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Impact of Flavour Variability on Electronic Cigarette Use Experience: An Internet Survey

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  • Konstantinos E. Farsalinos

    (Onassis Cardiac Surgery Center, Sygrou 356, Kallithea 17674, Greece)

  • Giorgio Romagna

    (ABICH S.r.l, Biological and Chemical Toxicology Research Laboratory, Via 42 Martiri, 213/B-28924 Verbania (VB), Italy)

  • Dimitris Tsiapras

    (Onassis Cardiac Surgery Center, Sygrou 356, Kallithea 17674, Greece)

  • Stamatis Kyrzopoulos

    (Onassis Cardiac Surgery Center, Sygrou 356, Kallithea 17674, Greece)

  • Alketa Spyrou

    (Onassis Cardiac Surgery Center, Sygrou 356, Kallithea 17674, Greece)

  • Vassilis Voudris

    (Onassis Cardiac Surgery Center, Sygrou 356, Kallithea 17674, Greece)

Abstract

Background: A major characteristic of the electronic cigarette (EC) market is the availability of a large number of different flavours. This has been criticised by the public health authorities, some of whom believe that diverse flavours will attract young users and that ECs are a gateway to smoking. At the same time, several reports in the news media mention that the main purpose of flavour marketing is to attract youngsters. The importance of flavourings and their patterns of use by EC consumers have not been adequately evaluated, therefore, the purpose of this survey was to examine and understand the impact of flavourings in the EC experience of dedicated users. Methods: A questionnaire was prepared and uploaded in an online survey tool. EC users were asked to participate irrespective of their current smoking status. Participants were divided according to their smoking status at the time of participation in two subgroups: former smokers and current smokers. Results: In total, 4,618 participants were included in the analysis, with 4,515 reporting current smoking status. The vast majority (91.1%) were former smokers, while current smokers had reduced smoking consumption from 20 to 4 cigarettes per day. Both subgroups had a median smoking history of 22 years and had been using ECs for 12 months. On average they were using three different types of liquid flavours on a regular basis, with former smokers switching between flavours more frequently compared to current smokers; 69.2% of the former subgroup reported doing so on a daily basis or within the day. Fruit flavours were more popular at the time of participation, while tobacco flavours were more popular at initiation of EC use. On a scale from 1 (not at all important) to 5 (extremely important) participants answered that variability of flavours was “very important” (score = 4) in their effort to reduce or quit smoking. The majority reported that restricting variability will make ECs less enjoyable and more boring, while 48.5% mentioned that it would increase craving for cigarettes and 39.7% said that it would have been less likely for them to reduce or quit smoking. The number of flavours used was independently associated with smoking cessation. Conclusions: The results of this survey of dedicated users indicate that flavours are marketed in order to satisfy vapers’ demand. They appear to contribute to both perceived pleasure and the effort to reduce cigarette consumption or quit smoking. Due to the fact that adoption of ECs by youngsters is currently minimal, it seems that implementing regulatory restrictions to flavours could cause harm to current vapers while no public health benefits would be observed in youngsters. Therefore, flavours variability should be maintained; any potential future risk for youngsters being attracted to ECs can be sufficiently minimized by strictly prohibiting EC sales in this population group.

Suggested Citation

  • Konstantinos E. Farsalinos & Giorgio Romagna & Dimitris Tsiapras & Stamatis Kyrzopoulos & Alketa Spyrou & Vassilis Voudris, 2013. "Impact of Flavour Variability on Electronic Cigarette Use Experience: An Internet Survey," IJERPH, MDPI, vol. 10(12), pages 1-11, December.
  • Handle: RePEc:gam:jijerp:v:10:y:2013:i:12:p:7272-7282:d:31416
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    References listed on IDEAS

