{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:06:14Z","timestamp":1790845574121,"version":"4.1.0"},"reference-count":21,"publisher":"Oxford University Press (OUP)","issue":"6","funder":[{"DOI":"10.13039\/100009210","name":"Food and Drug Administration","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009210","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,22]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>To examine ice flavor use and its correlates among middle and high school students who currently (any past 30 days) used e-cigarettes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The 2023 National Youth Tobacco Survey (NYTS) assessed for the first time the use of e-cigarette flavors that included the word \u201cice\u201d or \u201ciced\u201d 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\u2005=\u20051,565).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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 \u226520 of the past 30 days compared to 1\u20135 days (adjusted odds ratio [aOR]\u2005=\u20052.31, 95% confidence interval [CI] = 1.36 to 3.94); used fruit (aOR\u2005=\u20052.27, 95% CI = 1.36 to 3.80), candy (aOR\u2005=\u20052.73, 95% CI = 1.54 to 4.82), or mint flavors (aOR\u2005=\u20053.63, 95% CI = 1.98 to 6.65) compared to those who did not use the respective flavor type; reported any nicotine dependence compared to those who did not (aOR\u2005=\u20051.71, 95% CI = 1.04 to 2.80); or had mild\/moderate (aOR\u2005=\u20051.97, 95% CI = 1.01 to 3.83) or severe psychological distress (aOR\u2005=\u20052.41, 95% CI = 1.25 to 4.62) compared to those without psychological distress.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The present study found that ice-flavored e-cigarette use among youth was associated with the use of e-cigarettes for \u226520 days, the use of fruit, candy, or mint flavors, any symptoms of nicotine dependence, and psychological distress (mild\/moderate, severe). The emergence of novel flavor categories and features of e-cigarettes warrant continued surveillance to provide an understanding of associated use patterns, especially among youth.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications<\/jats:title>\n                  <jats:p>This study examined ice flavor use and its correlates among middle and high school students who currently use e-cigarettes. Ice-flavored e-cigarette use among youth was positively associated with frequent e-cigarette 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 the severity of psychological distress.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ntr\/ntae216","type":"journal-article","created":{"date-parts":[[2024,9,7]],"date-time":"2024-09-07T16:04:18Z","timestamp":1725725058000},"page":"1137-1141","source":"Crossref","is-referenced-by-count":7,"title":["Characteristics Associated With Ice Flavor Use Among Middle and High School Students Currently Using E-cigarettes: National Youth Tobacco Survey, 2023"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9146-0405","authenticated-orcid":false,"given":"Eunice","family":"Park-Lee","sequence":"first","affiliation":[{"name":"Center for Tobacco Products, Food and Drug Administration , Silver Spring, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Cowan","sequence":"additional","affiliation":[{"name":"Center for Tobacco Products, Food and Drug Administration , Silver Spring, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mo\u2019Nique","family":"Gaines-Harris","sequence":"additional","affiliation":[{"name":"Center for Tobacco Products, Food and Drug Administration , Silver Spring, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria R","family":"Cooper","sequence":"additional","affiliation":[{"name":"Center for Tobacco Products, Food and Drug Administration , Silver Spring, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4146-6897","authenticated-orcid":false,"given":"Michael D","family":"Sawdey","sequence":"additional","affiliation":[{"name":"Center for Tobacco Products, Food and Drug Administration , Silver Spring, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen A","family":"Cullen","sequence":"additional","affiliation":[{"name":"Center for Tobacco Products, Food and Drug Administration , Silver Spring, MD,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,7]]},"reference":[{"issue":"45","key":"2025062417161920100_CIT0001","doi-asserted-by":"publisher","first-page":"1276","DOI":"10.15585\/mmwr.mm6745a5","article-title":"Notes from the field: use of electronic cigarettes and any tobacco product among middle and high school students\u2014United States, 2011-2018","volume":"67","author":"Cullen","year":"2018","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"37","key":"2025062417161920100_CIT0002","doi-asserted-by":"publisher","first-page":"1310","DOI":"10.15585\/mmwr.mm6937e1","article-title":"E-cigarette use among middle and high school students\u2014United States, 2020","volume":"69","author":"Wang","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"44","key":"2025062417161920100_CIT0003","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.15585\/mmwr.mm7244a1","article-title":"Tobacco product use among U.S. middle and high school students\u2014National Youth Tobacco Survey, 2023","volume":"72","author":"Birdsey","year":"2023","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"2025062417161920100_CIT0004","volume-title":"E-cigarette Use Among Youth and Young Adults. 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