Examining E-Cigarette Flavor Use and Preference by Menthol Cigarette Status and Quit Duration Among US Adults Using E-Cigarettes in a Smoking Cessation Attempt.

Introduction: Switching to e-cigarettes may help some adults quit smoking. More research is needed to understand the role of flavors in e-cigarettes among adults who smoke menthol and non-menthol cigarettes to inform policy and efforts to reduce cigarette use.

Methods: Cross-sectional survey data from adults who used e-cigarettes to quit smoking (N = 857) were used to examine e-cigarette flavors used and preferred during the smoking cessation attempt and differences by cigarette type (menthol vs. non-menthol). A general linear model was used to examine the main effects and interaction of cigarette type (menthol vs. non-menthol) and preferred e-cigarette flavor for quitting on duration of smoking abstinence.

Results: Adults who smoked menthol cigarettes were more likely to prefer menthol/mint vs. tobacco (AOR = 12.29, 95% CI = 7.42-20.34) or other e-cigarette flavors (AOR = 7.55, 95% CI = 4.22-13.50). However, there was a significant interaction between cigarette type and preferred e-cigarette flavor (p = .01). Adults smoking non-menthol cigarettes who preferred to use menthol/mint flavored e-cigarettes to quit smoking had longer durations of abstinence compared to those preferring tobacco flavor (LSmean difference = 0.92, CI: 0.39-1.46) or other flavors (LSmean difference = 0.81, CI: 0.15-1.46). Among participants who typically smoked menthol cigarettes, e-cigarette flavor preference was not associated significantly with duration of abstinence (F 3,834 = 1.36, p = 0.25).

Conclusions: Menthol/mint e-cigarettes are more often preferred by adults who smoke menthol cigarettes, yet preferring menthol/mint e-cigarettes was associated with longer abstinence durations for those who smoke non-menthol (vs. menthol) cigarettes.

Implications: (100 word limit, current This study provides new information about the types of e-cigarette flavors used and preferred by adults who smoke menthol vs. non-menthol cigarettes when using e-cigarettes to try to quit. The association of e-cigarette flavors and abstinence duration varies by cigarette type. While menthol/mint e-cigarette flavors are preferred by adults who smoke menthol cigarettes, menthol/mint e-cigarettes are associated with longer quitting success for those who smoke non-menthol (vs. menthol) cigarettes. More research is needed to understand the impact of e-cigarette flavor by cigarette type. These results may help inform tobacco policy and efforts to maximize reductions in cigarette use.