title: Association between use of flavoured tobacco products and quit behaviours: findings from a cross-sectional survey of US adult tobacco users.
abstract: Non-menthol characterising flavours (eg, fruit, candy) are banned in cigarettes, yet are still permitted in non-cigarette tobacco (NCT) products. This study examined associations between first use and current use of flavoured tobacco products, and current flavoured tobacco use and quit behaviours.
  
  
  
  A nationally representative, telephone-based survey completed in 2012 by 1443 US adult tobacco users asked about use of 9 tobacco products: cigarettes, e-cigarettes, cigars, cigarillos, little filtered cigars, pipes, hookah, smokeless tobacco and snus. Ever users reported first use of flavoured products, while current users also reported current flavoured product use. Current users reported quit attempts made in the past year. Data were weighted to reflect the US adult tobacco user population. Logistic regression models were used to examine associations between first/current flavour use and quit behaviours.
  
  
  
  Over 70% of respondents reported first use of a flavoured tobacco product, while 54% reported current use of at least one flavoured product. Odds of current flavoured product use were greater among those who reported first use of a flavoured product (OR 14.82, 95% CI 9.96 to 22.06). First use of a flavoured product was associated with being a current tobacco user (OR 1.55, 95% CI 1.08 to 2.22). Compared to single product users, polytobacco users exhibited greater odds of reporting current use of flavoured products (OR 2.09, 95% CI 1.47 to 2.97). Forty-four percent of current tobacco users reported a past-year quit attempt. Adjusted analyses among current NCT users of at least one flavoured tobacco product showed reduced odds of reporting a quit attempt.
  
  
  
  First use of a flavoured tobacco product was associated with current flavoured tobacco use and polytobacco use. Users of only flavoured NCT products exhibited reduced odds of reporting a quit attempt. Findings from this study reinforce the importance of flavoured product availability in the USA, which may have significant implications for efforts to reduce tobacco initiation and use at a population level. The relationship between characterising flavours and quit behaviours merits further exploration in longitudinal, population-based samples.
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Smith
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Maansi
authors.initials: M
authors.lastname: Bansal-Travers
authors.affiliation: University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Jidong
authors.initials: J
authors.lastname: Huang
authors.affiliation: Barker Bi-Coastal Health Consultants, Inc., Calabasas, California, USA.
authors.forename: Dianne
authors.initials: D
authors.lastname: Barker
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Hyland
authors.affiliation: University of Illinois at Chicago, Chicago, Illinois, USA.
authors.forename: Frank
authors.initials: F
authors.lastname: Chaloupka
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems; D005260:Female; D005421:Flavoring Agents / Q000008:administration & dosage*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D062789:Tobacco Products / Q000706:statistics & numerical data*; D064424:Tobacco Use / Q000453:epidemiology*; D014030:Tobacco, Smokeless / Q000706:statistics & numerical data; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D005421:Flavoring Agents
keywords: Cessation; Non-cigarette tobacco products; Prevention; Public policy