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Teen E-Cigarette Use Drives Flavored Tobacco Sales

MedicalResearch.com Interview with:

Dr. Hongying Dai, PhD Associate Professor at the College of Public Health University of Nebraska Medical Center.

Dr. Dai

Dr. Hongying Dai, PhD
Associate Professor at the College of Public Health
University of Nebraska Medical Center.

MedicalResearch.com: What is the background for this study?

Response: The 2009 Family Smoking Prevention and Tobacco Control Act (FSPTCA) banned cigarettes with characterizing flavors (e.g., candy, fruit, clove) except menthol. However, there are no restrictions on the marketing and sales of flavored non-cigarette tobacco products. This has led to a proliferation of flavored tobacco products in the marketplace. Flavoring has become one of the leading reasons for current tobacco use among youth. It is reported that 81% of e-cigarette users, 79% of hookah users, 74% of cigar users, 69% of smokeless tobacco users, and 67% of snus users attributed the availability of appealing flavors for their tobacco use in 2013–2014 among teenagers aged 12 to 17 years. In November 2018, the FDA proposed new restrictions on flavored tobacco products.

MedicalResearch.com: What are the main findings?

Response: This study examined the recent changes in self-reported flavored tobacco product (FTP) use among current youth tobacco users in 2014-2017 by analyzing more than 78,0000 students from a school-based national survey. Here are the main findings:

  1. The prevalence of flavored tobacco product among current tobacco users decreased significantly from 69.4% in 2014 to 57.7% in 2016 and then rebounded from 2016 to 2017 (63.6%). The rebound was largely due to an increase of flavor use in e-cigarettes.
  2. As flavor use in other tobacco products decreased or leveled off, flavored e-cigarette use continued to increase from 2015 to 2017. 

MedicalResearch.com: What should readers take away from your report?

Response: Self-reported use of flavored tobacco products by U.S. middle and high school students decreased from 2014 to 2016, but the decreasing trend did not continue and flavored tobacco product use rebounded significantly from 2016 to 2017.

Flavored tobacco product could serve as a starter kit for smoking because adolescents often experiment with smoking in pursuit of curiosity and novelty. Also, concerns have been raised about the potential inhalation toxicity of flavoring.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Given the continuous increase of e-cigarette use among U.S. middle and high school students and the FDA warns that youth e-cigarette use is reaching an epidemic proportion in September 2018, continuous surveillance of FTP use and efforts to decrease flavored tobacco products use among youth are needed.


Dai H. Changes in Flavored Tobacco Product Use Among Current Youth Tobacco Users in the United States, 2014-2017. JAMA Pediatr. Published online January 07, 2019. doi:10.1001/jamapediatrics.2018.4595

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Last Updated on January 7, 2019 by Marie Benz MD FAAD