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Nicotine & Tobacco Research : Official... Sep 2019E-liquids are available in a high variety of flavors. A systematic classification of e-liquid flavors is necessary to increase comparability of research results. In the...
INTRODUCTION
E-liquids are available in a high variety of flavors. A systematic classification of e-liquid flavors is necessary to increase comparability of research results. In the food, alcohol, and fragrance industry, flavors are classified using flavor wheels. We systematically reviewed literature on flavors related to electronic cigarette use, to investigate how e-liquid flavors have been classified in research, and propose an e-liquid flavor wheel to classify e-liquids based on marketing descriptions.
METHODS
The search was conducted in May 2017 using PubMed and Embase databases. Keywords included terms associated with electronic cigarette, flavors, liking, learning, and wanting in articles. Results were independently screened and reviewed. Flavor categories used in the articles reviewed were extracted.
RESULTS
Searches yielded 386 unique articles of which 28 were included. Forty-three main flavor categories were reported in these articles (eg, tobacco, menthol, mint, fruit, bakery/dessert, alcohol, nuts, spice, candy, coffee/tea, beverages, chocolate, sweet flavors, vanilla, and unflavored). Flavor classifications of e-liquids in literature showed similarities and differences across studies. Our proposed e-liquid flavor wheel contains 13 main categories and 90 subcategories, which summarize flavor categories from literature to find a shared vocabulary. For classification of e-liquids using our flavor wheel, marketing descriptions should be used.
CONCLUSIONS
We have proposed a flavor wheel for classification of e-liquids. Further research is needed to test the flavor wheels' empirical value. Consistently classifying e-liquid flavors using our flavor wheel in research (eg, experimental, marketing, or qualitative studies) minimizes interpretation differences and increases comparability of results.
IMPLICATIONS
We reviewed e-liquid flavors and flavor categories used in research. A large variation in the naming of flavor categories was found and e-liquid flavors were not consistently classified. We developed an e-liquid flavor wheel and provided a guideline for systematic classification of e-liquids based on marketing descriptions. Our flavor wheel summarizes e-liquid flavors and categories used in literature in order to create a shared vocabulary. Applying our flavor wheel in research on e-liquids will improve data interpretation, increase comparability across studies, and support policy makers in developing rules for regulation of e-liquid flavors.
Topics: Biomedical Research; Electronic Nicotine Delivery Systems; Flavoring Agents; Humans; Terminology as Topic; Vaping
PubMed: 29788484
DOI: 10.1093/ntr/nty101 -
PloS One 2018Systematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type. (Review)
Review
OBJECTIVE
Systematic review of research examining consumer preference for the main electronic cigarette (e-cigarette) attributes namely flavor, nicotine strength, and type.
METHOD
A systematic search of peer-reviewed articles resulted in a pool of 12,933 articles. We included only articles that meet all the selection criteria: (1) peer-reviewed, (2) written in English, and (3) addressed consumer preference for one or more of the e-cigarette attributes including flavor, strength, and type.
RESULTS
66 articles met the inclusion criteria for this review. Consumers preferred flavored e-cigarettes, and such preference varied with age groups and smoking status. We also found that several flavors were associated with decreased harm perception while tobacco flavor was associated with increased harm perception. In addition, some flavor chemicals and sweeteners used in e-cigarettes could be of toxicological concern. Finally, consumer preference for nicotine strength and types depended on smoking status, e-cigarette use history, and gender.
CONCLUSION
Adolescents could consider flavor the most important factor trying e-cigarettes and were more likely to initiate vaping through flavored e-cigarettes. Young adults overall preferred sweet, menthol, and cherry flavors, while non-smokers in particular preferred coffee and menthol flavors. Adults in general also preferred sweet flavors (though smokers like tobacco flavor the most) and disliked flavors that elicit bitterness or harshness. In terms of whether flavored e-cigarettes assisted quitting smoking, we found inconclusive evidence. E-cigarette users likely initiated use with a cigarette like product and transitioned to an advanced system with more features. Non-smokers and inexperienced e-cigarettes users tended to prefer no nicotine or low nicotine e-cigarettes while smokers and experienced e-cigarettes users preferred medium and high nicotine e-cigarettes. Weak evidence exists regarding a positive interaction between menthol flavor and nicotine strength.
Topics: Age Factors; Consumer Behavior; Electronic Nicotine Delivery Systems; Flavoring Agents; Humans; Nicotine; Sex Factors; Sweetening Agents; Taste Perception
PubMed: 29543907
DOI: 10.1371/journal.pone.0194145 -
Current Addiction Reports Dec 2017To summarize current research on gender differences in mentholated cigarette use and related outcomes. Secondarily, to summarize literature on gender differences in...
PURPOSE OF REVIEW
To summarize current research on gender differences in mentholated cigarette use and related outcomes. Secondarily, to summarize literature on gender differences in mentholated cigarette use and related outcomes among Black smokers.