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    1. Konstantinos E. Farsalinos & Giorgio Romagna & Elena Allifranchini & Emiliano Ripamonti & Elena Bocchietto & Stefano Todeschi & Dimitris Tsiapras & Stamatis Kyrzopoulos & Vassilis Voudris, 2013. "Comparison of the Cytotoxic Potential of Cigarette Smoke and Electronic Cigarette Vapour Extract on Cultured Myocardial Cells," IJERPH, MDPI, vol. 10(10), pages 1-17, October.
    2. Lewis, M.J. & Wackowski, O., 2006. "Dealing with an innovative industry: A look at flavored cigarettes promoted by mainstream brands," American Journal of Public Health, American Public Health Association, vol. 96(2), pages 244-251.
    3. Taylor Jr., D.H. & Hasselblad, V. & Henley, S.J. & Thun, M.J. & Sloan, F.A., 2002. "Benefits of smoking cessation for longevity," American Journal of Public Health, American Public Health Association, vol. 92(6), pages 990-996.
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    1. Stephanie Bell & Judith Dean & Charles Gilks & Mark A. Boyd & Lisa Fitzgerald & Allyson Mutch & Peter Baker & Graham Neilsen & Coral E. Gartner, 2017. "Tobacco Harm Reduction with Vaporised Nicotine (THRiVe): The Study Protocol of an Uncontrolled Feasibility Study of Novel Nicotine Replacement Products among People Living with HIV Who Smoke," IJERPH, MDPI, vol. 14(7), pages 1-12, July.
    2. Jessica K. Pepper & Kurt M. Ribisl & Sherry L. Emery & Noel T. Brewer, 2014. "Reasons for Starting and Stopping Electronic Cigarette Use," IJERPH, MDPI, vol. 11(10), pages 1-17, October.
    3. Anastasia Moysidou & Konstantinos E. Farsalinos & Vassilis Voudris & Kyriakoula Merakou & Kallirrhoe Kourea & Anastasia Barbouni, 2016. "Knowledge and Perceptions about Nicotine, Nicotine Replacement Therapies and Electronic Cigarettes among Healthcare Professionals in Greece," IJERPH, MDPI, vol. 13(5), pages 1-25, May.
    4. Konstantinos E. Farsalinos & Giorgio Romagna & Dimitris Tsiapras & Stamatis Kyrzopoulos & Vassilis Voudris, 2014. "Characteristics, Perceived Side Effects and Benefits of Electronic Cigarette Use: A Worldwide Survey of More than 19,000 Consumers," IJERPH, MDPI, vol. 11(4), pages 1-18, April.
    5. Lei Wang & Yongcheng Zhan & Qiudan Li & Daniel D. Zeng & Scott J. Leischow & Janet Okamoto, 2015. "An Examination of Electronic Cigarette Content on Social Media: Analysis of E-Cigarette Flavor Content on Reddit," IJERPH, MDPI, vol. 12(11), pages 1-20, November.
    6. Konstantinos E. Farsalinos & I. Gene Gillman & Matt S. Melvin & Amelia R. Paolantonio & Wendy J. Gardow & Kathy E. Humphries & Sherri E. Brown & Konstantinos Poulas & Vassilis Voudris, 2015. "Nicotine Levels and Presence of Selected Tobacco-Derived Toxins in Tobacco Flavoured Electronic Cigarette Refill Liquids," IJERPH, MDPI, vol. 12(4), pages 1-14, March.
    7. Riccardo Polosa & Pasquale Caponnetto & Fabio Cibella & Jacques Le-Houezec, 2015. "Quit and Smoking Reduction Rates in Vape Shop Consumers: A Prospective 12-Month Survey," IJERPH, MDPI, vol. 12(4), pages 1-11, March.
    8. Ratika Sharma & Britta Wigginton & Carla Meurk & Pauline Ford & Coral E. Gartner, 2016. "Motivations and Limitations Associated with Vaping among People with Mental Illness: A Qualitative Analysis of Reddit Discussions," IJERPH, MDPI, vol. 14(1), pages 1-15, December.
    9. Allison Lee & Angela A. Chang & Joanne Chen Lyu & Pamela M. Ling & Stephanie L. Hsia, 2022. "Characterizing Participant Perceptions about Smoking-Cessation Pharmacotherapy and E-Cigarettes from Facebook Smoking-Cessation Support Groups," IJERPH, MDPI, vol. 19(12), pages 1-12, June.
    10. Cosima Hoetger & Rose S. Bono & Nicole E. Nicksic & Andrew J. Barnes & Caroline O. Cobb, 2019. "Influence of Electronic Cigarette Characteristics on Susceptibility, Perceptions, and Abuse Liability Indices among Combustible Tobacco Cigarette Smokers and Non-Smokers," IJERPH, MDPI, vol. 16(10), pages 1-15, May.
    11. Manoj Misra & Robert D. Leverette & Bethany T. Cooper & Melanee B. Bennett & Steven E. Brown, 2014. "Comparative In Vitro Toxicity Profile of Electronic and Tobacco Cigarettes, Smokeless Tobacco and Nicotine Replacement Therapy Products: E-Liquids, Extracts and Collected Aerosols," IJERPH, MDPI, vol. 11(11), pages 1-23, October.

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