Characteristics Associated with Ice Flavor Use among Middle and High School Students Currently Using E-cigarettes: National Youth Tobacco Survey, 2023

Eunice Park-Lee; Hannah Cowan; Mo'Nique Gaines-Harris; Maria Cooper; Michael D Sawdey; Karen A Cullen

doi:10.1093/ntr/ntae216

Characteristics Associated with Ice Flavor Use among Middle and High School Students Currently Using E-cigarettes: National Youth Tobacco Survey, 2023

Nicotine Tob Res. 2024 Sep 7:ntae216. doi: 10.1093/ntr/ntae216. Online ahead of print.

Authors

Eunice Park-Lee¹, Hannah Cowan¹, Mo'Nique Gaines-Harris¹, Maria Cooper¹, Michael D Sawdey¹, Karen A Cullen¹

Affiliation

¹ Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD.

PMID: 39243368
DOI: 10.1093/ntr/ntae216

Abstract

Purpose: To examine ice flavor use and its correlates among middle and high school students who currently (any past 30-day) used e-cigarettes.

Methods: The 2023 National Youth Tobacco Survey (NYTS) assessed for the first time the use of e-cigarette flavors that included the word "ice" or "iced" in the name. Using logistic regression, data from the 2023 NYTS were used to examine differences in sociodemographic characteristics and tobacco use behaviors by ice flavor use among students who currently used e-cigarettes (n=1,565).

Results: Among middle and high school students who currently used e-cigarettes, an estimated 1.1 million or 57.9% reported ice flavor use. Youth who currently used e-cigarettes were more likely to use ice flavors if they used e-cigarettes on ≥20 of the past 30 days compared to 1-5 days (adjusted Odds Ratio [aOR]=2.31, 95% CI: 1.36-3.94); used fruit (aOR=2.27, 95% CI: 1.36-3.80), candy (aOR=2.73, 95% CI:1.54-4.82), or mint flavors (aOR=3.63, 95% CI:1.98-6.65) compared to those who did not use the respective flavor type; reported any nicotine dependence compared to those who did not (aOR= 1.71, 95% CI:1.04-2.80); or had mild/moderate (aOR=1.97, 95% CI: 1.01-3.83) or severe psychological distress (aOR=2.41, 95% CI: 1.25-4.62) compared to those without psychological distress.

Conclusions: The present study found that ice-flavored e-cigarette use among youth was associated with use of e-cigarettes on ≥20 days, use of fruit, candy, or mint flavors, any symptoms of nicotine dependence, and psychological distress (mild/moderate, severe). Emergence of novel flavor categories and features of e-cigarettes warrant continued surveillance to provide an understanding of associated use patterns, especially among youth.

Implications: This study examined ice flavor use and its correlates among middle and high school students who currently used e-cigarettes. Ice-flavored e-cigarette use among youth was positively associated with frequent e-cigarettes use, use of fruit, candy, or mint flavors, and any symptoms of nicotine dependence. Additionally, the likelihood of ice-flavored e-cigarette use was associated with severity of psychological distress.

Keywords: National Youth Tobacco Survey; ice flavors; ice-flavored e-cigarettes; youth tobacco product use.

Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco 2024. This work is written by (a) US Government employee(s) and is in the public domain in the US.