally representative 2018-2019 survey]=== | |||
*E-cigarette use is positively associated with both making a quit attempt and quit success, and those using flavored e-cigarettes are more likely to successfully quit smoking, with no statistically significant differences between the use of menthol or mint-flavored e-cigarettes versus the use of other nontobacco flavored products. | |||
**Citation: Mok Y, Jeon J, Levy DT, Meza R. Associations Between E-cigarette Use and E-cigarette Flavors With Cigarette Smoking Quit Attempts and Quit Success: Evidence From a U.S. Large, Nationally Representative 2018-2019 Survey. Nicotine Tob Res. 2023 Feb 9;25(3):541-552. doi: 10.1093/ntr/ntac241. PMID: 36250607; PMCID: PMC9910159. | |||
===2022: [https://tobaccocontrol.bmj.com/content/31/e1/e10 Association of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USA]=== | |||
*Non-tobacco flavours, daily vaping and modifiable e-cigarette devices may help some smokers abstain from cigarette smoking via transitioning to exclusive e-cigarette use, but are also associated with ongoing exclusive e-cigarette use. | |||
**Citation: Harlow AF, Fetterman JL, Ross CS, et alAssociation of device type, flavours and vaping behaviour with tobacco product transitions among adult electronic cigarette users in the USATobacco Control 2022;31:e10-e17. | |||
===2020: [https://pubmed.ncbi.nlm.nih.gov/32881666/ Investigation on the antibacterial activity of electronic cigarette liquids (ECLs): a proof of concept study]=== <!--T:18--> | ===2020: [https://pubmed.ncbi.nlm.nih.gov/32881666/ Investigation on the antibacterial activity of electronic cigarette liquids (ECLs): a proof of concept study]=== <!--T:18--> | ||
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*There is 750x more diacetyl in a pack of cigarettes than there is in a days worth of vaping nicotine fluid, and to date we have no confirmation that smokers are getting popcorn lung. | |||
=== 2015 [http://tobaccoanalysis.blogspot.com/2015/12/new-study-finds-that-average-diacetyl.html New Study Finds that Average Diacetyl Exposure from Vaping is 750 Times Lower than from Smoking] === | |||
*There's just one minor fact that is omitted completely in the article, as well as in all the media coverage. | |||
*That fact: All conventional cigarettes produce tobacco smoke that contains diacetyl, and the levels of diacetyl in cigarettes are a lot higher than those produced by e-cigarettes. | |||
===2019: [https://www.sciencedirect.com/science/article/pii/S0887233318307768?via%3Dihub High Content Screening in NHBE cells shows significantly reduced biological activity of flavoured e-liquids, when compared to cigarette smoke condensate]=== <!--T:22--> | ===2019: [https://www.sciencedirect.com/science/article/pii/S0887233318307768?via%3Dihub High Content Screening in NHBE cells shows significantly reduced biological activity of flavoured e-liquids, when compared to cigarette smoke condensate]=== <!--T:22--> | ||
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*"The findings highlight that people who smoke and vape could be impacted by flavour restrictions in a range of ways, some of which could have a potential adverse impact on harm reduction efforts in the UK (e.g., by making smoking more appealing than vaping)." | *"The findings highlight that people who smoke and vape could be impacted by flavour restrictions in a range of ways, some of which could have a potential adverse impact on harm reduction efforts in the UK (e.g., by making smoking more appealing than vaping)." | ||
**Citation: Khouja, J.N., Dyer, M.L., Havill, M.A. et al. Exploring the opinions and potential impact of unflavoured e-liquid on smoking cessation among people who smoke and smoking relapse among people who previously smoked and now use e-cigarettes: findings from a UK-based mixed methods study. Harm Reduct J 21, 90 (2024). https://doi.org/10.1186/s12954-024-01003-z | **Citation: Khouja, J.N., Dyer, M.L., Havill, M.A. et al. Exploring the opinions and potential impact of unflavoured e-liquid on smoking cessation among people who smoke and smoking relapse among people who previously smoked and now use e-cigarettes: findings from a UK-based mixed methods study. Harm Reduct J 21, 90 (2024). https://doi.org/10.1186/s12954-024-01003-z | ||
===2024: [https://www.nber.org/papers/w32534 Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults]=== | |||
*"The vast majority of youth e-cigarette users consume flavored e-cigarettes, raising concerns from public health advocates that flavors may drive youth initiation into and continued use of e-cigarettes...Our findings suggest that statewide comprehensive flavor bans may have generated an unintended consequence by encouraging substitution towards traditional smoking in some populations." | |||
**Citation: Comprehensive E-cigarette Flavor Bans and Tobacco Use among Youth and Adults, Henry Saffer, Selen Ozdogan, Michael Grossman, Daniel L. Dench, and Dhaval M. Dave, NBER Working Paper No. 32534, June 2024, JEL No. H07,I12,I18,J13 | |||
===2024: [https://academic.oup.com/ntr/advance-article-abstract/doi/10.1093/ntr/ntae151/7697906?login=false The Impact of New Jersey’s 2020 E-cigarette Flavor Ban on E-cigarette, Cigarette, and Cigar Sales in New Jersey]=== | |||
*"Flavored e-cigarette sales were declining prior to the ban but the pace of the decline accelerated following federal and state restrictions on flavored e-cigarette sales, then slowed by the second half of 2020, with a brief period of increased cigarette and cigar sales immediately following the ban." | |||
