Fruit and menthol e-cigarette flavors drive use among teens, Indonesian study finds

In a recent study published in BMC Public Health, researchers examined the associations between sensation-seeking behavior and electronic cigarette (e-cigarette) use among Indonesian adolescents.

Study: Does sensation-seeking behavior influence the patterns of flavored e-cigarette use? A cross-sectional study among Indonesian adolescents and young adults. Image Credit: iama_sing/Shutterstock.comStudy: Does sensation-seeking behavior influence the patterns of flavored e-cigarette use? A cross-sectional study among Indonesian adolescents and young adults. Image Credit: iama_sing/Shutterstock.com

Background

E-cigarette use has globally increased, particularly among young adults and adolescents. Besides, concurrent use of both e-cigarettes and conventional cigarettes has been increasing among adolescents. Indonesia has the highest smoking rate among males in the world. The lack of regulation has significantly increased e-cigarettes use in Indonesia.

The existence of diverse e-cigarette flavors has been suggested to have a crucial role in initiating vaping; fruit and sweet flavors can motivate young people and reduce associated harm perceptions.

A survey showed that e-cigarette liquids in Indonesian stores were flavored, and most products featured public figures or cartoon images, which might be more appealing.

Adolescence is a critical phase characterized by increased novelty-seeking, exploration, and risk-taking behaviors. Sensation seeking is characterized by the search for novel, varied, intense, and complex feelings and experiences and the willingness to take risks for these experiences. Sensation-seeking may have long-term implications for health and longevity.

About the study

The present study investigated the relationship between sensation-seeking and e-cigarette use among young Indonesians.

They included individuals aged 15–24 from three provinces. Two universities and four high schools were selected per province to administer questionnaires in classrooms. Data were collected between March and August 2023.

Questionnaires collected data on sociodemographics, use of cigarettes and e-cigarettes, e-cigarette flavors, and sensation-seeking. Questionnaires solely containing responses for sociodemographics were excluded. Ever users of e-cigarettes or conventional cigarettes were those who used these products but not within the past 30 days.

Current users were those who used them in the past month. Dual users were those using both types in the past month. E-cigarette flavors included fruit, dessert, tobacco, spices, nuts, candy, mint, and beverages.

Participants indicated their interest levels in items related to experience or adventure seeking, thrill, boredom susceptibility, and disinhibition.

Multivariate multinomial regression was used to predict the current and ever use of e-cigarettes and conventional cigarettes.

Correlations between flavor use and demographic, behavioral, and personality factors were also explored. A latent class analysis was performed to identify flavor preference patterns.

Findings

Overall, 1,799 responses were received; 199 were excluded from analyses. The proportion of individuals currently using conventional cigarettes was higher than that of current e-cigarette users. Dual users constituted 8.5% of the sample. Males exhibited higher rates of ever and current use of e-cigarettes than females and were also more likely to be dual users. The most popular e-cigarette flavors were fruit, candy, and menthol.

Menthol and fruit flavors were more common in males, while the fruit flavor was predominant in females. The odds of currently using e-cigarettes or conventional cigarettes increased with age.

However, females were significantly less likely to be ever or current users of e-cigarettes or conventional cigarettes compared to males. Individuals with higher sensation-seeking had greater odds of using conventional cigarettes or e-cigarettes.

There were significant differences in odds ratios for the current use of conventional cigarettes or e-cigarettes by age, location, and sex. Further, there was a weak but significant correlation between age and the use of menthol and fruit flavors.

Sensation-seeking was associated with a preference for menthol and dessert flavors. Current e-cigarette users preferred menthol, dessert, and fruit flavors, whereas conventional cigarette users preferred tobacco, beverage, menthol, and dessert flavors.

Dual users preferred tobacco, menthol, and dessert flavors. The latent class analysis revealed three classes. Class 1 comprised 14% of respondents favoring menthol, class 2 comprised 76% preferring fruit flavors, and class 3 included individuals with multiple flavor preferences.

Class 1 mainly included males and was associated with the current use of conventional cigarettes. Class 2 subjects were less likely to be current users of either type. Class 3 was associated with higher sensation-seeking.

Conclusions

In sum, the study evaluated the use of conventional cigarettes and e-cigarettes among Indonesian youth. Users of both types were predominately male. Further, e-cigarettes were generally more acceptable among females than conventional cigarettes.

Notably, conventional cigarettes were more commonly used in rural areas, perhaps due to the popularity of the traditional, clove-flavored kretek cigarettes.

In contrast, e-cigarettes and filtered white cigarettes were popular in urban areas. Individuals with sensation-seeking behaviors preferred multiple flavors. The diverse e-cigarette flavors may offer unique sensations consistent with the preference for exciting experiences.

Both flavors and their varieties could be more appealing to young people. The authors posit that a widespread ban on e-cigarette flavors may be effective in curbing the initiation/use of e-cigarettes.

Journal reference:
Tarun Sai Lomte

Written by

Tarun Sai Lomte

Tarun is a writer based in Hyderabad, India. He has a Master’s degree in Biotechnology from the University of Hyderabad and is enthusiastic about scientific research. He enjoys reading research papers and literature reviews and is passionate about writing.

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