E-cigarette flavor and device preferences among US pregnant women who smoke: A latent class analysis

TL;DR

This study explores e-cigarette device and flavor preferences among pregnant women in the US who also smoke cigarettes.

Contribution

The study identifies distinct subgroups of e-cigarette preferences among pregnant women using latent class analysis.

Findings

Four classes of e-cigarette preferences were identified, with the majority preferring tobacco, mint, and sweet JUUL flavors.

Pregnant women who smoked more cigarettes were more likely to use THC, all flavors, and JUUL devices.

Findings suggest the need for targeted messaging campaigns considering device and flavor preferences.

Abstract

Little is known about e-cigarette device and flavor preferences among pregnant women. The purpose of this study was to identify classes of e-cigarette use based on device and flavor preferences among pregnant women who report dual use of e-cigarettes and cigarettes.

A sample of pregnant women (n=118), aged 18–40 years, living in the US, with dual cigarette and e-cigarette use, completed a cross-sectional online survey. Participants reported e-cigarette characteristics including past 30-day e-cigarette device (cartridge-based, JUUL, tank, and disposable) and flavor use (tobacco, mint, spice, sweet, alcohol, combined), and use of e-cigarettes containing delta-9-tetrahydrocannabinol (THC) in pregnancy. We used latent class analysis to classify subgroups based on e-cigarette preferences in pregnancy and examined the association of sociodemographic variables and cigarette smoking frequency with class membership.

We found four distinct classes of e-cigarette preferences: Class 1) tobacco, mint, and sweet JUUL (50.4%); Class 2) THC, all flavors, and JUUL (28.1%); Class 3) THC, all flavors, and all device (12.4%); and Class 4) THC, tobacco, mint, sweet, and tank device (9.1%). Pregnant women who smoked ≥11 cigarettes per day, compared to those who smoked 1–10 per day, were 5.22 (95% CI: 1.85–14.70) and 5.55 times (95% CI: 1.49–20.61) as likely to use THC, all flavors, and JUUL and all devices, respectively, compared with those who used tobacco, mint, and sweet flavors with JUUL.

Pregnant dual users of cigarettes and e-cigarettes are a heterogenous group. Device and flavor differences should be considered when developing targeted messaging campaigns and prevention strategies.

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