**Citation: Mary Hrywna, Arjun Teotia, Erin Miller Lo, Daniel P Giovenco, Cristine D Delnevo, The Impact of New Jersey’s 2020 E-cigarette Flavor Ban on E-cigarette, Cigarette, and Cigar Sales in New Jersey, Nicotine & Tobacco Research, 2024;, ntae151, https://doi.org/10.1093/ntr/ntae151 | |||
===2023: [https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4586701 E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales]=== | ===2023: [https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4586701 E-cigarette Flavor Restrictions’ Effects on Tobacco Product Sales]=== | ||
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*"Young adults who vape flavored e-cigarettes have mixed responses to e-cigarette flavor bans. Under both real-world and hypothetical e-cigarette flavor bans, most who use flavored e-cigarettes continue vaping. Under a real-world ban, the second most common response among those who exclusively vape is to switch to smoking; under a hypothetical federal ban, it is to quit all tobacco." | *"Young adults who vape flavored e-cigarettes have mixed responses to e-cigarette flavor bans. Under both real-world and hypothetical e-cigarette flavor bans, most who use flavored e-cigarettes continue vaping. Under a real-world ban, the second most common response among those who exclusively vape is to switch to smoking; under a hypothetical federal ban, it is to quit all tobacco." | ||
*Citation: Jamie Tam, Evelyn Jimenez-Mendoza, John Buckell, Jody Sindelar, Rafael Meza, Responses to Real-World and Hypothetical E-Cigarette Flavor Bans Among US Young Adults Who Use Flavored E-Cigarettes, Nicotine & Tobacco Research, 2023;, ntad258, https://doi.org/10.1093/ntr/ntad258 | *Citation: Jamie Tam, Evelyn Jimenez-Mendoza, John Buckell, Jody Sindelar, Rafael Meza, Responses to Real-World and Hypothetical E-Cigarette Flavor Bans Among US Young Adults Who Use Flavored E-Cigarettes, Nicotine & Tobacco Research, 2023;, ntad258, https://doi.org/10.1093/ntr/ntad258 | ||
===2022: [https://www.sciencedirect.com/science/article/abs/pii/S0091743522001116 Effect of flavored E-cigarette bans in the United States: What does the evidence show?]=== | |||
*However, in this paper, we propose an evidence-based version of this model based on several years' worth of longitudinal and econometric research, which suggests that youth e-cigarette use has instead worked to replace a culture of youth smoking. From this analysis, we propose a re-evaluation of current policies surrounding e-cigarette sales so that declines in e-cigarette use will not come at the cost of increasing cigarette use among youth and adults. | |||
**Citation: Siegel M, Katchmar A. Effect of flavored E-cigarette bans in the United States: What does the evidence show? Prev Med. 2022 Dec;165(Pt B):107063. doi: 10.1016/j.ypmed.2022.107063. Epub 2022 Apr 20. PMID: 35452711. | |||
===2022: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9287473/ Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas]=== | |||
*Results from this study highlight heterogeneity in young adult e-cigarette users’ reactions to existing flavored e-cigarette sales restrictions and hypothetical restrictions. Some reduced e-cigarette use, but many reported intentions to continue e-cigarette use, by using tank-based e-cigarettes, available flavors, or flavors accessed through alternative sources. More concerning, some switched to cigarettes. Similarly, in response to future restrictions of all flavored e-liquids, young adult e-cigarette users largely indicated that they would either quit vaping – the ideal scenario – or switch to cigarettes – the least desirable scenario. Another major concern highlighted was access to flavored e-cigarettes despite restrictions (e.g., online, across state lines). Collectively, findings suggest that implications of flavored e-cigarette sales restrictions are complex, with the potential for both reductions in e-cigarette use and unintended consequences among young adults, including continued use of flavored e-cigarettes or switching to cigarettes, and retail and consumer circumvention of restrictions. | |||
**Citation: Romm KF, Henriksen L, Huang J, Le D, Clausen M, Duan Z, Fuss C, Bennett B, Berg CJ. Impact of existing and potential e-cigarette flavor restrictions on e-cigarette use among young adult e-cigarette users in 6 US metropolitan areas. Prev Med Rep. 2022 Jul 9;28:101901. doi: 10.1016/j.pmedr.2022.101901. PMID: 35855926; PMCID: PMC9287473. | |||
===2022: [https://academic.oup.com/ntr/article/24/9/1332/6550857 The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review]=== | ===2022: [https://academic.oup.com/ntr/article/24/9/1332/6550857 The Role of Nicotine and Flavor in the Abuse Potential and Appeal of Electronic Cigarettes for Adult Current and Former Cigarette and Electronic Cigarette Users: A Systematic Review]=== | ||
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=== | ===2024: [https://pubmed.ncbi.nlm.nih.gov/39787830/ The impact of non-tobacco e-cigarette flavoring on e-cigarette uptake, cigarette smoking reduction, and cessation: A secondary analysis of a nationwide clinical trial]=== | ||
=== | ===2024: [https://jamanetwork.com/journals/jama-health-forum/fullarticle/2828404 Flavored E-Cigarette Sales Restrictions and Young Adult Tobacco Use]=== | ||
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