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Introduction Youth use of electronic cigarettes (e-cigarettes) is rising globally and is associated with health harms. Flavor descriptions on e-liquid packaging may contribute to the appeal of e-cigarettes among youth. This study compared subjective ratings of e-liquid packaging flavor descriptions among nonsmoking and non-vaping UK adolescents. Aims and Methods This was an online observational study in a UK sample of nonsmoking and non-vaping adolescents aged 11–17 years. The primary analyses compared flavored versus unflavored descriptions and the secondary analyses compared sweet flavor versus fruit flavor descriptions. Outcomes were packaging appraisal, packaging receptivity, perceived harm, and perceived audience. Results The survey was completed by 120 participants (74% female). Packaging appraisal ratings were higher for e-liquids with flavored descriptions than unflavored descriptions (mean difference 5.9, 95% CI: 4.2 to 7.6, p  < .001). Similarly, packaging receptivity ratings were higher for e-liquids with flavored descriptions than unflavored descriptions (mean difference 4.2, 95% CI: 2.8 to 5.6, p  < .001). Participants also perceived e-liquids with flavored (vs. unflavored) descriptions as less "grown-up" (mean difference −5.2, 95% CI: −7.3 to −3.1, p  < .001). However, ratings of perceived harm were similar for flavored and unflavored descriptions (mean difference −1.0, 95% CI: −2.6 to.5, p  = .189). Conclusions Although this study found differences in subjective ratings of e-liquids with flavored and unflavored descriptions, nonsmoking and non-vaping UK adolescents generally had low appraisal and receptivity for e-liquids and they perceived them as being "grown-up" and harmful. Implications Youth use of electronic cigarettes (e-cigarettes) is increasing globally, leading to concerns about health harms. This study compared adolescents' ratings of e-liquids with flavored versus unflavored descriptions and e-liquids with sweet flavor versus fruit flavor descriptions. This study adds to previous studies that have compared adolescents' ratings of e-liquids with tobacco flavor versus non-tobacco flavor descriptions. Although packaging appraisal and receptivity ratings were higher (more positive) for e-liquids with flavored versus unflavored descriptions, overall, adolescents who do not smoke or vape had low appraisal and receptivity for e-liquids, and they perceived them as being "grown-up" and harmful. [ABSTRACT FROM AUTHOR]

Background Smokers report poorer sleep than nonsmokers and sleep quality deteriorates further during cessation, increasing risk of smoking relapse. Better understanding of the relationship between sleep and relapse-related outcomes could inform novel approaches to smoking cessation support. The aim of this study was to investigate same-day associations of self-reported sleep quality and fatigue severity with factors associated with successful cessation and cessation beliefs, among regular smokers. Methods This cross-sectional observational study (n = 412) collected self-reported sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs among regular smokers via an online survey (60% male). Results There was evidence of an association between sleep quality (SQ) and reduced 24-hour (β = −0.12, p =.05) and lifetime (β = −0.09, p =.04) abstinence self-efficacy. In addition, poorer SQ and higher fatigue severity (FS) were associated with increased smoking urges (SQ: β = 0.27, p <.001; FS: β = 0.32, p <.001), increased barriers to cessation (SQ: β = 0.19, p <.001; FS: β = 0.32, p <.001), and increased perceived risks to cessation (SQ: β = 0.18, p <.001; FS: β = 0.26, p <.001). Fatigue severity was weakly associated with increased perceived benefits to cessation (β = 0.12, p =.017). Conclusions Self-reported sleep quality and fatigue severity were associated with multiple factors associated with successful cessation and cessation beliefs. Further research is needed to extend these findings by using different methods to identify the temporal direction of associations and causality. Implications This study is the first to examine associations between sleep quality, fatigue severity, and factors associated with successful cessation and cessation beliefs. Findings show that both sleep quality and fatigue severity are associated with multiple factors associated with successful cessation and could be modifiable targets for future smoking cessation interventions. Furthermore, our data suggest that fatigue severity has an independent effect on multiple factors associated with successful cessation when accounting for sleep quality. This indicates that fatigue, independent of sleep quality, could be an important factor in a quit attempt. [ABSTRACT FROM AUTHOR]

Aims: The study aimed to estimate the impact of introducing a draught alcohol‐free beer, thereby increasing the relative availability of these products, on alcohol sales and monetary takings in bars and pubs in England. Design: Randomised crossover field trial. Setting: England. Participants: Fourteen venues that did not previously sell draught alcohol‐free beer. Intervention and comparator: Venues completed two intervention periods and two control periods in a randomised order over 8 weeks. Intervention periods involved replacing one draught alcoholic beer with an alcohol‐free beer. Control periods operated business as usual. Measurements The primary outcome was mean weekly volume (in litres) of draught alcoholic beer sold. The secondary outcome was mean weekly revenue [in GBP (£)] from all drinks. Analyses adjusted for randomised order, special events, season and busyness. Findings The adjusted mean difference in weekly sales of draught alcoholic beer was −20 L [95% confidence interval (CI) = −41 to +0.4], equivalent to a 4% reduction (95% CI = 8% reduction to 0.1% increase) in the volume of alcoholic draught beer sold when draught alcohol‐free beer was available. Excluding venues that failed at least one fidelity check resulted in an adjusted mean difference of −29 L per week (95% CI = −53 to −5), equivalent to a 5% reduction (95% CI = 8% reduction to 0.8% reduction). The adjusted mean difference in weekly revenue was +61 GBP per week (95% CI = −328 to +450), equivalent to a 1% increase (95% CI = 5% decrease to 7% increase) when draught alcohol‐free beer was available. Conclusions: Introducing a draught alcohol‐free beer in bars and pubs in England reduced the volume of draught alcoholic beer sold by 4% to 5%, with no evidence of the intervention impacting net revenue. [ABSTRACT FROM AUTHOR]

Background and Aims: There is concern that young people may be attracted to e‐liquid flavours, prompting long‐term vaping in naive users and potentially subsequent tobacco smoking. We aimed to review the use of e‐liquid flavours by young people and describe associations with uptake or cessation of both regular vaping and tobacco smoking, adverse effects and subjective experiences. Design Systematic review, including interventional, observational and qualitative studies reporting on the use of e‐cigarette flavours by young people (aged < 18 years). Setting: Studies published in English language from any country or cultural setting. Participants: Young people and their carers (aged < 18 years). Measurements A meta‐analysis was not possible due to substantial heterogeneity, inconsistency in reporting of flavour categorizations and non‐interventional study designs; thus, we narratively report findings. Findings In total, 58 studies were included. The quality of the evidence was extremely low. Most (n = 39) studies were cross‐sectional survey designs. In total, 11 longitudinal cohort studies assessed trajectories; eight qualitative studies reported on user experiences. Studies reported views and experiences of a total of 512 874 young people. Both cross‐sectional and longitudinal studies suggested that flavours are important for initiation and continuation of vaping. Qualitative evidence shows interest and enjoyment in flavours. There was judged to be insufficient evidence that use of e‐liquid flavours specifically is associated with uptake of smoking. No studies found clear associations between flavours and cessation in this population. We found no included reports of adverse effects of flavours. Conclusions: Flavours may be an important motivator for e‐cigarette uptake, but the role of flavours in tobacco smoking uptake or cessation is unclear. The quality of the evidence on use of e‐cigarette flavours by young people is low overall. [ABSTRACT FROM AUTHOR]