Evolution of Electronic Cigarette Brands From 2013-2014 to 2016-2017: Analysis of Brand Websites

Hsu, Greta; Sun, Jessica Y; Zhu, Shu‐Hong

doi:10.2196/jmir.8550

Cited by 127 publications

(81 citation statements)

References 35 publications

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“…This is in line with another study that looked at JUUL flavor usage in middle-schoolers and high-schoolers, which showed that fruit-flavored pods like mango and fruit were preferred by this young cohort [23]. Despite the fact that e-cigarettes were first introduced to the market in 2007, there has been a rapid market expansion with the amount of unique flavors more than doubling from 2013-2014 to 2016-2017, with 15,568 distinct flavors being sold [24]. With this continuously changing product, future studies should be conducted in a longitudinal model with a larger cohort, looking at immunoglobulin, pro-inflammatory, and oxidative stress biomarkers in e-cigarette users and non-users, with a specific interest in the flavoring effects on these biomarkers.…”

Section: Discussionsupporting

confidence: 81%

Flavor Preference and Systemic Immunoglobulin Responses in E-Cigarette Users and Waterpipe and Tobacco Smokers: A Pilot Study

Jackson

Singh

Lamb

et al. 2020

IJERPH

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Electronic cigarette (e-cigarette) use has had an exponential increase in popularity since the product was released to the public. Currently, there is a lack of human studies that assess different biomarker levels. This pilot study attempts to link e-cigarette and other tobacco product usage with clinical respiratory symptoms and immunoglobulin response. Subjects completed surveys in order to collect self-reported data on tobacco product flavor preferences. Along with this, plasma samples were collected to test for immunoglobulin G (IgG) and E (IgE) levels. Our pilot study’s cohort had a 47.9% flavor preference towards fruit flavors and a 63.1% preference to more sweet flavors. E-cigarette and traditional cigarette smokers were the two subject groups to report the most clinical symptoms. E-cigarette users also had a significant increase in plasma IgE levels compared to non-tobacco users 1, and dual users had a significant increase in plasma IgG compared to non-tobacco users 2, cigarette smokers, and waterpipe smokers. Our pilot study showed that users have a preference toward fruit and more sweet flavors and that e-cigarette and dual use resulted in an augmented systemic immune response.

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Section: Discussionsupporting

confidence: 81%

Flavor Preference and Systemic Immunoglobulin Responses in E-Cigarette Users and Waterpipe and Tobacco Smokers: A Pilot Study

Jackson

Singh

Lamb

et al. 2020

IJERPH

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“…The NAS considered toxicity of flavorings, with little attention to attraction among youth despite the US Surgeon General concluding that many ENDS flavors are marketed to youth [4]; flavor varieties now exceed 15 500 [9], including 'Hello Kitty' and cotton candy. For example, the European Union (EU) and Canada restrict ENDS advertising to youth; the EU requires graphic health warnings and limits the nicotine strength of e-liquid to ≤ 20 mg/ml, and Canada bans confectionary ENDS flavors.…”

mentioning

confidence: 99%

The public health consequences of e‐cigarettes: a review by the National Academies of Sciences. A call for more research, a need for regulatory action