RECENT FINDINGS
Women smokers are more likely to use menthol cigarettes than men. Other than prevalence, there is a paucity of research on gender differences in menthol related outcomes (e.g., cessation, disease). Among both women and men, menthol preference is stable during adolescence and young adulthood. A substantial portion of both women and men who smoke menthol report an expectation of quitting should menthol be banned. We did not identify any studies of gender differences in mentholated cigarette use among Black smokers.
SUMMARY
Despite public health relevance, there is little current research on gender differences in mentholated cigarette use, other than studies of prevalence, and very little research on gender differences among Black smokers, including prevalence.
PubMed: 29497593
DOI: 10.1007/s40429-017-0175-6 -
BMC Public Health Dec 2017Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product... (Review)
Review
BACKGROUND
Although menthol was not banned under the Tobacco Control Act, the law made it clear that this did not prevent the Food and Drug Administration from issuing a product standard to ban menthol to protect public health. The purpose of this review was to update the evidence synthesis regarding the role of menthol in initiation, dependence and cessation.
METHODS
A systematic review of the peer-reviewed literature on menthol cigarettes via a PubMed search through May 9, 2017. The National Cancer Institute's Bibliography of Literature on Menthol and Tobacco and the FDA's 2011 report and 2013 addendum were reviewed for additional publications. Included articles addressing initiation, dependence, and cessation were synthesized based on study design and quality, consistency of evidence across populations and over time, coherence of findings across studies, and plausibility of the findings.
RESULTS
Eighty-two studies on menthol cigarette initiation (n = 46), dependence (n = 14), and cessation (n = 34) were included. Large, representative studies show an association between menthol and youth smoking that is consistent in magnitude and direction. One longitudinal and eight cross-sectional studies demonstrate that menthol smokers report increased nicotine dependence compared to non-menthol smokers. Ten studies support the temporal relationship between menthol and reduced smoking cessation, as they measure cessation success at follow-up.
CONCLUSIONS
The strength and consistency of the associations in these studies support that the removal of menthol from cigarettes is likely to reduce youth smoking initiation, improve smoking cessation outcomes in adult smokers, and in turn, benefit public health.
Topics: Cigarette Smoking; Health Policy; Humans; Menthol; Public Health; Randomized Controlled Trials as Topic; United States
PubMed: 29284458
DOI: 10.1186/s12889-017-4987-z -
American Journal of Clinical Dermatology Oct 2017Primary localized cutaneous amyloidosis (PLCA) is characterized by extracellular deposition of heterogenic amyloid proteins in the skin without systemic involvement.... (Review)
Review
BACKGROUND
Primary localized cutaneous amyloidosis (PLCA) is characterized by extracellular deposition of heterogenic amyloid proteins in the skin without systemic involvement. Lichen amyloidosis, macular amyloidosis, and (primary localized cutaneous) nodular amyloidosis are different subtypes of PLCA.
OBJECTIVE
The aim of this study was to review the current reported treatment options for PLCA.
METHODS
This systematic review was based on a search in the PubMed database for English and German articles from 1985 to 2016.
RESULTS
Reports on the treatment of PLCA were limited predominantly to case reports or small case series. There were a few clinical trials but these lacked control groups. A variety of treatment options for PLCA were reported including retinoids, corticosteroids, cyclophosphamide, cyclosporine, amitriptyline, colchicine, cepharanthin, tacrolimus, dimethyl sulfoxide, vitamin D analogs, capsaicin, menthol, hydrocolloid dressings, surgical modalities, laser treatment, and phototherapy.
CONCLUSION
No definitive recommendation of preferable treatment procedures can be made based on the analyzed literature. Randomized controlled trials are needed to offer patients an evidence-based therapy with high-quality standardized treatment regimens for PLCA.
Topics: Amyloidosis, Familial; Bandages, Hydrocolloid; Dermatologic Agents; Dermatologic Surgical Procedures; Europe; Humans; Laser Therapy; Phototherapy; Practice Guidelines as Topic; Skin; Skin Diseases, Genetic
PubMed: 28342017
DOI: 10.1007/s40257-017-0278-9 -
International Journal of Environmental... Mar 2017Although a few countries have banned flavored cigarettes (except menthol), flavors in most tobacco products remain unregulated across the globe. We conducted a... (Review)
Review
Although a few countries have banned flavored cigarettes (except menthol), flavors in most tobacco products remain unregulated across the globe. We conducted a systematic review of qualitative studies examining perceptions of and experiences with flavored non-menthol tobacco products. Of 20 studies on flavored tobacco products included in our qualitative systematic review, 10 examined hookah, six examined e-cigarettes, two examined little cigars and cigarillos (LCCs), and three examined other tobacco products, including cigarettes. The majority of studies, regardless of product type, reported positive perceptions of flavored tobacco products, particularly among young adults and adolescents. In six studies that assessed perceptions of harm (including hookah, LCCs, and other flavored tobacco products), participants believed flavored tobacco products to be less harmful than cigarettes. In studies that examined the role of flavors in experimentation and/or initiation (including three studies on e-cigarettes, one hookah study and one LCC study), participants mentioned flavors as specifically leading to their experimentation and/or initiation of flavored tobacco products. Given that many countries have not yet banned flavors in tobacco products, these findings add to existing research on why individuals use flavored tobacco products and how they perceive harm in flavored tobacco products, providing further support for banning non-menthol flavors in most tobacco products.
