title: Flavored Tobacco Products in the United States: A Systematic Review Assessing Use and Attitudes.
abstract: OBJECTIVE
  We systematically reviewed research examining use of and attitudes toward nonmenthol-flavored tobacco products to provide information relevant to a decision to regulate these products in the future.
  
  
  METHODS
  To identify eligible studies, we searched PubMed, CINHAL, Embase, LILACS, and PsycINFO on September 19, 2013, without date restrictions. We obtained additional studies via gray literature searches, expert contacts, and hand-searching citations of included articles. We included participants of all ages. We conducted a qualitative synthesis for included studies.
  
  
  RESULTS
  The 32 studies included in this review exhibited substantial heterogeneity and were of varied methodological quality. Findings from observational, experimental, and quasiexperimental studies suggest that flavored tobacco use is associated with young age and that consumers may perceive flavored products more favorably than nonflavored products. Evidence from qualitative studies indicates that flavoring in tobacco is viewed favorably by users and nonusers of these products.
  
  
  CONCLUSIONS
  The Food and Drug Administration has expressed interest in regulating flavored tobacco products. This systematic review strengthens the evidence base relating to this issue by synthesizing the literature from the United States on the use of and attitudes toward flavored tobacco. To address gaps in the literature, more research is needed to understand how flavoring impacts tobacco use over time. The evidence base would further be strengthened with the collection of brand-, flavor-, and product-specific data.
authors: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; The Schroeder Institute for Tobacco Research and Policy Studies, Legacy, Washington, DC; sfeirman@legacyforhealth.org.
authors: Shari P
authors: SP
authors: Feirman
authors: Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
authors: Diana
authors: D
authors: Lock
authors: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
authors: Joanna E
authors: JE
authors: Cohen
authors: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD;
authors: David R
authors: DR
authors: Holtgrave
authors: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
authors: Tianjing
authors: T
authors: Li
mesh_terms: D001290:Attitude; D005421:Flavoring Agents / Q000008:administration & dosage*; D006801:Humans; D012907:Smoking / Q000453:epidemiology / Q000331:legislation & jurisprudence / Q000523:psychology; D062789:Tobacco Products / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology* / Q000331:legislation & jurisprudence / Q000523:psychology; D014030:Tobacco, Smokeless / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D014486:United States Food and Drug Administration / Q000331:legislation & jurisprudence
chemical_list: D005421:Flavoring Agents