Menthol flavour enhances vaping experiences: a randomised crossover clinical trial.

Abstract

Objective: This study examined the effect of menthol flavour on e-cigarette users' satisfaction, enjoyment and sensory experiences.

Methods: A randomised crossover trial was conducted among 77 current e-cigarette users aged 21-35 in Miami, Florida, USA. Participants used the same e-cigarette device in two separate sessions, differing by flavour (menthol/tobacco) in random order. Each session involved ad libitum 60 min vaping after 12-hour plasma nicotine-validated abstinence. The primary outcomes were satisfaction, pleasure, enjoyment, appeal and sensory experiences measured after each session.

Results: Higher scores were observed in measures of satisfaction, product liking, interest to use in future, willingness to use again, enjoyment, puff liking, taste and craving reduction during the menthol-flavoured e-cigarette session compared with tobacco flavour (all p<0.05). Additionally, participants in the moderate to high-dependence group had overall better subjective experiences (eg, user satisfaction (psychological reward, β=5.34, p<0.001), appeal and sensory experience (puff liking, β=0.64, p=0.04)) in the menthol condition (vs tobacco) compared with low-dependent users. Women also had better experience (eg, user satisfaction (psychological reward, β=3.82, p=0.01)) than men in the menthol condition (vs tobacco).

Conclusions: In this randomised crossover clinical trial, menthol-flavoured e-cigarettes significantly enhanced e-cigarette use experience compared with tobacco flavour. These findings provide important evidence that menthol flavour plays a substantial role in making e-cigarettes more appealing, suggesting that menthol in e-cigarettes poses a risk to nicotine-naïve youth to initiate e-cigarette use and keep those young people currently using, addicted. Therefore, it could be a potential target for regulatory action to limit e-cigarette use among young people.

Trial registration number: NCT05338801.