Reasons for using flavored liquids among electronic cigarette users: A concept mapping study

Abstract

Background Electronic cigarettes (ECIGs) aerosolize liquids often containing flavorants for inhalation. Few studies have examined the role of flavors in ECIG use. This study’s purpose was to examine reasons for flavored ECIG use using a mixed-method approach, concept mapping (CM). Methods Forty-six past 30-day adult ECIG users recruited from vape forums/conferences completed three online CM tasks. Participants brainstormed responses to a prompt: “A specific reason I use flavored e-liquid in my electronic cigarette product is…”. The final 107 brainstormed statements were sorted by participants into groups of similar content. Participants rated each statement on a 7-point scale (1-Definitely NOT a reason to 7-Definitely a reason) based on a prompt: “This is a specific reason why I used flavored e-liquid in my electronic cigarette product in the past month.” A cluster map was generated from participants’ sorting and ratings using CM statistical software. Cluster mean ratings were compared. Results Analysis revealed five clusters of reasons for flavored ECIG use including Increased Satisfaction/Enjoyment, Better Feel/Taste than Cigarettes, Variety/Customization, Food Craving Suppression, and Social Impacts. Statements in the Increased Satisfaction/Enjoyment and Better Feel/Taste than Cigarettes clusters were rated significantly higher than statements from other clusters (ps<.05). Some statements indicated flavors were perceived as masking agents for nicotine or other bad tastes associated with cigarette smoking making ECIG use more palatable. Conclusions Flavored ECIGs are used for many reasons. Some statements suggested flavors may increase the risk of ECIG addiction. These results support continued examination of the role of flavors and ECIG use behaviors.

Electronic Cigarette Use in US Adults at Risk for or with COPD: Analysis from Two Observational Cohorts

“…Surprisingly, older adults also frequently used candy and fruit flavors in their e-cigarettes. The use of flavors may lead to more enjoyment, better taste, and food craving, 25 but there is concern that some flavor additives, such as benzaldehyde, common in cherry-flavored liquid, may cause increased airway irritation. 26 Other flavors also contain diacetyl, which has been associated with bronchiolitis obliterans, or Bpopcorn workers lung.^2 7 Although we found insufficient evidence that flavors were associated with lung disease, our studies are underpowered for looking at these associations.…”

E-liquid-related posts to Twitter in 2018: Thematic analysis

“…E-liquid is the solution aerosolized by e-cigarette devices to produce vapor. These liquids come in a variety of flavors ( Marynak et al, 2017 ; Zhu et al, 2014 ) that are linked with greater perceived enjoyment ( Soule, Lopez, Guy, & Cobb, 2016 ), and lower harm perceptions compared to combustible cigarettes ( Pepper, Ribisl, & Brewer, 2016 ), and e-cigarettes initiation in youth ( Zare, Nemati, & Zheng, 2018 ). They also have varied nicotine concentrations ( Etter, Zäther, & Svensson, 2013 ; Goniewicz, Hajek, & McRobbie, 2014 ; Goniewicz, Kuma, Gawron, Knysak, & Kosmider, 2013 ), with implications for abuse liability wherein higher concentrations are associated with higher yields of nicotine, an addictive substance ( Talih et al, 2017 ).…”

Reasons for Transition From Electronic Cigarette Use to Cigarette Smoking Among Young Adult College Students

“…Ratings were made on a seven-point Likert-type scale with response anchors ranging from one (Definitely NOT true for me) to seven (Definitely TRUE for me). [17,18] In general, higher rated statements and clusters are "more true" for participants and may suggest these statements and clusters have more importance in promoting e-cigarette to cigarette transition. Rating data were monitored by investigators to ensure they were complete (i.e., !…”