E-cigarette flavors decrease perception of harm among youth

October 24, 2019

CHAPEL HILL, NC - October 24, 2019 - As more and more youth use electronic cigarettes, combined with research showing the health consequences of vaping - including nicotine addiction - researchers at the University of North Carolina-Chapel Hill found that non-menthol flavors attract youth and adults to use e-cigarettes and that the use of flavored e-cigarettes contributes to multiple pathways linked to higher e-cigarette use among youth.

The study, published in the British Medical Journal Open, is a systematic review of all peer-reviewed scientific literature published on e-cigarette use behaviors and perceptions through March of 2018. The researchers reviewed 51 articles, including 17 published before 2016 and 34 published between 2016 and 2018.

The researchers found:"Consistent evidence shows that flavors attract both youth and adults to use e-cigarettes," said Adam Goldstein, MD, MPH, professor of family medicine and member of the UNC Lineberger Comprehensive Cancer Center. "Given the fact that nicotine is highly addictive and can affect brain development - as well as these clear findings that the impact of flavors on youth is strong and consistent, we believe that banning non-menthol flavors in e-cigarettes will help reduce the epidemic of youth e-cigarette use."

Most e-cigarettes contain nicotine, and most include at least one of about 7,000 e-cigarette flavors available for purchase, such as blueberry cheesecake, mango, cinnamon, sweet milk, and lemon crumble cake. Many flavors have candy or sweet names, such as gummy bear, cookies 'n cream, and cotton candy, that appeal more to younger e-cigarette users. Studies over the past five years have shown a steady rise in vaping among youth, and a 2019 study showed that about 28 percent of U.S. youth are current e-cigarette users.

Lead author Hannah Baker, MPH, research associate in the UNC Department of Family Medicine and UNC Lineberger, said, "Many studies we reviewed showed that flavors were particularly appealing to youth and cited as a primary reason for use among this age group. The use of e-cigarettes among youth may be a gateway to future cigarette use, and nicotine is especially harmful to developing adolescent brains. These facts, along with biomedical research linking vaping to multiple adverse health effects, make the recent precipitous increase in e-cigarette use among youth particularly alarming."

Baker added, "Our synthesis of evidence regarding the role of non-menthol flavors in e-cigarettes on product perceptions and use is particularly relevant to the FDA's recently proposed policy framework that seeks to place additional regulations on the sale of non-menthol-flavored e-cigarettes to youth."

This new BMJ Open review significantly expands earlier findings about e-cigarettes and flavors. The researchers' previous review showed initial evidence that flavors in e-cigarettes were primary reasons for willingness to try or use the products. This expanded systematic review includes emerging longitudinal data and adds evidence regarding the expanded role of flavors in e-cigarettes, particularly among youth.

"Among youth, flavors increase not only preferences for e-cigarettes but they also increase e-cigarette product appeal, willingness to use, susceptibility to use and initiation, as well as decrease e-cigarette product harm perceptions," Goldstein said. "Among adults, the expanded research now shows that e-cigarette flavors also increase product appeal and enjoyment."
The other authors of this paper are first author Clare Meernik, MPH, a researcher at the UNC Gillings School of Global Public Health; and Sarah Kowitt, PhD, MPH, postdoctoral research associate, and Leah Ranney, PhD, MA, assistant professor and director of the UNC Tobacco Prevention and Evaluation Program, both in the UNC Department of Family Medicine at the UNC School of Medicine.

University of North Carolina Health Care

Related Nicotine Articles from Brightsurf:

Nicotine vapour more rewarding for adolescents than adults
University of Guelph researchers are the first to discover that adolescents react differently to e-cigarette vapour than adults.

Understanding the link between nicotine use and misuse of 'benzos'
Lately, misuse of prescription benzodiazepines (such as alprazolam or Xanax, and diazepam or Valium) has been linked to nicotine use.

Popular electronic cigarette may deliver nicotine more effectively than others
When it comes to nicotine delivery, not all electronic cigarettes are created equally, according to Penn State researchers.

Fetal nicotine exposure harms breathing in infants
Exposure to nicotine during development inhibits the function of neurons controlling the tongue, according to research in newborn rats recently published in eNeuro.

Diabetes drug relieves nicotine withdrawal
A drug commonly used to treat Type II diabetes abolishes the characteristic signs of nicotine withdrawal in rats and mice, according to new research published in JNeurosci.

The nicotine in e-cigarettes appears to impair mucus clearance
E-cigarette vaping with nicotine appears to hamper mucus clearance from the airways, according to new research published online in the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

Truth telling about tobacco and nicotine
In 'Truth Telling about Tobacco and Nicotine,' PRC researchers explain that, although there is agreement among researchers about evidence that vaping can be less harmful than combustible cigarettes, the tobacco control community remains divided about how to communicate -- or even whether to communicate -- information about the relative risks of tobacco and nicotine products.

This is a neuron on nicotine
Newly developed sensors visually illustrate how nicotine affects cells from the inside out.

New data suggests nicotine while pregnant alters genes
A University of Houston biomedical research team is reporting that a possible cure for addiction may be found by following the pathways of significantly altered dopamine neurons in newborns who were chronically exposed to nicotine in utero.

Ex-smokers might be better off with high rather than low nicotine e-cigs
Vapers using low rather than high nicotine e-cigarettes may be using their devices more intensely, potentially increasing the risk of exposure to toxins in the vapour, according to new research funded by Cancer Research UK and published in Addiction today.

Read More: Nicotine News and Nicotine Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.