Tobacco Regulatory Policy Research Articles

Racial Differences in Nicotine Reduction: Pooled Results from Two Double-Blind Randomized Controlled Trials.

Tobacco regulatory policies are generally intended to apply to all segments of the population and to be equitable. Results from clinical trials on switching from commercial cigarettes to reduced nicotine cigarettes have included black populations but race-specific findings are not widely reported. Data were pooled from two parallel randomized controlled trials of gradually reduced nicotine in cigarettes from 11.6mg per cigarette down to 0.2mg nicotine (very low nicotine content; VLNC) vs. usual nicotine content (UNC) cigarettes (11.6mg) over an 18-week period in smokers with low socioeconomic status (SES) and mental health conditions, respectively. We used linear regression to determine the potential effects of cigarettes and biomarker reductions (blood cotinine and exhaled carbon monoxide) when using VLNC study cigarettes. An intention-to-treat (ITT) analysis included all randomized participants regardless of adherence to the protocol. A secondary compliance analysis compared control subjects (11.6mg cigarettes) only to those switched to low nicotine cigarettes who were biochemically determined to be compliant to exclusively using VLNC cigarettes. Both Black and White VLNC smokers had significantly lower plasma cotinine and exhaled carbon monoxide compared to those randomized to UNC cigarettes. The treatment × race interaction term was not significant for the outcome measures in both the ITT and secondary compliance analyses, except for cotinine in the ITT analysis (Whites: - 190ng/mL vs. Blacks: - 118ng/mL; p = 0.05). A reduced nicotine regulation for cigarettes would result in substantial reduction in exposure to nicotine and toxicants in Black and White smokers.

Identifying e-cigarette content on TikTok: Using a BERTopic Modeling approach.

The use of hashtags is a common way to promote e-cigarette content on social media. Analysis of hashtags may provide insight into e-cigarette promotion on social media. However, the examination of text data is complicated by the voluminous amount of social media data. This study used machine learning approaches (i.e., Bidirectional Encoder Representations from Transformers [BERT] topic modeling) to identify e-cigarette content on TikTok. We used 13 unique hashtags related to e-cigarettes (e.g., #vape) for data collection. The final analytic sample included 12,573 TikTok posts. To identify the best fitting number of topic clusters, we used both quantitative (i.e., coherence test) and qualitative approaches (i.e., researchers checked the relevance of text from each topic). We, then, grouped and characterized clustered text to each theme. We evaluated that N=18 was the ideal number of topic clusters. The 9 overarching themes were identified: Social media and TikTok-related features (N=4; "duet", "viral"), Vape shops and brands (N=3; "store"), Vape tricks (N=3; "ripsaw"), Modified use of e-cigarettes (N=1; "coil", "wire"), Vaping and girls (N=1; "girl"), Vape flavors (N=1; "flavors"), Vape and cigarettes (N=1; "smoke"), Vape identities and communities (N=1; "community"), and Non-English language (N=3; Romanian and Spanish). This study used a machine learning method, BERTopic modeling, to successfully identify relevant themes on TikTok. This method can inform future social media research examining other tobacco products, and tobacco regulatory policies such as monitoring of e-cigarette marketing on social media. This study can inform future social media research examining other tobacco products, and tobacco regulatory policies such as monitoring of e-cigarette marketing on social media.

National longitudinal tobacco product discontinuation rates among US youth from the PATH Study: 2013–2019 (waves 1–5)

ObjectiveDetermine longitudinal tobacco product discontinuation rates among youth (ages 12–17 years) in the USA between 2013 and 2019.MethodsThe Population Assessment of Tobacco and Health Study, a nationally representative, longitudinal cohort...

Adolescents and Young Adults Use of Social Media and Following of e-Cigarette Influencers

