Do Flavour Descriptions Influence Subjective Ratings of Flavoured and Unflavoured E-Liquids among Non-Smoking and Non-Vaping UK Adolescents?

Maddy L Dyer; Steph F Suddell; Jasmine N Khouja; Michelle A Havill; Anna K M Blackwell; Olivia M Maynard; Marcus R Munafò; Angela S Attwood

doi:10.1093/ntr/ntae054

Do Flavour Descriptions Influence Subjective Ratings of Flavoured and Unflavoured E-Liquids among Non-Smoking and Non-Vaping UK Adolescents?

Nicotine Tob Res. 2024 Mar 12:ntae054. doi: 10.1093/ntr/ntae054. Online ahead of print.

Authors

Maddy L Dyer^{1

2}, Steph F Suddell³, Jasmine N Khouja^{1

2}, Michelle A Havill⁴, Anna K M Blackwell⁵, Olivia M Maynard^{1

2}, Marcus R Munafò^{1

2

6}, Angela S Attwood^{1

2}

Affiliations

¹ School of Psychological Science, University of Bristol, Bristol, UK.
² Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK.
³ Trinity College Institute of Neuroscience (TCIN), Trinity College Dublin, Dublin, Ireland.
⁴ Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK.
⁵ Department of Psychology, University of Bath, Bath, UK.
⁶ National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

PMID: 38468465
DOI: 10.1093/ntr/ntae054

Abstract

Introduction: Youth use of electronic cigarettes (e-cigarettes) is rising globally and is associated with health harms. Flavour descriptions on e-liquid packaging may contribute to the appeal of e-cigarettes among youth. This study compared subjective ratings of e-liquid packaging flavour descriptions among non-smoking and non-vaping UK adolescents.

Methods: This was an online observational study in a UK sample of non-smoking and non-vaping adolescents aged 11-17 years. The primary analyses compared flavoured versus unflavoured descriptions and the secondary analyses compared candy/sweet flavour versus fruit flavour descriptions. Outcomes were packaging appraisal, packaging receptivity, perceived harm, and perceived audience.

Results: The survey was completed by 120 participants (74% female). Packaging appraisal ratings were higher for e-liquids with flavoured descriptions than unflavoured descriptions (mean difference 5.9, 95% CI 4.2 to 7.6, p<.001). Similarly, packaging receptivity ratings were higher for e-liquids with flavoured descriptions than unflavoured descriptions (mean difference 4.2, 95% CI 2.8 to 5.6, p<.001). Participants also perceived e-liquids with flavoured (versus unflavoured) descriptions as less 'grown-up' (mean difference -5.2, 95% CI -7.3 to -3.1, p<.001). However, ratings of perceived harm were similar for flavoured and unflavoured descriptions (mean difference -1.0, 95% CI -2.6 to 0.5, p=.189).

Conclusions: Although this study found differences in subjective ratings of e-liquids with flavoured and unflavoured descriptions, non-smoking and non-vaping UK adolescents generally had low appraisal and receptivity for e-liquids and they perceived them as being 'grown-up' and harmful.

Implications: Youth use of electronic cigarettes (e-cigarettes) is increasing globally, leading to concerns about health harms. This study compared adolescents' ratings of e-liquids with flavoured versus unflavoured descriptions and e-liquids with candy/sweet flavour versus fruit flavour descriptions. This study adds to previous studies that have compared adolescents' ratings of e-liquids with tobacco flavour versus non-tobacco flavour descriptions. Although packaging appraisal and receptivity ratings were higher (more positive) for e-liquids with flavoured versus unflavoured descriptions, overall, adolescents who do not smoke or vape had low appraisal and receptivity for e-liquids, and they perceived them as being 'grown-up' and harmful.

Keywords: e-liquid packaging; electronic cigarette; flavour; vaping; youth.