Send to

Choose Destination
Tob Regul Sci. 2019 Nov;5(6):518-531. doi: 10.18001/TRS.5.6.4.

Flavored ENDS Use among Adults Who Have Used Cigarettes and ENDS, 2016-2017.

Author information

University of Arkansas for Medical Sciences, College of Public Health, Little Rock, AR.
Georgia State University, School of Public Health, Department of Population Health Sciences, Atlanta, GA.
Georgia State University, School of Public Health, Department of Health Policy and Behavioral Sciences, Atlanta, GA.



In this study, we assessed differences in type, number, and perceptions of ENDS flavors used at initiation and currently among 4 smoking and ENDS use profiles of US adults with a history of smoking and ENDS use.


Our nationally representative survey sample included 1814 participants. We estimated Rao-Scott χ2 and adjusted odds ratios. Use profiles included: (1) Dual Users (current smokers/current ENDS users), (2) ENDS Rejecters (current smokers/former ENDS users), (3) Switchers (former smokers/current ENDS users), and (4) Quitters (former smokers/former ENDS users).


Multiple flavor use at initiation was associated with higher odds of being a Dual User or Switcher. Those who used mint/wintergreen/menthol flavored ENDS at initiation had lower odds of being an ENDS Rejecter (vs Dual User). Current use of tobacco/unflavored or menthol/mint/wintergreen flavor was associated with higher odds of being a Dual User (vs Switcher). Switchers were more likely to perceive flavors as safe in ENDS and rate flavors as important to their ENDS use.


Multiple flavor use at initiation, perceiving flavors as safe, and use of specific flavors (mint/wintergreen/menthol) at initiation may discourage rejecting ENDS. However, current use of traditional cigarette flavors (ie, tobacco, menthol) may promote sustained smoking.


cessation; dual use; e-cigarettes; flavors; harm reduction; risk perceptions; smoking

Conflict of interest statement

Conflict of Interest Disclosure Statement MPE receives unrestricted research funding support from Pfizer, Inc (‘Diffusion of Tobacco Control Fundamentals to Other Large Chinese Cities’ MPE, Principal Investigator). DLA has received funds for work done for the World Health Organization Tobacco Free Initiative and as a Special Government Employee of the US Food and Drug Administration.

Supplemental Content

Full text links

Icon for PubMed Central
Loading ...
Support Center