Topics: Flavoring Agents; Humans; Menthol; Qualitative Research; Smoking; Surveys and Questionnaires; Taste; Tobacco Products
PubMed: 28333107
DOI: 10.3390/ijerph14040338 -
Tobacco Control Nov 2017This systematic review examines the impact of non-menthol flavours in tobacco products on tobacco use perceptions and behaviours among youth, young adults and adults. (Review)
Review
OBJECTIVE
This systematic review examines the impact of non-menthol flavours in tobacco products on tobacco use perceptions and behaviours among youth, young adults and adults.
DATA SOURCES
English-language peer-reviewed publications indexed in 4 databases were searched through April 2016.
STUDY SELECTION
A search strategy was developed related to tobacco products and flavours. Of 1688 articles identified, we excluded articles that were not English-language, were not peer-reviewed, were qualitative, assessed menthol-flavoured tobacco products only and did not contain original data on outcomes that assessed the impact of flavours in tobacco products on perceptions and use behaviour.
DATA EXTRACTION
Outcome measures were identified and tabulated. 2 researchers extracted the data independently and used a validated quality assessment tool to assess study quality.
DATA SYNTHESIS
40 studies met the inclusion criteria. Data showed that tobacco product packaging with flavour descriptors tended to be rated as more appealing and as less harmful by tobacco users and non-users. Many tobacco product users, especially adolescents, reported experimenting, initiating and continuing to use flavoured products because of the taste and variety of the flavours. Users of many flavoured tobacco products also showed decreased likelihood of intentions to quit compared with non-flavoured tobacco product users.
CONCLUSIONS
Flavours in most tobacco products appear to play a key role in how users and non-users, especially youth, perceive, initiate, progress and continue using tobacco products. Banning non-menthol flavours from tobacco products may ultimately protect public health by reducing tobacco use, particularly among youth.
Topics: Adolescent; Adult; Age Factors; Commerce; Flavoring Agents; Health Knowledge, Attitudes, Practice; Humans; Menthol; Smoking; Tobacco Products; Young Adult
PubMed: 27872344
DOI: 10.1136/tobaccocontrol-2016-053196 -
British Journal of Clinical Pharmacology Jan 2017
Review
Topics: Anemia, Hemolytic; Asymptomatic Diseases; Food; Food Coloring Agents; Glucosephosphate Dehydrogenase Deficiency; Humans; Menthol; Naphthalenes; Pollen; Prunus persica; Trigonella; Vicia faba
PubMed: 27650490
DOI: 10.1111/bcp.13091 -
Journal of Environmental Science and... 2016Tobacco smoking is currently on the rise among women, and can pose a greater health risk. In order to understand the nature of the increase in smoking prevalence among... (Review)
Review
Tobacco smoking is currently on the rise among women, and can pose a greater health risk. In order to understand the nature of the increase in smoking prevalence among women, we focused on the vulnerability of women to smoking behaviors--smoking cessation or tobacco addiction--and performed a systematic review of the socioeconomic and intrinsic factors as well as tobacco ingredients that affect women's susceptibility to smoking tobacco. We observed that nicotine and other tobacco components including cocoa-relatives, licorice products, and menthol aggravate tobacco addiction in women rather than in men. Various genetic and epigenetic alterations in dopamine pathway and the pharmaco-kinetics and -dynamic factors of nicotine also showed potential evidences for high susceptibility to tobacco addiction in women. Therefore, we suggest systemic approaches to prevent tobacco smoking-related health risks, considering gene-environment-gender interaction.
Topics: Behavior, Addictive; Epigenesis, Genetic; Female; Genetic Predisposition to Disease; Hormones; Humans; Male; Menthol; Nicotine; Smoking; Smoking Cessation; Smoking Prevention; Socioeconomic Factors
PubMed: 26669465
DOI: 10.1080/10590501.2015.1131539 -
American Journal of Public Health Sep 2015We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant... (Review)
Review
We systematically reviewed evidence of disparities in tobacco marketing at tobacco retailers by sociodemographic neighborhood characteristics. We identified 43 relevant articles from 893 results of a systematic search in 10 databases updated May 28, 2014. We found 148 associations of marketing (price, placement, promotion, or product availability) with a neighborhood demographic of interest (socioeconomic disadvantage, race, ethnicity, and urbanicity). Neighborhoods with lower income have more tobacco marketing. There is more menthol marketing targeting urban neighborhoods and neighborhoods with more Black residents. Smokeless tobacco products are targeted more toward rural neighborhoods and neighborhoods with more White residents. Differences in store type partially explain these disparities. There are more inducements to start and continue smoking in lower-income neighborhoods and in neighborhoods with more Black residents. Retailer marketing may contribute to disparities in tobacco use. Clinicians should be aware of the pervasiveness of these environmental cues.
Topics: Black or African American; Commerce; Humans; Income; Marketing; Menthol; Residence Characteristics; Small-Area Analysis; Smoking; United States; Urban Population
PubMed: 26180986
DOI: 10.2105/AJPH.2015.302777