Menthol flavour enhances vaping experiences: a randomised crossover clinical trial

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

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.

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).

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.

NCT05338801.