Device and liquid characteristics used with sweet, menthol/mint, and tobacco ENDS liquid flavors: The population-based VAPER study

Crespi, Elizabeth; Hardesty, Jeffrey J; Nian, Qinghua; Sinamo, Joshua; Welding, Kevin; Cohen, Joanna E.; Kennedy, Ryan David

doi:10.1016/j.addbeh.2023.107727

Cited by 4 publications

(4 citation statements)

References 39 publications

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“…Though the number of liquid products increased, the number of liquid brands decreased; the corresponding increase in the number of liquid products per brand may suggest rising popularity of certain brands and expanded use of various products within those brands. Among the unique liquids in our sample, sweet was the most common flavor across all waves (80-84%); this aligns with current literature showing the high popularity of sweet flavors among ENDS users [30][31][32][33] . FDA may consider prioritizing enforcement against sweet-flavored products given their popularity and importance in youth use [30][31][32][33][34][35] .…”

Section: Discussionsupporting

confidence: 88%

“…Among the unique liquids in our sample, sweet was the most common flavor across all waves (80-84%); this aligns with current literature showing the high popularity of sweet flavors among ENDS users [30][31][32][33] . FDA may consider prioritizing enforcement against sweet-flavored products given their popularity and importance in youth use [30][31][32][33][34][35] .…”

Section: Discussionsupporting

confidence: 88%

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Decisions of the FDA on premarket tobacco product applications: Changes in the number of unique devices and liquids used by US adults who frequently use electronic nicotine delivery systems, 2020–2023

Crespi,

Hardesty,

Nian

et al. 2024

Tob. Induc. Dis.

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INTRODUCTION The majority of decisions on electronic nicotine delivery system (ENDS) premarket tobacco product applications (PMTAs) were made from October 2020 to February 2023; 99% (>25 million) had determinations by March 2023 and just twenty-three received marketing granted orders. We examined the unique devices and liquids used among US adults frequently using ENDS before, during, and after a majority of PMTA decisions were made. METHODS Data are from waves 1-5 (W1: May–Oct 2020, n=1179; W5: Feb–Apr 2023, n=1290) of a longitudinal survey of US adults (≥21 years) using ENDS ≥5 days/week. User-submitted photos of participants’ most used devices and liquids were coded. Descriptive analyses and Wilcoxon signed-rank tests were used to understand the number and types of unique devices and liquids used in W1-W5, and the top brands in each wave. RESULTS From W1-W5, the number of unique ENDS device models and liquid products used by participants increased from 279 to 357 (p<0.001) and 546 to 695 (p<0.001), respectively. More unique devices in W5 versus W1 were disposable (W1: 16.5%; W5: 36.1%); fewer were disposable pod (W1: 6.5%; W5: 3.1%) or tank (W1: 53.8%; W5: 30.8%) devices. Liquids were primarily sweet-flavored (W1: 81.1%; W5: 82.0%). The median liquid nicotine concentration increased from 12 to 50 mg/mL. In W5, few participants used FDA-approved devices (n=17; 1.3%) or liquids (n=6; 0.5%), and Elf Bar was the most commonly used device and liquid brand. Results for all waves are reported. CONCLUSIONS Despite PMTA decisions, an increase in the number of unique device models and liquid products used among adults who frequently use ENDS was observed from 2020 to 2023. Few participants in 2023 were using FDA-approved devices or liquids. Further research and monitoring are needed to inform how FDA prioritizes enforcement actions and what types of enforcement actions are effective.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

Decisions of the FDA on premarket tobacco product applications: Changes in the number of unique devices and liquids used by US adults who frequently use electronic nicotine delivery systems, 2020–2023

Crespi,

Hardesty,

Nian

et al. 2024

Tob. Induc. Dis.

Self Cite

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“…Self-report data were used where photo data were missing. We categorized flavors following the ENDS liquid flavor wheel developed by Krüsemann et al 15 and then classified the primary flavor into four categories 16 : 1) sweet (including dessert, fruit, candy, other sweets, or other flavors with subcategory listed as sweet); 2) menthol/mint; 3) tobacco; and 4) other (including coffee/tea, nuts, spices, unflavored, multiple flavors, or concept flavor).…”

Section: Measurementsmentioning

confidence: 99%

Transitions in device and liquid characteristic groupings among US adults frequently using electronic nicotine delivery systems (ENDS) over three timepoints, 2020–2021

Nian,

Hardesty,

Crespi

et al. 2023

Tob. Induc. Dis.

