Youth uptake of e-cigarettes driven by flavors and high nicotine levels 

Youth uptake of e-cigarettes driven by flavors and high nicotine levels which are also found to be important in cessation for adult smokers using e-cigarettes; How to address this contradictory situation?

US Federal Trade Commission. The Federal Trade Commission’s First Report on E-Cigarette Sales and Advertising Reveals Disturbing Trends Affecting the Health of Young Americans. March 17, 2022.
“Flavored cartridges, nicotine concentration, and deep discounting surged between 2015 and 2018, likely fueling increased underage consumption.

For Adult Smokers : Gades MS, Alcheva A, Riegelman AL, et al. The role of nicotine and flavor in the abuse potential and appeal of electronic cigarettes for adult current and former cigarette and electronic cigarette users: A systematic review. Nicotine & Tobacco Research, ntac073,
“Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake (new users) may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers.”

Comment: The “population as a whole” is most impacted by the uptake of new users, while present smokers have multiple ways of quitting without the use of e-cigarettes. In fact, e-cigarettes are largely rejected as an effective cessation method in tobacco control based on present evidence. Cessation efforts may be improved to address the need for higher concentrations of nicotine and flavors (taste with nicotine therapies) for smokers without the use of e-cigarettes.
Stephen Hamann

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