{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T14:14:05Z","timestamp":1790345645233,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:00:00Z","timestamp":1740441600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Addiction"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>E\u2010cigarette flavours have the potential to impact the appeal, harms and use of e\u2010cigarettes and combustible tobacco. Systematic reviews have synthesised evidence on their impacts but have always focused on specific outcomes or populations. This overview aimed to draw together syntheses from past systematic reviews of e\u2010cigarette flavours to provide a holistic, population\u2010wide view.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Overview of systematic reviews investigating the impacts of e\u2010cigarette flavours on any outcome. We searched six databases to February 2024, and appraised reviews using AMSTAR2. We used association direction plots and narratively synthesised results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 32 reviews (11 higher quality; 21 lower). Reviews reported impacts of e\u2010cigarette flavours on: appeal\/perceptions of vaping (13 reviews); harms (12); smoking (7); and vaping (13) behaviours. Availability of non\u2010tobacco e\u2010cigarette flavours may increase the appeal of (8 reviews) and motivation to try\/continue using e\u2010cigarettes (5) and decrease harm perceptions (5). There were no clear differences in impacts based on age or history of combustible tobacco use, and little difference in findings between higher and lower quality reviews. Two reviews indicated that among adolescents, experimenting with different flavours increased e\u2010cigarette appeal. Twelve reviews indicated that a range of specific flavours (including cinnamon, menthol and various sweet\/fruity flavours) may be harmful; this often came from in vitro experiments and chemical analyses. Findings were inconclusive on the impact of e\u2010cigarette flavours on smoking cessation (six reviews not showing clear impact), smoking initiation (two reviews not showing clear impact) and vaping initiation (two reviews showing increased initiation and two not showing clear impact).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010tobacco flavourings for e\u2010cigarettes may increase e\u2010cigarette appeal and harms; this increase may vary by flavour and apply across different population groups. The impacts of e\u2010cigarette flavours on e\u2010cigarette and cigarette use are inconclusive.<\/jats:p><\/jats:sec>","DOI":"10.1111\/add.70017","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T03:33:46Z","timestamp":1741750426000},"page":"1327-1344","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The impacts of e\u2010cigarette flavours: An overview of systematic reviews"],"prefix":"10.1111","volume":"120","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3757-5591","authenticated-orcid":false,"given":"Jonathan","family":"Livingstone\u2010Banks","sequence":"first","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nargiz","family":"Travis","sequence":"additional","affiliation":[{"name":"Lombardi Comprehensive Cancer Center Georgetown Medical University  Washington D.C. USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9669-9180","authenticated-orcid":false,"given":"Monserrat","family":"Conde","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixian (Crystal)","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Integrative Oncology British Columbia Cancer Research Institute  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padmo","family":"Zi","sequence":"additional","affiliation":[{"name":"Department of Epidemiology University of Michigan School of Public Health  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holly","family":"Jarman","sequence":"additional","affiliation":[{"name":"Department of Health Management and Policy University of Michigan School of Public Health  Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2539-9268","authenticated-orcid":false,"given":"Nicola","family":"Lindson","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Hartmann\u2010Boyce","sequence":"additional","affiliation":[{"name":"Nuffield Department of Primary Care Health Sciences University of Oxford  UK"},{"name":"Department of Health Promotion and Policy University of Massachusetts Amherst  Amherst MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD010216.pub8"},{"key":"e_1_2_9_3_1","volume-title":"Use of e\u2010cigarettes (vapes) among young people in Great Britain","author":"Action on Smoking and Health (ASH)","year":"2024"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000360220"},{"key":"e_1_2_9_5_1","volume-title":"E\u2010cigarettes and harm reduction: an evidence review","author":"Royal College of Physicians","year":"2024"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19159054"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16010"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.23960"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-92617-x"},{"key":"e_1_2_9_10_1","volume-title":"Nicotine vaping in England: an evidence update including health risks and perceptions, September 2022. A report commissioned by the Office for Health Improvement and Disparities","author":"McNeill A","year":"2022"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2023.08.002"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15723"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/10937404.2022.2124563"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntac073"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0194145"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-019-0855-0"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j4008"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc21-0930"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40615-023-01553-1"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.51890"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntab017"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/app13179654"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD013629"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.17843\/rpmesp.2021.384.7776"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20206936"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2021.09.024"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntz046"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntv176"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/nty054"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2022.107425"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0270818"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1080\/08897077.2019.1671937"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14040338"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2021.106684"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2023.100143"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16091"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.16736"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-031598"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinane.2022.110952"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2013-051122"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2015.11.003"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2020.12.013"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0234189"},{"key":"e_1_2_9_46_1","doi-asserted-by":"publisher","DOI":"10.1111\/jop.13273"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.7189\/jogh.13.04076"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1080\/10408444.2020.1713726"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00106-7"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0256044"}],"container-title":["Addiction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/add.70017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,2]],"date-time":"2025-06-02T11:43:54Z","timestamp":1748864634000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/add.70017"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,25]]},"references-count":49,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2025,7]]}},"alternative-id":["10.1111\/add.70017"],"URL":"https:\/\/doi.org\/10.1111\/add.70017","archive":["Portico"],"relation":{},"ISSN":["0965-2140","1360-0443"],"issn-type":[{"value":"0965-2140","type":"print"},{"value":"1360-0443","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,25]]},"assertion":[{"value":"2024-10-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-27","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-02-25","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}