Flavored Tobacco Product Use in Youth and Adults: Findings From the First Wave of the PATH Study (2013–2014)

Abstract

Introduction 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 forms of tobacco (e.g., smokeless, cigars, hookah, e-cigarettes). Methods A cross-sectional analysis of Wave 1 data from 45,971 U.S. adults and youth, aged ≥12 years in the Population Assessment of Tobacco and Health (PATH) Study collected in 2013–2014, was conducted in 2016. This study examined: (1) the prevalence and reasons for use of flavored tobacco products; (2) the proportion of ever tobacco users reporting that their first product was flavored; and (3) correlates of current flavored tobacco product use. Results Current flavored (including menthol) tobacco product use was highest in youth (80%, aged 12–17 years), and young adult tobacco users (73%, aged 18–24 years), and lowest in older adult tobacco users aged ≥65 years (29%). Flavor was a primary reason for using a given tobacco product, particularly among youth. Eighty-one percent of youth and 86% of young adult ever tobacco users reported that their first product was flavored versus 54% of adults aged ≥25 years. In multivariable models, reporting that one’s first tobacco product was flavored was associated with a 13% higher prevalence of current tobacco use among youth ever tobacco users and a 32% higher prevalence of current tobacco use among adult ever users. Conclusions These results add to the evidence base that flavored tobacco products may attract young users and serve as starter products to regular tobacco use.

Flavored Tobacco Product Use among Youth and Young Adults: What if Flavors Didn't Exist?

“…Our results add to the body of literature showing flavored tobacco product use is high appeals to both youth 9,10,14–16 and young adults. 16,17 More than 4 out of every 5 past 30-day e-cigarette or tobacco users in our studies from Texas reported using a flavored product.…”

Flavour capsule cigarette use among US adult cigarette smokers

“…Menthol cigarette use is now growing in all groups, but particularly among white and Hispanic young adults,9 and our study demonstrates that flavour capsule products are being disproportionately used by those very groups for whom menthol use is expanding. Studies are needed to understand if the introduction of flavour capsule cigarettes may in part be responsible for the growth in the menthol market.…”

“…Here, we expand on the previous consumer marketing panel study9 by examining the characteristics of flavour capsule smokers using data from the nationally representative Population Assessment for Tobacco and Health (PATH) Study 12. We further assess whether smoking histories, measures of nicotine dependence and reasons for product selection differ among flavour capsule cigarette smokers compared with mentholated and non-mentholated cigarette smokers among those with the highest prevalence of flavour capsule use: smokers aged 18–24 years.…”

National and state patterns of concept-flavoured cigar sales, USA, 2012–2016

“…Most respondents to a large population survey who report having ever used a tobacco product state that the first product used was ‘flavoured to taste like menthol, mint, clove, spice, candy, fruit, chocolate, alcohol (such as wine or cognac), or other sweets' 8. Furthermore, the prevalence of current tobacco use (that is, smoking/using tobacco products some days or everyday) is significantly higher for those whose first tobacco product was flavoured 8. During 2013–2014, 65.4% of first-time cigar users aged 12–17 years smoked a flavoured cigar, and 71.7% of past 30-day cigar users smoked flavoured cigars 9.…”