Sex and Gender in Relation to use of E-cigarette Product Characteristics in United States Datasets: A Systematic...

Electronic cigarette (e-cigarette) product characteristics impact appeal, addictive potential, toxicity, and/or harm reduction potential. We conducted a systematic review to characterize sex and gender differences in e-cigarette product characteristics used in the United States (U.S.).

Included studies used U.S. population-representative datasets to assess sex and gender differences, sex-specific findings, or differences by sexual and gender minority (SGM) status in relation to e-cigarette product characteristics (eg, flavors, nicotine (ie, nicotine in e-liquid), cannabis vaping (ie, cannabis in e-liquid), device types, other). Additionally, articles had to be written in English and published in peer-reviewed journals. Searches were conducted in PubMed on March 9, 2024, and in PsycInfo and Medline on February 23, 2025.

The 52 included papers used 7 datasets and addressed flavor (N = 28), nicotine (N = 14), cannabis vaping (N = 15), device (N = 6), and other characteristics (N = 3; 1 package size; 2 other toxicant exposure). Samples included youth (N = 23) and/or adults (N = 32). Although data are somewhat mixed, taken together findings indicate that the while prevalence of e-cigarette use is higher in males, among those who use e-cigarettes, the prevalence of flavor use is higher in females and the prevalence of nicotine and cannabis vaping and open (adjustable) device type use is higher in males.

E-cigarette product characteristics are a tractable target for regulation. Understanding e-cigarette product characteristics used by males and females in the U.S. could shed light on sex and gender differences in the course of e-cigarette use and the addictive potential, appeal, or harm reduction potential of e-cigarette products.

There are sex and gender differences in the use and cessation of tobacco products like combustible cigarettes. E-cigarettes have become more popular and characteristics such as flavors, nicotine, cannabis vaping (ie, cannabis in e-liquid), and device types impact appeal and addiction potential. This review is the first to synthesize the literature on sex and gender in relation to e-cigarette characteristics among United States youth and adults and highlight gaps where more research is needed. This information can help guide that regulation and other efforts related to e-cigarettes so they are as effective as possible across sex and gender groups.