BACKGROUND-AIM:
Vaping products are available in a wide range of flavors and nicotine concentrations. Research suggests that sweet and fruity flavors appeal to young people and that this is an industry strategy to target them. However, the relative influence of these factors compared to older age groups remains underexplored. Understanding the preferences of young and older adult vapers is crucial for developing effective global regulations, particularly in regions where nicotine limits are absent. This study aimed to evaluate the relative importance of nicotine concentration versus flavor in product choice and to draw conclusions regarding regulatory strategies.

METHODS:
Between 2019 and 2021, data were collected in Buffalo, New York, USA from 126 adults aged 18-54 who reported using flavored nicotine vaping products daily for at least six months. Participants completed a survey detailing their preferred flavor categories and nicotine concentrations. Each participant also provided an e-liquid sample, which was analyzed in a laboratory using gas chromatography-mass spectrometry (GC-MS) to determine the actual nicotine content. To evaluate the accuracy of self-reported information, the nicotine concentrations obtained in the survey responses were compared with laboratory results using Cohen’s kappa coefficient. Participants were also presented with a hypothetical scenario in which their preferred nicotine concentration was unavailable in their usual flavor and asked how they would respond. Differences between younger adults (18-26 years, n=61) and older adults (27-54 years, n=65) were analyzed using chi-squared tests.

RESULTS:
Fruit and sweet flavors were highly popular in both age groups (83.6% vs. 76.9%). Young adults preferred higher nicotine concentrations compared to older adults (≥24 mg/mL: 50.8% vs. 30.8%), a trend confirmed by laboratory analysis (≥24 mg/mL: 44.4% vs. 23.4%), with high agreement between self-report and lab measures (Kappa: 0.73 vs. 0.71). Most participants indicated they would maintain their usual nicotine concentration while switching flavors if their preferred flavor was unavailable (60.7% vs. 60.0%).

CONCLUSIONS:
Sweet and fruit flavors appeal to older people as well as young adults. Notably, the study showed that younger adult vapers prioritize higher nicotine concentrations, which highlights potential dependence risks. Both younger and older adults consistently prioritize nicotine strength over flavor, suggesting that while flavors attract, it is nicotine that retains users. These findings emphasize the need for global regulation of nicotine concentrations in vaping products to reduce potential harm and prevent escalation of use among young adults. However, emerging evidence suggests that such regulation may be ineffective, as reducing nicotine concentration has been shown to alter puffing behavior. Therefore, when developing comprehensive nicotine content regulations, other product characteristics, including device power and user puffing behavior, should also be considered.