title: Flavored e-cigarette use: Characterizing youth, young adult, and adult users.
abstract: The purpose of this study is to investigate how the use of flavored e-cigarettes varies between youth (12-17 years old), young adults (18-29 years old), and older adults (30 + years old). Cross-sectional surveys of school-going youth (n= 3907) and young adult college students (n= 5482) in Texas, and young adults and older adults (n= 6051) nationwide were administered in 2014-2015. Proportions and 95% confidence intervals were used to describe the percentage of e-cigarette use at initiation and in the past 30 days that was flavored, among current e-cigarette users. Chi-square tests were applied to examine differences by combustible tobacco product use and demographic factors. Most e-cigarette users said their first and "usual" e-cigarettes were flavored. At initiation, the majority of Texas school-going youth (98%), Texas young adult college students (95%), and young adults (71.2%) nationwide said their first e-cigarettes were flavored to taste like something other than tobacco, compared to 44.1% of older adults nationwide. Fruit and candy flavors predominated for all groups; and, for youth, flavors were an especially salient reason to use e-cigarettes. Among adults, the use of tobacco flavor at initiation was common among dual users (e-cigarettes + combustible tobacco), while other flavors were more common among former cigarette smokers (P = 0.03). Restricting the range of e-cigarette flavors (e.g., eliminating sweet flavors, like fruit and candy) may benefit youth and young adult prevention efforts. However, it is unclear what impact this change would have on adult smoking cessation.
authors.affiliation: UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
authors.forename: M B
authors.initials: MB
authors.lastname: Harrell
authors.affiliation: Georgia State University Tobacco Center of Regulatory Science & Division of Epidemiology & Biostatistics, School of Public Health, Georgia State University, 33 Gilmer Street SE, Atlanta, GA 30303, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Weaver
authors.affiliation: Department of Kinesiology & Health Education, University of Texas at Austin, 2109 San Jacinto Blvd., Stop D3700, Austin, TX 78712-1415, USA.
authors.forename: A
authors.initials: A
authors.lastname: Loukas
authors.affiliation: UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
authors.forename: M
authors.initials: M
authors.lastname: Creamer
authors.affiliation: Department of Kinesiology & Health Education, University of Texas at Austin, 2109 San Jacinto Blvd., Stop D3700, Austin, TX 78712-1415, USA.
authors.forename: C N
authors.initials: CN
authors.lastname: Marti
authors.affiliation: UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
authors.forename: C D
authors.initials: CD
authors.lastname: Jackson
authors.affiliation: Georgia State University Tobacco Center of Regulatory Science, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA.
authors.forename: J W
authors.initials: JW
authors.lastname: Heath
authors.affiliation: Georgia State University Tobacco Center of Regulatory Science, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA.
authors.forename: P
authors.initials: P
authors.lastname: Nayak
authors.affiliation: UTHealth School of Public Health in Austin, Michael & Susan Dell Center for Healthy Living, , 1616 Guadalupe, Suite 6.300, Austin, TX 78701, USA.
authors.forename: C L
authors.initials: CL
authors.lastname: Perry
authors.affiliation: Georgia State University Tobacco Center of Regulatory Science & Division of Health Management & Policy, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA.
authors.forename: T F
authors.initials: TF
authors.lastname: Pechacek
authors.affiliation: Georgia State University Tobacco Center of Regulatory Science & Division of Health Management & Policy, Urban Life Building, 140 Decatur Street, NE, Atlanta, GA 30303, USA.
authors.forename: M P
authors.initials: MP
authors.lastname: Eriksen
keywords: Adults; E-cigarettes; Flavors; Young adults; Youth