Perceptions and Experiences with Flavored Non-Menthol Tobacco Products: A Systematic Review of Qualitative Studies.
Although a few countries have banned flavored cigarettes (except menthol), flavors in most tobacco products remain unregulated across the globe. We conducted a systematic review of qualitative studies examining perceptions of and experiences with flavored non-menthol tobacco products. Of 20 studies on flavored tobacco products included in our qualitative systematic review, 10 examined hookah, six examined e-cigarettes, two examined little cigars and cigarillos (LCCs), and three examined other tobacco products, including cigarettes. The majority of studies, regardless of product type, reported positive perceptions of flavored tobacco products, particularly among young adults and adolescents. In six studies that assessed perceptions of harm (including hookah, LCCs, and other flavored tobacco products), participants believed flavored tobacco products to be less harmful than cigarettes. In studies that examined the role of flavors in experimentation and/or initiation (including three studies on e-cigarettes, one hookah study and one LCC study), participants mentioned flavors as specifically leading to their experimentation and/or initiation of flavored tobacco products. Given that many countries have not yet banned flavors in tobacco products, these findings add to existing research on why individuals use flavored tobacco products and how they perceive harm in flavored tobacco products, providing further support for banning non-menthol flavors in most tobacco products.
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA. kowitt@email.unc.edu.|Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA. kowitt@email.unc.edu.
Sarah D
SD
Kowitt
Department of Family Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, Chapel Hill, NC 27599, USA. cmeernik@email.unc.edu.
Clare
C
Meernik
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA. hmbaker2@unc.edu.
Hannah M
HM
Baker
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA. amirao@email.unc.edu.
Amira
A
Osman
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA. liling_huang@med.unc.edu.
Li-Ling
LL
Huang
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 101 Manning Dr, Chapel Hill, NC 27514, USA. adam_goldstein@med.unc.edu.|Department of Family Medicine, University of North Carolina at Chapel Hill, 590 Manning Drive, Chapel Hill, NC 27599, USA. adam_goldstein@med.unc.edu.
Adam O
AO
Goldstein
D005421:Flavoring Agents; D006801:Humans; D008610:Menthol; D036301:Qualitative Research; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013649:Taste; D062789:Tobacco Products
D005421:Flavoring Agents; D008610:Menthol
flavored tobacco products; other tobacco products; regulation; tobacco control