Role of flavored e-cigarettes on cigarette smoking uptake, cessation unclear in youth
Click Here to Manage Email Alerts
Flavors are an important motivator for e-cigarette uptake in youth, but the role of flavored e-cigarettes on uptake of tobacco smoking or cessation remains unclear, according to a systematic review published in Addiction.
“There has been a lot of concern that young people may start vaping because they are attracted to e-liquid flavors and that it could potentially lead them to start smoking tobacco,” Caitlin Notley, PhD, professor at Norwich Medical School at the University of East Anglia in Norwich, England, said in a press release from the institution. “We wanted to find out more about the links between vape flavors, the uptake of vaping among young people and whether it leads to regular vaping and, potentially, tobacco smoking.”
The systematic review evaluated 58 interventional, observational and qualitative studies conducted from 2004 to 2020 among 512,874 young people younger than 18 years with data on use of e-cigarettes with flavored liquids. Included studies compared flavored e-cigarettes vs. another e-cigarette flavor, flavored e-cigarettes vs. unflavored e-cigarettes, and e-cigarette uptake, prevalence, incidence and outcomes in smokers vs. nonsmokers.
Total quality of evidence among all studies was low, according to the researchers, with 39 cross-sectional survey studies, 11 longitudinal cohort studies that assessed e-cigarette trajectories and eight qualitative studies that reported on e-cigarette user experiences.
The researchers said the cross-sectional and longitudinal studies suggested that flavors were a motivator for initiation and continued use of e-cigarettes. In addition, qualitative evidence demonstrated young individuals’ interest and enjoyment in e-cigarette flavors, according to the results.
However, the researchers said there was not sufficient evidence to suggest e-cigarette flavor use was associated with uptake of tobacco cigarettes. Moreover, no studies reported clear associations between e-cigarette flavors and tobacco cessation, and there were no reports of adverse events related to use of flavored e-cigarettes.
According to the researchers, an important public health goal is to protect youths from harms associated with tobacco smoke exposure, and the attractiveness of e-cigarette flavors may play an important role in diverting youths from tobacco and aiding in tobacco cessation.
“We found that flavored e-liquids are an important aspect of vaping that young people enjoy. This suggests that flavored products may encourage young people to switch away from harmful tobacco smoking towards less harmful vaping,” Notley said. “Flavors may be an important motivator for e-cigarette uptake — but we found no evidence that using flavored e-liquids attracted young people to go on to take up tobacco smoking.”