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Introduction Flavors other than tobacco flavor have been identified as a major reason for electronic nicotine delivery system (ENDS) initiation in youth and are thought to contribute to the continued use of ENDS in users of all ages. Our previous research showed a significant association between overall ENDS use and COPD. This study aims to identify the association of ENDS flavor categories with self-reported COPD. Methods The data analysis included 4909 adults from Population Assessment of Tobacco and Health (PATH) Wave 4 data who were ever established ENDS users and responded to an item about diagnosis of COPD. Weighted multivariable logistic regression models were used to examine the association between different ENDS flavors and self-reported COPD considering complex sampling design. Results Among 4909 ever established ENDS users, 418 adults (weighted percentage 9.8%) had self-reported COPD. Self-reported COPD prevalence differed between different ENDS flavor categories, with the highest (weighted percentage 19.9%) occurring among tobacco flavor users. Compared to non-tobacco flavor categories, tobacco flavor category showed significantly higher association with self-reported COPD (AOR=2.05; 95% CI: 1.20–3.53), after adjusting for potential confounding variables. No significant associations with self-reported COPD were found for other examined ENDS flavor categories including menthol/mint, fruit, candy/ desserts/other-sweets, and other flavors, compared to their corresponding non-users. Conclusions Tobacco flavored ENDS use was significantly associated with self-reported COPD. Future studies are needed to confirm the biological and epidemiological association of flavored ENDS use with COPD.

Introduction Among US adults 40 years and older, about 23% report problems with their ability to smell, and 19% report problems with their ability to taste. Chemosenses are a first line of defence against environmental hazards (e.g. fires and leaking gas). A potential risk factor of chemosensory disorders includes nicotine product use, such as cigarette use. This study aims to assess the relationship of taste and smell alterations with type of recent nicotine product use (e.g. inhaled versus smokeless), recent cigarette use, and mentholation status based on data from NHANES 2013–2014. Methods A total of 3186 men and women, 40 years and older, from NHANES 2013–2014 were assessed for smell and taste impairment, according to their recent nicotine product use. Taste impairment was identified as inability to identify quinine as bitter in the whole-mouth taste test. Impairment of smell was defined as failing to identify six or more of eight specific odors. Logistic regression models were adjusted for age, gender, and race/ethnicity. Results Approximately 13% of participants failed the smell examination. No significant association between smell examination outcome and recent nicotine product use was found, though recent cigarette use showed a trend toward positive association (OR=1.66, 95% CI: 0.76–3.63) and mentholation status showed a trend toward negative association (OR=0.57, 95% CI: 0.22–1.49) on smell examination results. About 17% of participants failed the taste examination, and trends toward positive association were seen between taste examination outcomes and both recent nicotine product use (OR=1.28, 95% CI: 0.99–1.65) and recent cigarette use (OR=1.30, 95% CI: 0.50–3.40). Conclusions Findings indicate that recent use of nicotine products has an inconsistent relationship to dysfunctions in taste and smell. However, limiting the use of inhaled nicotine products, such as from cigarette use, could prove beneficial to a person’s taste and smell ability.