Positive Swiss Flavour Study

The researchers involved in the study work at the University of Bern, Lucerne Cantonal Hospital, the University of Fribourg, the University of Lausanne, University Hospital of Geneva, Kantonsspital St. Gallen, and the University Hospital Bern.

They state that many smokers attempt to quit by using vapes, adding “we aimed to describe e-liquid flavours and nicotine concentration use over 6 months in a prospective cohort of smokers willing to quit with ENDS [Electronic Nicotine Delivery Systems].” 

ENDS are commonly referred to as vapes.

The team recruited 622 participants from an intervention group of the Efficacy, Safety and Toxicology of ENDS randomised controlled trial. 

All of the adults taking part were smokers, self-reporting that they used at least five cigarettes a day. 

The participants were given free vape kits with a choice of 6 different juice flavours and coming in four different nicotine concentrations. The trial cohort members also received smoking cessation counselling. 

“We tracked flavour choice and nicotine concentration at 1, 2, 4, and 8 weeks, and at 6 months, after the target quit date, comparing participants who reported only vaping (exclusive e-cigarette users) to those who vaped and smoked (dual users) over the last 7 days. We applied multivariable regression models to compute adjusted risk ratios,” they write.

They found:

• Week 1: 66% (n=409) were exclusive e-cigarette users, and 21% (n=129) were dual users
• Month 6: 43% (n=266) were exclusive e-cigarette users, and 16% (n=102) were dual users

At the start of the trial, the team report that flavour choices were similar between Exclusive vapers and dual-users. This changed six months later as those who had remained vaping exclusively (and therefore quit smoking) had moved on to fruity flavours.

The nicotine strength chosen by the two groups was also similar at the beginning of the trial, but this changed with time. At the conclusion of the study, those who only used a vape were vaping lower strength juices.

While the team says, “we urge refraining from the causal interpretation of the study findings on the effectiveness of the choice of flavours and nicotine concentration on tobacco and nicotine abstinence outcomes,” it is still striking that the vaping-only result mirrors the real-world experience of Planet of the Vapes forum members – were vapers agree on the importance of flavours in their successful quit smoking attempt.

The researchers concluded: “Among participants in a smoking cessation trial that allowed participants to have a broad choice of free e-liquids over 6 months combined with standard-care smoking cessation counselling allowing NRT and further smoking cessation drug therapy, we found that exclusive e-cigarette users used more fruity-flavoured ENDS after 6 months and less tobacco-flavoured ENDS than dual users at 8 weeks and at 6 months after their target quit date. 

“The proportions of participants reporting using menthol, other, or mixed flavours remained similar across groups over all visits. 

“Exclusive e-cigarette users and dual users reduced their e-liquid nicotine concentration over time, but exclusive e-cigarette users reduced their nicotine concentration even more. Exclusive e-cigarette users reduced their total nicotine equivalent. In contrast, dual users increased their total nicotine equivalent over time, so smokers quitting with the help of ENDS and wanting to reduce their nicotine intake should be encouraged to switch to ENDS completely and avoid dual use.”

References:

• E-liquid flavors and nicotine concentration choices over 6 months after a smoking cessation attempt with ENDS: Secondary analyses of a randomized controlled trial - https://www.tobaccopreventioncessation.com/E-liquid-flavors-and-nicotine-concentration-choices-over-6-months-after-a-smoking,196136,0,2.html

Photo Credit:

• Banner image generated by author, logo added

Dave Cross

Journalist at POTV

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Dave is a freelance writer; with articles on music, motorbikes, football, pop-science, vaping and tobacco harm reduction in Sounds, Melody Maker, UBG, AWoL, Bike, When Saturday Comes, Vape News Magazine, and syndicated across the Johnston Press group. He was published in an anthology of “Greatest Football Writing”, but still believes this was a mistake. Dave contributes sketches to comedy shows and used to co-host a radio sketch show. He’s worked with numerous start-ups to develop content for their websites.