Prochaska

2018

Addiction

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Electronic nicotine delivery systems (ENDS) are less harmful than combustible cigarettes but lack demonstrated safety. They may help some smokers to quit, while enticing future generations to smoke. The US regulatory environment has restricted research on ENDS for tobacco cessation yet extended the time for open market sales. Calls for further research ought not to stall regulatory action.Electronic nicotine delivery systems (ENDS; e.g. ecigarettes) have gained world-wide attention. Gaps in the evidence on ENDS have contributed to varied opinions, many passionately at odds. The National Academies of Sciences' (NAS) review of more than 800 research papers on ENDS was congressionally mandated and sponsored by the US Food and Drug Administration (FDA) to summarize the state of the science and identify research needs [1]. The NAS report provides a useful summary for policymakers, practitioners and researchers internationally and sheds light on the nuances in the risk/benefit equation for ENDS.Of the nearly 50 conclusions in the NAS report, the strongest evidence (deemed as substantial or conclusive) is listed in Box 1. Are ENDS harm-reducing or harm-creating? The answer is probably both. That is, ENDS may be harm-reducing for smokers seeking to quit (i.e. when the comparator is combustible tobacco), while harm-creating for former or never smokers, particularly among youth, for whom ENDS use appears to increase the risk of future use of combustible tobacco.Being less harmful than combustible cigarettes, which contribute to the deaths of two in three long-term users [2,3], does not mean ENDS are safe. ENDS aerosol contains nicotine, which is addictive; ultrafine particles, that can be inhaled deeply into the lungs; flavorings such as diacetyl, a chemical linked to serious lung disease; volatile organic compounds; cancer-causing chemicals; and heavy metals such as nickel, tin and lead, although all at lower levels than in combusted tobacco smoke [4]. This list is limited by the chemicals assayed to date. Other toxicants, yet to be determined, may be created by repeated heating of the plastic and metal devices.The NAS findings were incorporated into a dynamic population model, and the conclusion was a net public health benefit with reduced loss of life when modeled out to 2050. These gains, however, were lost when extended

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“…This occurs primarily through masking the initial harshness of nicotine/tobacco that is aversive to new and beginning smokers and therefore increases smoking initiation [ 12 , 13 ]. Although non-menthol flavors are banned in combustible cigarettes, >15,000 flavor options are available for ENDS products with a 67% increase in flavor production from 2013 to 2014 [ 14 , 15 ]. In 2019, more than 50% and 60% of high school users used menthol and fruit flavored ENDS, respectively, and more than half of ENDS users prefer flavored products [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of Electronic Nicotine Delivery System (ENDS) Flavors on Nicotinic Acetylcholine Receptors and Nicotine Addiction-Related Behaviors

Cooper

Henderson

2020

Molecules

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Over the past two decades, combustible cigarette smoking has slowly declined by nearly 11% in America; however, the use of electronic cigarettes has increased tremendously, including among adolescents. While nicotine is the main addictive component of tobacco products and a primary concern in electronic cigarettes, this is not the only constituent of concern. There is a growing market of flavored products and a growing use of zero-nicotine e-liquids among electronic cigarette users. Accordingly, there are few studies that examine the impact of flavors on health and behavior. Menthol has been studied most extensively due to its lone exception in combustible cigarettes. Thus, there is a broad understanding of the neurobiological effects that menthol plus nicotine has on the brain including enhancing nicotine reward, altering nicotinic acetylcholine receptor number and function, and altering midbrain neuron excitability. Although flavors other than menthol were banned from combustible cigarettes, over 15,000 flavorants are available for use in electronic cigarettes. This review seeks to summarize the current knowledge on nicotine addiction and the various brain regions and nicotinic acetylcholine receptor subtypes involved, as well as describe the most recent findings regarding menthol and green apple flavorants, and their roles in nicotine addiction and vaping-related behaviors.

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Evolution of Electronic Cigarette Brands From 2013-2014 to 2016-2017: Analysis of Brand Websites

Cited by 127 publications

References 35 publications

Flavor Preference and Systemic Immunoglobulin Responses in E-Cigarette Users and Waterpipe and Tobacco Smokers: A Pilot Study

Flavor Preference and Systemic Immunoglobulin Responses in E-Cigarette Users and Waterpipe and Tobacco Smokers: A Pilot Study

The public health consequences of e‐cigarettes: a review by the National Academies of Sciences. A call for more research, a need for regulatory action

The Impact of Electronic Nicotine Delivery System (ENDS) Flavors on Nicotinic Acetylcholine Receptors and Nicotine Addiction-Related Behaviors

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