{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T00:17:59Z","timestamp":1793233079520,"version":"4.5.0"},"reference-count":41,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T00:00:00Z","timestamp":1758067200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Milbank Quarterly"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>\n                      <jats:boxed-text content-type=\"box\" position=\"anchor\">\n                        <jats:caption>\n                          <jats:title>Policy Points<\/jats:title>\n                        <\/jats:caption>\n                        <jats:p>\n                          <jats:list list-type=\"bullet\">\n                            <jats:list-item>\n                              <jats:p>Menthol\u2010flavored e\u2010cigarettes are disproportionately used by youth who co\u2010use other substances; allowing menthol sales may undermine efforts to reduce poly\u2010tobacco and poly\u2010substance use.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>Fruit\/ice\u2010fruit flavors are most common among lower\u2010risk youth (those not engaged in other substance use), and banning these flavors could help prevent nicotine initiation.<\/jats:p>\n                            <\/jats:list-item>\n                            <jats:list-item>\n                              <jats:p>Because nearly all youth who vape use non\u2013tobacco\u2010flavored e\u2010cigarettes, comprehensive policies that eliminate access to all non\u2013tobacco\u2010flavored e\u2010cigarettes, including menthol, may be more effective than selective bans. Stronger enforcement and broader flavor restrictions could help prevent initiation and reduce sustained use, particularly among youth who co\u2010use menthol\u2010flavored e\u2010cigarettes and other substances.<\/jats:p>\n                            <\/jats:list-item>\n                          <\/jats:list>\n                        <\/jats:p>\n                      <\/jats:boxed-text>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>The specific nontobacco e\u2010cigarette flavors used by US youth who exclusively vape e\u2010cigarettes compared with youth who engage in poly\u2010tobacco or poly\u2010substance use can help identify the populations most likely to be impacted by e\u2010cigarette flavor policies. This study examines correlations between e\u2010cigarette flavor use and past 30\u2010day tobacco and substance use among US youth who vape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed the Monitoring the Future survey data (2021\u20132023), a nationally representative annual study of US eighth, tenth, and 12th graders. Among 14,675 participants who vaped nicotine in the past year, we assessed their most frequently used e\u2010cigarette flavor: fruit\/ice\u2010fruit, menthol, mint, sweet, tobacco, or unflavored. Log\u2010binomial regression models estimated adjusted prevalence ratios (APRs) for correlations between e\u2010cigarette flavor use and past 30\u2010day tobacco and substance use, adjusting for sociodemographic characteristics and e\u2010cigarette use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings<\/jats:title>\n                    <jats:p>Few youth predominately vaped tobacco\u2010flavored (1.3%) or unflavored (3.6%) e\u2010cigarettes, regardless of whether they did or did not use other tobacco products or nontobacco substances. Menthol\u2010flavored (12.1%) e\u2010cigarette use was correlated with past 30\u2010day cigarette (APR 1.53, 95% CI 1.29\u20101.81), smokeless tobacco (APR 1.53, 95% CI 1.24\u20101.89), cigars\/hookah tobacco products (APR 1.51, 95% CI 1.13\u20102.02), and alcohol (APR 1.16, 95% CI 1.02\u20101.32) use. In contrast, fruit\/ice\u2010fruit\u2013flavored (72.3%) e\u2010cigarettes were less commonly used among youth who smoked cigarettes (APR 0.83, 95% CI 0.76\u20100.90), used smokeless tobacco (APR 0.83, 95% CI 0.75\u20100.91), or reported noncannabis illicit drug use (APR 0.89, 95% CI 0.80\u20100.98).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Closing federal regulatory loopholes and implementing state and local bans on all non\u2013tobacco\u2010flavored e\u2010cigarettes may support efforts to reduce youth nicotine uptake. Policies that limit access and sales to menthol\u2010flavored e\u2010cigarettes could be particularly relevant for youth at risk of poly\u2010tobacco or poly\u2010substance use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1468-0009.70051","type":"journal-article","created":{"date-parts":[[2025,9,17]],"date-time":"2025-09-17T17:15:20Z","timestamp":1758129320000},"page":"392-410","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Correlations Between Flavored E\u2010Cigarette Use and Tobacco and Substance Use Among US Youth, 2021 to 2023"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1270-6951","authenticated-orcid":false,"given":"LOUISIANA M.","family":"SANCHEZ","sequence":"first","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6617-1625","authenticated-orcid":false,"given":"JUNHAN","family":"CHO","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ALYSSA F.","family":"HARLOW","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"},{"name":"USC Norris Comprehensive Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"RICHARD A.","family":"MIECH","sequence":"additional","affiliation":[{"name":"Institute for Social Research University of Michigan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"STEVEN","family":"SUSSMAN","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"},{"name":"USC Norris Comprehensive Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"HONGYING D.","family":"DAI","sequence":"additional","affiliation":[{"name":"University of Nebraska Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ABIGAIL","family":"ADJEI","sequence":"additional","affiliation":[{"name":"University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DAE\u2010HEE","family":"HAN","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MING","family":"LI","sequence":"additional","affiliation":[{"name":"University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"LEAH","family":"MEZA","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"ADAM M.","family":"LEVENTHAL","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"},{"name":"USC Norris Comprehensive Cancer Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"DAYOUNG","family":"BAE","sequence":"additional","affiliation":[{"name":"University of Southern California"},{"name":"Institute for Addiction Science University of Southern California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,17]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7244a1"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2021.306686"},{"key":"e_1_2_9_4_1","unstructured":"US Department of Health and Human Services.E\u2010cigarette use among youth and young adults: a report of the Surgeon General.US Department of Health and Human Services.2016. 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