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Survey finds youth drawn to tobacco with flavored products

October 27, 2015 Among a survey of 12-17 year olds, most who self-reported ever using tobacco started with a product with flavors including fruit or chocolate, according to data in a research letter published online in October by The Journal of the American Medical Association.
"Consistent with national school-based estimates, this study confirms widespread appeal of flavored products among youth tobacco users," researchers say.
Bridget K. Ambrose, Ph.D., of the Center for Tobacco Products, U.S. Food and Drug Administration, and colleagues examined flavored tobacco use among U.S. youth using data from the Population Assessment of Tobacco and Health Study, a household-based, nationally representative study of 45,971 adults and youth (12-17 years).
Youth responded to questions about ever and past 30-day use of tobacco products including cigarettes, e-cigarettes, hookahs, cigars, pipe tobacco, all types of smokeless tobacco, dissolvable tobacco, bidis and kreteks.
For each product ever used, youth answered whether the first product they used was flavored (e.g., "Was the first e-cigarette you used flavored to taste like menthol, mint, clove, spice, candy, fruit, chocolate, alcohol [such as wine or cognac], or other sweets?").
The majority of youth ever-users reported that the first product they had used was flavored, including 88.7 percent of ever hookah users, 81 percent of ever e-cigarette users, 65.4 percent of ever users of any cigar type, and 50.1 percent of ever cigarette smokers, according to the study.
For past 30-day youth tobacco use, the overall proportion of flavored product use was 79.8 percent among users of any product and 89 percent among hookah users, 85.3 percent among e-cigarette users, 71.7 percent among users of any cigar type and 59.5 percent among cigarette smokers, the study says.
For past 30-day noncigarette tobacco users, youth consistently reported product flavoring as a reason for use across all product types, including e-cigarettes (81.5 percent), hookahs (78.9 percent), cigars (73.8 percent), smokeless tobacco (69.3 percent), and snus pouches (67.2 percent).
"In addition to continued proven tobacco control and prevention strategies, efforts to decrease use of flavored tobacco products among youth should be considered," the authors write.
Relatedly, a systematic review published in October by The Journal of the American Dental Association looked at the association between waterpipe (hookah) smoking and head and neck conditions. The authors found that waterpipe smoking was associated with greater inflammation, Candida, periodontitis, dry socket, blood chromium and nickel levels, premalignant lesions, oral cancer, esophageal squamous cell carcinoma, attic retraction, edema in the vocal cords and lower habitual vocal pitch and voice turbulence index.