Fruit, candy, menthol flavors make e-cigarettes more attractive to teens, research finds

RESEARCH TRIANGLE PARK, North Carolina — Certain e-cigarette flavors appeal to teenagers more than others, and these preferences are partly due to perceptions of health harms, according to a new study by researchers at RTI International and the University of North Carolina at Chapel Hill.

The study, published in the journal Tobacco Control, found teens were more interested in trying e-cigarettes with menthol, candy, or fruit flavors than those made to taste like alcohol or tobacco. Fruit flavors were most appealing, with interest levels almost six times higher than that of tobacco-flavored e-cigarettes.

Previous research on tobacco pointed to the general appeal of flavored products, but did not distinguish among the variety of flavors.

“Maybe we shouldn’t be using ‘flavored’ as a catch-all category to cover every flavor other than tobacco,” said Jessica Pepper, an RTI research public health analyst and the lead author. “There’s nuance there that isn’t being captured.”

This study also brought in the element of perceived harm, which varies by flavor. According to the researchers, the teens also believed the candy, menthol, and fruit flavors were less harmful than tobacco flavor — and their perception of harm affected their interest in trying e-cigarettes.

“The more they believed the flavors were less harmful, the more they were interested in trying those flavors,” Pepper said.

The study, led by Kurt Ribisl, PhD, and Noel Brewer, PhD, at UNC-CH, was based on phone interviews with a national sample of 1,125 English- and Spanish-speaking boys and girls ages 13 to 17.

Research on e-cigarette flavors is important in the current regulatory environment, the researchers noted. Although the Food and Drug Administration has banned non-menthol flavored cigarettes since 2009, there is no mention of flavors among the new e-cigarette regulations set to begin this August. The health effects of e-cigarette flavorings are not yet known.

“Using candy flavors to appeal to children is a dangerous practice,” said Brewer, a professor at the UNC-CH Gillings School of Global Public Health. “We need new regulations to protect our children from addictive and harmful chemicals in e-cigarettes.”