Department of Psychology, University of Minnesota, 75 E. River Road, Minneapolis, MN, 55454, USA.
Division of Environmental Health Sciences, School of Public Health and Masonic Cancer Center, University of Minnesota, 2231 6th Street SE, Minneapolis, MN 55455, USA.
Nicotine Tob Res. 2022 Aug 6;24(9):1332-1343. doi: 10.1093/ntr/ntac073.
Many adult cigarette smokers use electronic cigarettes (e-cigarettes) to cut down on or quit smoking cigarettes. E-cigarettes with higher abuse potential and appeal might facilitate complete switching. E-liquid nicotine concentration and flavor are two of the characteristics that may affect the abuse potential and appeal of e-cigarettes. The objective of this systematic review was to compile results from survey, animal, human laboratory, and clinical studies to understand the possible effects of nicotine concentration and flavor on abuse potential and appeal of e-cigarettes in adult current and former cigarette and e-cigarette users.
A comprehensive literature search was conducted in Ovid Medline and PsycINFO followed by citation tracking in Web of Science Core Collection. Peer-reviewed studies published in English between 2007 and August 2020 were selected that analyzed differences between e-liquid nicotine concentration and/or flavors, had outcome measures related to abuse potential and/or appeal, and included adult humans (18+) or animals. A total of 1624 studies were identified and screened. A qualitative synthesis of results was performed.
Results from 104 studies included in this review suggest that higher nicotine concentration and access to a variety of flavors are likely to be associated with higher abuse potential and appeal of e-cigarettes for adult current and former cigarette and e-cigarette users.
Higher nicotine concentrations and the availability of a variety of flavors in e-cigarettes might facilitate complete substitution for cigarettes. Future e-cigarette regulations should take into account their impact on smokers, for whom e-cigarettes may be a cessation tool or reduced-harm alternative.
E-cigarettes may provide a reduced-harm alternative to cigarettes for smokers unwilling/unable to quit or serve as a path for quitting all nicotine products. Higher nicotine concentrations and flavor variety are associated with higher abuse potential and appeal of e-cigarettes. Higher abuse potential and appeal products may help facilitate complete switching from cigarettes to e-cigarettes. Regulation of nicotine concentration and flavors aimed at decreasing naïve uptake may inadvertently decrease uptake and complete switching among smokers, reducing the harm reduction potential of e-cigarettes. Evidence-based effects of regulating nicotine concentration and flavors must be considered for the population as a whole, including smokers.
许多成年烟民使用电子烟（e-cigarettes）来减少或戒除香烟。具有更高滥用潜力和吸引力的电子烟可能会促进完全转换。电子烟液尼古丁浓度和口味是可能影响电子烟滥用潜力和吸引力的两个特征。本系统评价的目的是综合调查、动物、人体实验室和临床研究的结果，了解尼古丁浓度和口味对成年当前和前香烟和电子烟使用者电子烟滥用潜力和吸引力的可能影响。
在 Ovid Medline 和 PsycINFO 中进行全面的文献检索，然后在 Web of Science 核心合集（Web of Science Core Collection）中进行引文追踪。选择了 2007 年至 2020 年 8 月期间以英文发表的、分析电子烟液尼古丁浓度和/或口味差异、具有与滥用潜力和/或吸引力相关的结果测量指标、并包括成年人类（18+）或动物的同行评审研究。共确定并筛选了 1624 项研究。对结果进行了定性综合。
本综述纳入的 104 项研究的结果表明，较高的尼古丁浓度和获得各种口味可能与成年当前和前香烟和电子烟使用者对电子烟的更高滥用潜力和吸引力相关。
电子烟中较高的尼古丁浓度和多种口味的可用性可能会促进对香烟的完全替代。未来的电子烟法规应考虑到它们对吸烟者的影响，对于这些吸烟者来说，电子烟可能是一种戒烟工具或减少危害的替代品。
对于不愿意/无法戒烟的吸烟者或希望完全戒掉尼古丁产品的吸烟者来说，电子烟可能是一种减少危害的替代品。较高的尼古丁浓度和口味多样性与电子烟的更高滥用潜力和吸引力相关。更高的滥用潜力和吸引力产品可能有助于促进从香烟到电子烟的完全转换。旨在降低初始使用率的尼古丁浓度和口味法规可能会无意中降低吸烟者的使用率和完全转换率，从而降低电子烟的减少危害潜力。必须考虑到整个人群（包括吸烟者）的基于证据的尼古丁浓度和口味调节效果。
