Objectives. To examine the impact of US restrictions implemented in February 2020 prohibiting flavors other than menthol and tobacco in cartridge-based e-cigarettes.

Methods. We analyzed 5 cross-sectional waves of the International Tobacco Control Policy Evaluation Project Youth Tobacco and Vaping Surveys, conducted online with youths aged 16 to 19 years in the United States, Canada, and England, for differences in usual e-cigarette flavor, device, and brand reported by past-30-day vapers (n = 9512) before (2017, 2018, 2019), during (February 2020), and after (August 2020) implementation of US flavor restrictions.

Results. In August 2020, 78.7% of vapers in the United States reported using a flavor prohibited in cartridges or pods, versus 86.3% in Canada (adjusted odds ratio [AOR] = 1.73; 95% CI = 1.25, 1.40) and 79.8% in England (AOR = 1.10; 95% CI = 0.78, 1.55). Disposable e-cigarettes (exempt from flavor restrictions) increased to a greater extent among vapers in the United States (13.2% to 36.8%) versus Canada (7.7% to 14.2%; AOR = 2.01; 95% CI = 1.33, 3.04) and England (10.8% to 16.4%; AOR = 2.33; 95% CI = 1.52, 3.57). Puff Bar (disposable) emerged as the most popular brand in the United States.

Conclusions. Usual flavors used by youth vapers in the United States were unchanged after 2020 restrictions on cartridge-based e-cigarettes. Youths used brands and devices exempt from the restrictions. (Am J Public Health. 2022;112(7):1014–1024. https://doi.org/10.2105/AJPH.2022.306780)


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David Hammond, PhD , Jessica L. Reid, MSc , Robin Burkhalter, MMath , Maansi Bansal Travers, PhD , Shannon Gravely, PhD , Andy Hyland, PhD , Karin Kasza, PhD , and Ann McNeill, PhD David Hammond, Jessica L. Reid, and Robin Burkhalter are with the School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada. Maansi Bansal Travers, Andy Hyland, and Karin Kasza are with the Roswell Park Comprehensive Cancer Center, Buffalo, NY. Shannon Gravely is with the Department of Psychology, University of Waterloo. Ann McNeill is with the Department of Addictions, Institute of Psychiatry, Psychology, and Neuroscience, King’s College London, London, UK. “E-Cigarette Flavors, Devices, and Brands Used by Youths Before and After Partial Flavor Restrictions in the United States: Canada, England, and the United States, 2017‒2020”, American Journal of Public Health 112, no. 7 (July 1, 2022): pp. 1014-1024.


PMID: 35622007