Effects of electronic cigarette e-liquid flavouring on cigarette craving

Dyer, Maddy L.; Khouja, Jasmine N.; Jackson, Abigail R.; Havill, Michelle A.; Dockrell, Martin J.; Munafo, Marcus R.; Attwood, Angela S.

Abstract

BACKGROUND: E-liquid flavour restrictions may discourage electronic cigarette (e-cigarette) uptake among youth. However, possible unintended consequences may include reduced appeal and effectiveness of e-cigarettes for smoking cessation. Non-tobacco flavours appear to be important for smoking cessation, but how and why are currently unclear. METHODS: We conducted an experimental study in a UK sample of adult daily smokers using an independent groups design (N=84). Participants were randomised to use an e-cigarette with nicotine-containing fruit/sweet-flavoured e-liquid (blackcurrant, strawberry, vanilla, caramel) or unflavoured e-liquid for 1 week. The primary outcomes were average, peak and cue-elicited cigarette craving (the latter was assessed using a cue exposure task). The secondary outcomes were smoking lapse occurrence, enjoyment of the e-cigarette, ease of transitioning from smoking to using an e-cigarette, intentions to continue using an e-cigarette, intentions and motivation to quit smoking, return to smoking, and continuation of e-cigarette use. RESULTS: E-liquid flavouring did not appear to have an effect on average cigarette craving (b 0.18, 95% CI -0.44 to 0.79, p=0.57), peak cigarette craving (b -0.12, 95% CI -0.59 to 0.35, p=0.62) or cue-elicited cigarette craving (b -0.21, 95% CI -3.86 to 3.43, p=0.91). We did not find evidence of a difference in secondary outcomes. CONCLUSIONS: We did not find evidence to suggest that nicotine-containing fruit/sweet-flavoured and unflavoured e-liquids have different effects on cigarette cravings after 1 week of use. Further research is needed to establish if differences emerge over longer periods of exposure and extend to smoking cessation outcomes.

• Journal Article Type: Article
• Acceptance Date: Nov 3, 2021
• Online Publication Date: Nov 17, 2021
• Publication Date: Mar 17, 2023
• Deposit Date: Sep 12, 2023
• Publicly Available Date: Sep 15, 2023
• Journal: Tobacco control
• Print ISSN: 0964-4563
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 32
• Issue: e1
• Pages: e3-e9
• DOI: https://doi.org/10.1136/tobaccocontrol-2021-056769
• Public URL: https://uwe-repository.worktribe.com/output/10875661