Kids Who Starting Smoking with Flavored Tobacco More Likely to Keep Smoking

MedicalResearch.com Interview with:

Andrea Villanti, PhD, MPH Associate Professor Department of Psychiatry Vermont Center on Behavior and Health University of Vermont

Dr. Villanti

Andrea Villanti, PhD, MPH
Associate Professor
Department of Psychiatry
Vermont Center on Behavior and Health
University of Vermont 

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

Response: Our earlier work documented a significant association between first use of a flavored tobacco product and current tobacco use (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5522636/) in a cross-sectional sample. The goal of this study was to examine whether there was a prospective relationship between first use of a flavored tobacco product and subsequent use of that product in longitudinal data.. 

MedicalResearch.com: What are the main findings?

Response: Findings from the study show that first use of flavored tobacco products was positively associated with subsequent product use compared with first use of a nonflavored product. 

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

There are three important findings from this study:

  • First, among new users of tobacco products, youth and young adults are more likely than adults to first use a flavored tobacco product.
  • Second, first flavored cigarette and first menthol cigarette use are associated with subsequent cigarette use in all age groups – youth, young adults, and adults. This is consistent with other studies showing that menthol cigarettes facilitate initiation and progression in young smokers.
  • Third, in young adults and adults, first flavored use is associated with subsequent regular use of cigarettes, cigars, hookah, e-cigarettes, and smokeless tobacco products. The consistency of this relationship across a range of products supports the role of flavors in the establishment and maintenance of tobacco use.

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

Response: Few longitudinal studies have examined the relationship between initiating with a flavored tobacco product and subsequent tobacco product use. Addressing this question in the context of today’s diverse tobacco product market will add to the existing evidence base.

MedicalResearch.com: Is there anything else you would like to add?

Response: The 2009 Family Smoking Prevention and Tobacco Control Act banned characterizing flavors other than menthol in cigarettes, but did not restrict their use in other tobacco products (e.g., smokeless, cigars, hookah, e-cigarettes). Since that time, states and localities have enacted flavored tobacco bans in various forms – most recently, bans on flavored e-cigarettes.

Findings from our study highlight that flavors in tobacco products put users at risk for subsequent tobacco use and that this is not limited to a single product (e.g., e-cigarettes). Importantly, first menthol cigarette use is related to subsequent daily cigarette use in all age groups (youth, young adults, and adults) and flavored cigarettes, cigars, hookah, e-cigarettes, and smokeless tobacco products are associated with established regular use of those products in young adults and adults.

This work was supported by the National Institute on Drug Abuse, National Institutes of Health, and the Center for Tobacco Products, US Food and Drug Administration, Department of Health and Human Services, under contract HHSN271201100027C to Westat. The views and opinions expressed in this manuscript are those of the authors only and do not necessarily represent the views, official policy, or position of the US Department of Health and Human Services or any of its affiliated institutions or agencies.

Citation:

Villanti AC, Johnson AL, Glasser AM, et al. Association of Flavored Tobacco Use With Tobacco Initiation and Subsequent Use Among US Youth and Adults, 2013-2015. JAMA Netw Open. Published online October 23, 20192(10):e1913804. doi:10.1001/jamanetworkopen.2019.13804

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Last Updated on October 23, 2019 by Marie Benz MD FAAD