Youth who experiment with tobacco products are more likely to try flavored products, according to the results of a research letter published Oct. 26 in the Journal of the American Medical Association.

Led by Bridget K. Ambrose, PhD, MPH, et al., researchers examined the results of the Population Assessment of Tobacco and Health Study to assess the use of flavored tobacco products among 13,651 youth, aged 12 to 17. Survey data was collected from September 2013 through December 2014 and asked students to respond about their ever and 30-day tobacco use, including cigarettes, e-cigarettes, hookahs, cigars, pipe tobacco, all types of smokeless tobacco, dissolvable tobacco, bidis and kreteks.

Results showed that a majority of youth report first using a flavored tobacco product, with the overall proportion of flavored products at 79.8 percent for 30-day use of any product. In youth ever-users of tobacco, 88.7 percent of hookah users, 81 percent of e-cigarette users, 65.4 percent of cigar users and 50.1 percent of cigarette users report that the first product they used was flavored.

The authors of the study note that these results "confirm widespread appeal of flavored products among youth tobacco users. In addition to continued proven tobacco control and prevention strategies, efforts to decrease use of flavored tobacco products among youth should be considered."

"This study supports what common sense tells us: that adding flavors to tobacco and nicotine products makes them appealing to young people and most likely increase the chances they will use tobacco products," said Kim Allan Williams Sr., MD, FACC, president of the ACC. "The U.S. has made excellent progress reducing smoking and reducing related preventable diseases, such as cardiovascular disease. Allowing companies to market these products to children, including with flavors that appeal to young people, is a harmful development. This trend threatens to undo the work to reduce deaths in cardiovascular disease from the decline in cigarettes smoking in the last 50 years."

"Considerable progress has been made in reducing the use of tobacco products, particularly traditional cigarettes, among youth,” adds Pamela B. Morris, MD, FACC, chair of the ACC Prevention of Cardiovascular Disease Section. “However, new forms of flavored tobacco-related products, which have broad appeal and ready availability, have the potential to initiate the process of nicotine addiction in young persons and lead to sustained use of these dangerous substances."

Keywords: Adolescent, Electronic Nicotine Delivery Systems, Flavoring Agents, Nicotine, Smoking, Tobacco

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