There was a significant decrease in flavored tobacco product use among U.S. youth in middle and high school between 2014 and 2016, but the trend reversed from 2016 to 2017, according to a study published in JAMA Pediatrics.
“Flavored tobacco products could serve as a starter kit for smoking because adolescents often experiment with smoking in pursuit of curiosity and novelty,” Hongying Dai, PhD, an associate professor at the College of Public Health, University of Nebraska Medical Center, told Infectious Diseases in Children. “Also, concerns have been raised about the potential inhalation toxicity of flavoring. No form of tobacco use is safe for teens.”
Dai conducted an analysis of data from 2014 to 2017 from the annual National Youth Tobacco Survey (49.2% girls). The survey included 78,265 middle- and high-school students (55.9% high school), with 57% non-Hispanic white, 13.9% non-Hispanic black and 23.9% Hispanic students.
The survey defined current use of tobacco as use of any tobacco product at least 1 day in the last 30 days. If students reported using menthol cigarettes or any flavored noncigarette tobacco product, the researchers placed the students in the category of flavored tobacco product (FTP) user.
Dai reported that the prevalence of current use of any tobacco products dropped from 17.3% in 2014 to 13.6% in 2017. She reported a significant decrease in the prevalence of FTP use among current tobacco users between 2014 (69.4%) and 2016 (57.7%), but she noted a rebound in 2016 to 2017 (63.6%).
Dai used multivariate analysis to show that the odds of FTP use among current tobacco users were higher in 2014, 2015 and 2017 compared with 2016. She wrote that girls, high school students and non-Hispanic white students were more likely to report using FTP.
The initial decrease in FTP use could be attributed to public education campaigns, changes in labeling on noncigarette tobacco products and plans to reduce teen access to FTPs, Dai wrote. She noted that the rebounding increase was attributed to flavor use in e-cigarettes, even as flavors in other tobacco products decreased or leveled off.
“This study adds to the substantial evidence showing that flavors are a key reason why kids use e-cigarettes and underscores the urgent need for FDA to address the youth e-cigarette epidemic by prohibiting all flavored e-cigarettes that have not been subject to public health review,” Becky Wexler, a spokesperson for Campaign for Tobacco-Free Kids, told Infectious Diseases in Children. – by Bruce Thiel
Disclosure: Dai reports no relevant financial disclosures.