title: Flavored Electronic Cigarette Use and Smoking Among Youth.
abstract: Flavored electronic cigarettes (e-cigarettes) are not prohibited in the United States, and e-cigarette flavors proliferate on the market. This study sought to examine flavored e-cigarette use and its association with smoking among youth.
  
  
  
  Estimates of flavored e-cigarette use from the 2014 National Youth Tobacco Survey were investigated. A logistic regression model was used to assess whether flavored e-cigarette use was associated with (1) intention to initiate cigarette use among never-smoking youth (n = 16 471), (2) intention to quit tobacco use among current-smoking youth (n = 1338), and (3) perception of tobacco's danger among all respondents (n = 21 491).
  
  
  
  A total of 2017 respondents reported using e-cigarettes in the last 30 days, of whom 1228 (60.9%) reported using flavored e-cigarettes. Among never-smoking youth, 55.6% (288) of current e-cigarette users reported using flavored e-cigarettes. Among current smokers, 68.4% (495) of current e-cigarette users reported using flavored e-cigarettes. Compared with not using e-cigarettes in the past 30 days, using flavored e-cigarettes was associated with higher odds of intention to initiate cigarette use among never-smoking youth (adjusted odds ratio [aOR] = 5.7; P < .0001), lower odds of intention to quit tobacco use among current-smoking youth (aOR = 0.6; P = .006), and a lower prevalence of perception of tobacco's danger among all respondents (aOR = 0.5; P < .0001).
  
  
  
  Flavored e-cigarette use is associated with increased risks of smoking among youth. Comprehensive tobacco control and prevention strategies that address flavored e-cigarette products are critically needed to reduce tobacco use among youth.
authors.affiliation: Division of Health Services and Outcomes Research, Children's Mercy Hospital, Kansas City, Missouri; hdai@cmh.edu.|Departments of Biomedical and Health Informatics, and.|Pediatrics, University of Missouri-Kansas City, Kansas City, Missouri; and.
authors.forename: Hongying
authors.initials: H
authors.lastname: Dai
authors.affiliation: College of Business, Bellevue University, Omaha, Nebraska.
authors.forename: Jianqiang
authors.initials: J
authors.lastname: Hao
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology*; D000367:Age Factors; D003430:Cross-Sectional Studies; D066300:Electronic Nicotine Delivery Systems / Q000706:statistics & numerical data*; D005260:Female; D005421:Flavoring Agents / Q000494:pharmacology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D014481:United States
chemical_list: D005421:Flavoring Agents