This section discusses the use of flavoured products, being those with a specific characterising flavour such as ‘fruit flavour’.
Use of flavoured tobacco products is over-represented among young people, where it is associated with experimentation and initiation of smoking.1 A 2013–14 US survey found that flavoured tobacco product use (including menthol) was highest among adolescents (aged 12 to 17 years) at 80% of use, second highest among young adults (18 to 24 years) at 73% of use, and lowest among those over 65 years at 29% of use.2 Analysis of the same cohort found that users of non-cigarette tobacco products often chose flavoured tobacco. Most (82.5%) of waterpipe users, 36% of cigar smokers and 50.3% of smokeless tobacco users chose products with a characteristic flavour.3 Younger adults (18 to 24 years) were more likely than those in older age groups to use non-cigarette flavoured products.3 The taste and variety of flavours is reported to have influenced young people in experimenting with tobacco products.4
Flavoured tobacco product use may also be more popular with specific ethnicities. A Canadian study of students from grades 10 to 12 showed that flavoured tobacco use was highest amongst male students and those who self-identified as Aboriginal (23.9%), Hispanic (21.3%) or Black (19.0%).5 Tobacco industry documents show that the industry has marketed flavoured little cigars and cigarillos to specific groups such as new tobacco users, women and African Americans6 and have targeted new users with flavoured smokeless tobacco.7
Menthol tobacco use by specific groups of people is discussed in Section 12.7.4.
References
1. Kowitt SD, Meernik C, Baker HM, Osman A, Huang LL, et al. Perceptions and experiences with flavored non-menthol tobacco products: A systematic review of qualitative studies. International Journal of Environmental Research and Public Health, 2017; 14(4). Available from: https://www.ncbi.nlm.nih.gov/pubmed/28333107
2. Villanti AC, Johnson AL, Ambrose BK, Cummings KM, Stanton CA, et al. Flavored tobacco product use in youth and adults: Findings from the first wave of the PATH study (2013-2014). American Journal of Preventive Medicine, 2017; 53(2):139-51. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28318902
3. Bonhomme MG, Holder-Hayes E, Ambrose BK, Tworek C, Feirman SP, et al. Flavoured non-cigarette tobacco product use among us adults: 2013-2014. Tobacco Control, 2016; 25(Suppl 2):ii4-ii13. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27794065
4. Huang LL, Baker HM, Meernik C, Ranney LM, Richardson A, et al. Impact of non-menthol flavours in tobacco products on perceptions and use among youth, young adults and adults: A systematic review. Tobacco Control, 2017; 26(6):709-19. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27872344
5. Bird Y, May J, Nwankwo C, Mahmood R, and Moraros J. Prevalence and characteristics of flavoured tobacco use among students in grades 10 through 12: A national cross-sectional study in Canada, 2012-2013. Tobacco Induced Diseases, 2017; 15:20. Available from: https://www.ncbi.nlm.nih.gov/pubmed/28352213
6. Kostygina G, Glantz SA, and Ling PM. Tobacco industry use of flavours to recruit new users of little cigars and cigarillos. Tobacco Control, 2016; 25(1):66-74. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25354674
7. Kostygina G and Ling PM. Tobacco industry use of flavourings to promote smokeless tobacco products. Tobacco Control, 2016; 25(Suppl 2):ii40-ii9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/27856998