Influence of Electronic Cigarette Characteristics on Susceptibility, Perceptions, and Abuse Liability Indices among Combustible Tobacco Cigarette Smokers and Non-Smokers.

Cosima Hoetger,Caroline O Cobb,Nicole E Nicksic,Andrew J Barnes,Rose S Bono

doi:10.3390/ijerph16101825

Cosima Hoetger, Caroline O Cobb + Show 3 more

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https://doi.org/10.3390/ijerph16101825

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Abstract

This study assessed how electronic cigarette (ECIG) characteristics amenable to regulation—namely nicotine content, flavor, and modified risk messages—impact ECIG use susceptibility, harm/addiction perceptions, and abuse liability indices among combustible tobacco cigarette (CTC) smokers and non-smokers. CTC smokers and non-smokers varying in ECIG use recruited via Amazon Mechanical Turk (MTurk) completed an online survey in 2016 (analytic n = 706). Participants were randomly assigned to one of eight conditions differing in ECIG characteristics: nicotine content (no, low, high), flavor (menthol, tobacco, fruit), or modified risk message (reduced harm, reduced carcinogen exposure). Regressions assessed ECIG susceptibility, harm/addiction perceptions, and abuse liability indices (purchase task measures of breakpoint/intensity) within each regulatory domain (nicotine content, flavor, message) and their interactions with CTC/ECIG status. Differential effects on ECIG susceptibility, harm/addiction perceptions, and abuse liability indices were observed by regulatory domain with many effects moderated by CTC/ECIG status. ECIG nicotine content and flavor conditions were the most influential across outcomes. Greater nicotine content, tobacco-flavored and reduced carcinogen exposure ECIGs were more highly preferred by CTC smokers with some differing preferences for non-users. Findings reinforce consideration of discrete ECIG preferences across tobacco use status to improve regulatory efficacy.

Highlights

Recent increases in the use of alternative tobacco products, such as electronic nicotine delivery devices or electronic cigarettes (ECIGs), especially among youth and young adults in the United States (US) and elsewhere have raised concerns about the public health impact of tobacco use [1,2]
Regulatory domains, 64% of non-users and combustible tobacco cigarette (CTC)-only smokers were susceptible to ECIG use
CE = carcinogen exposure; CTC = Combustible Tobacco Cigarette; ECIG = e-cigarette; AOR = Adjusted Odds Ratio; Bold values indicate statistical significance (p < 0.05). a Due to cell size frequency, this response category was not included in analyses for the susceptibility to ECIG use outcome. Results from this online randomized design suggest that three ECIG regulatory domains—nicotine content, flavors, and modified risk messages—can influence measures of susceptibility to ECIG use, perceived ECIG relative harm and addiction, and ECIG abuse liability indices, and many of these effects were moderated by CTC/ECIG status

Summary

Introduction

Recent increases in the use of alternative tobacco products, such as electronic nicotine delivery devices or electronic cigarettes (ECIGs), especially among youth and young adults in the United States (US) and elsewhere have raised concerns about the public health impact of tobacco use [1,2]. 2016, 15.4% of US adults reported having used ECIGs at some point, with individuals aged 18–24 representing nearly one quarter of these users [3]. In 2014, almost half (47.6%) of combustible tobacco cigarette (CTC) smokers from a national US sample reported having used ECIGs at some point [4]. There is limited data on the short and long-term health effects of ECIGs as well as their. Res. Public Health 2019, 16, 1825; doi:10.3390/ijerph16101825 www.mdpi.com/journal/ijerph

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