Flavored E-cigarette Use and Progression of Vaping in Adolescents

https://pediatrics.aappublications.org/content/early/2019/10/25/peds.2019-0789?sso=1&sso_redirect_count=3&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3A%20No%20local%20token&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token

Comment; No real surprises here, non-traditional flavored vapes (not pure tobacco or menthol, but sweet, fruity, etc.) cause adolescents to use more. Unfortunately, the flavorings can be toxic and the other components of the vape are definitely toxic, add to this the poor prefrontal development of adolescents with the lack of adequate inhibition leads to a big wave of future problems hitting them!

Adam M. Leventhal, Nicholas I. Goldenson, Junhan Cho, Matthew G. Kirkpatrick, Rob S. McConnell, Matthew D. Stone, Raina D. Pang, Janet Audrain-McGovern and Jessica L. Barrington-TrimisPediatrics October 2019, e20190789; DOI: https://doi.org/10.1542/peds.2019-0789

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Abstract

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OBJECTIVES: Electronic cigarettes (e-cigarettes) are available in nontraditional flavors (eg, fruit and candy) that are banned in combustible cigarettes in the United States. Whether adolescent use of e-cigarettes in nontraditional flavors prospectively predicts continuation of vaping and progression to more frequent vaping is unknown.

METHODS: High school students in Los Angeles, California, completed 5 semiannual surveys (2014–2017 [10th grade to 12th grade]). Among past-6-month e-cigarette users at survey waves 1 to 4 (N = 478), e-cigarette flavor (or flavors) used was coded into 2 mutually exclusive categories at each wave (use of ≥1 nontraditional flavors [fruit, candy, sweet or dessert, buttery, blends or combinations, and other] versus exclusive use of tobacco, menthol or mint, or flavorless). Flavor used during waves 1 to 4 was modeled as a time-varying, time-lagged regressor of vaping status and frequency outcomes 6 months later at waves 2 to 5.

RESULTS: Across waves 1 to 4, there were 739 (93.8%) observations of nontraditional-flavor use and 49 (6.2%) observations of exclusive use of tobacco, mint or menthol, or flavorless e-cigarettes. Use of e-cigarettes in nontraditional flavors (versus only tobacco, mint or menthol, or flavorless) was positively associated with vaping continuation (64.3% vs 42.9%; adjusted odds ratio = 3.76 [95% confidence interval 1.20 to 10.31]) and past-30-day number of puffs per nicotine vaping episode (mean: 3.1 [SD 5.5] vs 1.5 [SD 3.8]; adjusted rate ratio = 2.41 [95% confidence interval 1.08 to 5.92]) 6 months later. Flavor used was not associated with the subsequent number of past-30-day vaping days or episodes per day.

CONCLUSIONS: Adolescents who vaped e-cigarettes in nontraditional flavors, compared with those who exclusively vaped tobacco-flavored, mint- or menthol-flavored, or flavorless e-cigarettes, were more likely to continue vaping and take more puffs per vaping occasion 6 months later.