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INTRODUCTION Electronic nicotine delivery system (ENDS) and liquid characteristics affect nicotine and toxicant exposure and use behaviors. Little is known about how adults who frequently use ENDS transition between ENDS device/liquid groupings. METHODS A total of 379 US adults (≥21 years) using ENDS frequently (≥5 days/ week) self-reported and uploaded photos of their most used ENDS device and liquid in three waves of online surveys (May 2020 -November 2021). Device/ liquid grouping was defined by device (i.e. disposable/refillable tank/refillable pod or cartridge/disposable pod or cartridge, adjustable/no adjustable settings) and liquid (i.e. salt/freebase) characteristics. Participants using the same grouping across waves were considered stable users. RESULTS The most prevalent wave (W) 1 grouping was tank (freebase, adjustable settings; 36.8%). From W1 to W3, the number of disposable device (salt, no adjustable settings) users increased 156.4% and the number of disposable pod/ cartridge (salt, no adjustable settings) users decreased 15.2%. In W2 and W3, compared to stable users, participants using tank (freebase, adjustable settings) in W1 and another grouping in W2 and/or W3 reported significantly higher nicotine concentrations (mg/mL) (W2: 15.1 vs 5.5, p<0.001; W3: 22.9 vs 5.6, p<0.001) and lower device power (watt) (W2: 46.8 vs 58.7, p=0.02; W3: 34.0 vs 57.2, p<0.001). CONCLUSIONS Over a 1.5-year period, a rapid growth in disposable device (salt, no adjustable settings) use and a decrease in disposable pod/cartridge (salt, no adjustable settings) use were observed. Participants who transitioned from tank (freebase, adjustable settings) to other groupings were more likely to increase liquid nicotine concentration and reduce device power compared to stable users.

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“…When studying the components of e-liquid, a wide variety of flavors are utilized, serving as a significant factor in promoting initiation and higher usage frequency among young users [ 40 ]. Various flavors are available in marketing, including tobacco, menthol/mint, fruit, sweet/dessert, and drink flavors [ 41 ]. An international survey of adult former smokers indicated that flavor diversity played a ‘significant’ role in their attempts to quit smoking, reduce enjoyment, and ease the transition from smoking to using e-cigarettes [ 40 ].…”

Section: E-cigarettes In Smoking Cessation and Harm Reductionmentioning

confidence: 99%

Zebrafish (Danio rerio) as a Model for the Study of Developmental and Cardiovascular Toxicity of Electronic Cigarettes

Hussen,

Aakel,

Shaito

et al. 2023

IJMS

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The increasing popularity of electronic cigarettes (e-cigarettes) as an alternative to conventional tobacco products has raised concerns regarding their potential adverse effects. The cardiovascular system undergoes intricate processes forming the heart and blood vessels during fetal development. However, the precise impact of e-cigarette smoke and aerosols on these delicate developmental processes remains elusive. Previous studies have revealed changes in gene expression patterns, disruptions in cellular signaling pathways, and increased oxidative stress resulting from e-cigarette exposure. These findings indicate the potential for e-cigarettes to cause developmental and cardiovascular harm. This comprehensive review article discusses various aspects of electronic cigarette use, emphasizing the relevance of cardiovascular studies in Zebrafish for understanding the risks to human health. It also highlights novel experimental approaches and technologies while addressing their inherent challenges and limitations.

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Device and liquid characteristics used with sweet, menthol/mint, and tobacco ENDS liquid flavors: The population-based VAPER study

Cited by 4 publications

References 39 publications

Decisions of the FDA on premarket tobacco product applications: Changes in the number of unique devices and liquids used by US adults who frequently use electronic nicotine delivery systems, 2020–2023

Decisions of the FDA on premarket tobacco product applications: Changes in the number of unique devices and liquids used by US adults who frequently use electronic nicotine delivery systems, 2020–2023

Transitions in device and liquid characteristic groupings among US adults frequently using electronic nicotine delivery systems (ENDS) over three timepoints, 2020–2021

Zebrafish (Danio rerio) as a Model for the Study of Developmental and Cardiovascular Toxicity of Electronic Cigarettes

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