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How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys.
Nicotine Tob Res. 2021 08 18; 23(9):1490-1497.NT

Abstract

INTRODUCTION

There is limited research on the role of flavors in nicotine vaping products (NVPs) in relation to smoking. We examined patterns of flavor use in NVPs in relation to progression toward quitting.

AIMS AND METHODS

Data come from 886 concurrent users of NVPs (at least weekly) and cigarettes who were first surveyed in 2016 and then successfully recontacted in 2018 as part of the ITC 4CV Surveys conducted in Australia, Canada, England, and the United States. Participants were asked about their main vaping flavor categorized as: (1) tobacco or unflavored, (2) menthol or mint flavored, and (3) "sweet" flavors (eg, fruit or candy). We examined whether flavor was associated with progression toward quitting smoking between survey years.

RESULTS

Overall, 11.1% of baseline concurrent users quit smoking by 2018. Compared with users of tobacco flavors, those vaping "sweet" flavors were more likely to quit smoking between surveys (13.8% vs. 9.6%; adjusted odds ratio [aOR] = 1.61, 95% confidence interval [CI] 1.01-2.58, p < .05), but those using menthol flavors were no more likely to quit smoking (8.3% vs. 9.6%, aOR = 0.87, 95% CI 0.43-1.47, p = .69). Among those who had quit smoking in 2018, 52.0% were still vaping, which was lower than the 65.8% among continuing smokers (aOR = 0.60, 95% CI 0.39-0.92, p = .02). Sweet flavor users were no more likely to continue vaping compared with tobacco flavor users, either for those continuing smoking or those having quit smoking by 2018. There was a net shift away from tobacco flavor among those who continued to vape at follow-up.

CONCLUSIONS

Use of fruit and other sweet flavored e-liquids is positively related to smokers' transition away from cigarettes.

IMPLICATIONS

With multiple jurisdictions considering limiting or banning the sale of flavored NVPs, it is important to consider how such policies may impact smokers using NVPs to transition away from cigarette smoking. Our results indicate that vapers who used sweet flavors were more likely to transition away from cigarette smoking and quit cigarette use, at least in the short term, compared with those who used tobacco or unflavored NVPs. Randomized clinical trials are needed to establish if the observed association between use of flavored e-liquids and smoking cessation is due to self-selection or is truly causal.

Links

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Authors+Show Affiliations

Li L
Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.
Borland R
Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.
Cummings KM
Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
Fong GT
Department of Psychology, University of Waterloo, Waterloo, ON, Canada. School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. Ontario Institute for Cancer Research, Toronto, ON, Canada.
Gravely S
Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
Smith DM
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Goniewicz ML
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
O'Connor RJ
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Thompson ME
Department of Statistics and Actuarial Science, University of Waterloo, Waterloo, ON, Canada.
McNeill A
Addictions Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Shaping Public hEalth poliCies To Reduce ineqUalities and harm (SPECTRUM), UK.

MeSH

Electronic Nicotine Delivery SystemsFlavoring AgentsHumansSmokingSmoking CessationTobacco ProductsUnited StatesVaping

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

33631007

Citation

Li, Lin, et al. "How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys." Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, vol. 23, no. 9, 2021, pp. 1490-1497.
Li L, Borland R, Cummings KM, et al. How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys. Nicotine Tob Res. 2021;23(9):1490-1497.
Li, L., Borland, R., Cummings, K. M., Fong, G. T., Gravely, S., Smith, D. M., Goniewicz, M. L., O'Connor, R. J., Thompson, M. E., & McNeill, A. (2021). How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys. Nicotine & Tobacco Research : Official Journal of the Society for Research On Nicotine and Tobacco, 23(9), 1490-1497. https://doi.org/10.1093/ntr/ntab033
Li L, et al. How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys. Nicotine Tob Res. 2021 08 18;23(9):1490-1497. PubMed PMID: 33631007.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - How Does the Use of Flavored Nicotine Vaping Products Relate to Progression Toward Quitting Smoking? Findings From the 2016 and 2018 ITC 4CV Surveys. AU - Li,Lin, AU - Borland,Ron, AU - Cummings,Kenneth Michael, AU - Fong,Geoffrey T, AU - Gravely,Shannon, AU - Smith,Danielle M, AU - Goniewicz,Maciej L, AU - O'Connor,Richard J, AU - Thompson,Mary E, AU - McNeill,Ann, PY - 2020/06/02/received PY - 2021/02/22/accepted PY - 2021/2/26/pubmed PY - 2021/11/25/medline PY - 2021/2/25/entrez SP - 1490 EP - 1497 JF - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco JO - Nicotine Tob Res VL - 23 IS - 9 N2 - INTRODUCTION: There is limited research on the role of flavors in nicotine vaping products (NVPs) in relation to smoking. We examined patterns of flavor use in NVPs in relation to progression toward quitting. AIMS AND METHODS: Data come from 886 concurrent users of NVPs (at least weekly) and cigarettes who were first surveyed in 2016 and then successfully recontacted in 2018 as part of the ITC 4CV Surveys conducted in Australia, Canada, England, and the United States. Participants were asked about their main vaping flavor categorized as: (1) tobacco or unflavored, (2) menthol or mint flavored, and (3) "sweet" flavors (eg, fruit or candy). We examined whether flavor was associated with progression toward quitting smoking between survey years. RESULTS: Overall, 11.1% of baseline concurrent users quit smoking by 2018. Compared with users of tobacco flavors, those vaping "sweet" flavors were more likely to quit smoking between surveys (13.8% vs. 9.6%; adjusted odds ratio [aOR] = 1.61, 95% confidence interval [CI] 1.01-2.58, p < .05), but those using menthol flavors were no more likely to quit smoking (8.3% vs. 9.6%, aOR = 0.87, 95% CI 0.43-1.47, p = .69). Among those who had quit smoking in 2018, 52.0% were still vaping, which was lower than the 65.8% among continuing smokers (aOR = 0.60, 95% CI 0.39-0.92, p = .02). Sweet flavor users were no more likely to continue vaping compared with tobacco flavor users, either for those continuing smoking or those having quit smoking by 2018. There was a net shift away from tobacco flavor among those who continued to vape at follow-up. CONCLUSIONS: Use of fruit and other sweet flavored e-liquids is positively related to smokers' transition away from cigarettes. IMPLICATIONS: With multiple jurisdictions considering limiting or banning the sale of flavored NVPs, it is important to consider how such policies may impact smokers using NVPs to transition away from cigarette smoking. Our results indicate that vapers who used sweet flavors were more likely to transition away from cigarette smoking and quit cigarette use, at least in the short term, compared with those who used tobacco or unflavored NVPs. Randomized clinical trials are needed to establish if the observed association between use of flavored e-liquids and smoking cessation is due to self-selection or is truly causal. SN - 1469-994X UR - https://www.unboundmedicine.com/medline/citation/33631007/How_Does_the_Use_of_Flavored_Nicotine_Vaping_Products_Relate_to_Progression_Toward_Quitting_Smoking_Findings_From_the_2016_and_2018_ITC_4CV_Surveys_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓11 ↑40]

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