Background With high rates of both e-cigarette and social media use among adolescents and young adults (AYAs), social media influencers who promote e-cigarettes are particularly concerning but are understudied. We examined the association between AYAs’ use of 11 different social media platforms (e.g. Facebook, Twitter, Instagram, TikTok, and YouTube) and exposure to social media e-cigarette influencers. Objectives From November 2022 to February 2023, we conducted an online, US national survey of AYAs (14–29 years) who endorsed past-30-day e-cigarette use. We used binomial logistic regression to examine associations between the frequency of use of each social media platform and following e-cigarette influencers, controlling for age, sex, race, ethnicity, e-cigarette use frequency, and other tobacco and substance use (i.e., alcohol and cannabis). The model was stratified by adolescents (14–17 years; n = 293) and young adults (18–29 years; n = 654). Results The most frequently used social media platforms were Snapchat, TikTok and Instagram among adolescents, and YouTube, Instagram and TikTok among young adults. In adjusted models, following e-cigarette influencers was associated with more frequent use of TikTok (adjusted odds ratio [95% CI]; 1.33 [1.05, 1.68]) and Pinterest (1.18 [1.02, 1.38]) among adolescents, and more frequent use of Twitter (1.17 [1.06, 1.29]) among young adults. Conclusions The use of different platforms was associated with exposure to e-cigarette influencers: TikTok and Pinterest among adolescents and Twitter among young adults. These findings can inform tobacco regulatory policy and social media platform restrictions of e-cigarette influencers on the platforms that are popular among AYAs.

Reactions to a Hypothetical Ban of Open-System Electronic Cigarettes Among People Who Currently Use Electronic Cigarettes.

Policies limiting electronic cigarette (ECIG) device and liquid characteristics have been considered to prevent dependence potential and youth product appeal. "Open-system" ECIGs allow people to adjust device and liquid characteristics, which may undermine these policies. This study examined anticipated reactions to a policy prohibiting the sale of open-system ECIG devices in the United States using concept mapping. In 2020, adults who reported ECIG use in the past 30 days (n = 70; 45.1% women; mean age = 33.0, SD = 10.6) recruited from a research registry of individuals from across the United States provided statements into a shared list that completed a prompt: "If open-system vaping devices were no longer sold in the US and only closed-system vaping devices were available, what is a specific reaction or response you would have?" at a study website. Participants rated statements (1-7) on how true the statements were for them. Multidimensional scaling and hierarchical cluster analyses were used to identify thematic clusters. Mean ratings of statements were calculated and compared based on the type of ECIG used and current cigarette smoking status. Participants generated 85 unique statements. The analysis identified eight themes that were organized into two broad groups. The first group of five clusters described behavioral responses to the hypothetical policy (Loopholes, Switch to Closed-System ECIGs, Legal Approaches to Use Open-System ECIGs, ECIG Use Cessation, Switch to non-ECIG Products). The second group of three clusters described psychological responses to the hypothetical policy (Closed-System ECIG Cons, Psychological Responses, Policy Outcome Concerns). While a ban on open-system ECIG devices may have positive impacts on public health, policy loopholes, and consumer behaviors may undermine the policy. Efforts to support policy enforcement could increase policy effectiveness. Open-system electronic cigarettes (ECIGs) that allow people who use ECIGs to modify ECIG device and liquid characteristics may limit the effectiveness of policies that establish product standards which attempt to limit nicotine delivery and flavor content in ECIG liquids. This study identified predicted reactions to a hypothetical policy prohibiting the sale of open-system ECIGs in the United States. Results suggest that people who use ECIGs may view a policy prohibiting open-system ECIGs unfavorably, but would be willing to use closed-system ECIGs. However, many ECIG users may attempt to find loopholes in the policy or alternative sources to purchase open-system ECIGs if open-systems were banned. Future research should identify strategies for tobacco regulatory policy enforcement to increase effectiveness.

Electronic Nicotine Delivery Systems (ENDS), Marginalized Populations, and Tobacco Regulatory Policies.

Electronic Nicotine Delivery Systems (ENDS), Marginalized Populations, and Tobacco Regulatory Policies.

E-cigarette Use Patterns, Flavors, and Device Characteristics Associated With Quitting Smoking Among a U.S. sample of Adults Using E-cigarettes in a Smoking Cessation Attempt.

Many adults who smoke cigarettes use e-cigarettes to try to quit smoking; however, some are not successful. Identifying factors that are associated with successfully quitting smoking using e-cigarettes is important for maximizing cigarette cessation. Online survey data were collected in 2021 from 857 adults in the United States who reported using e-cigarettes in a recent attempt to quit smoking. Survey items assessed patterns of e-cigarette use and device characteristics (flavors, device, and nicotine) used when trying to quit smoking. Multivariable linear regression models examined characteristics associated with the longest duration of smoking abstinence when using e-cigarettes to try to quit. The average duration of smoking abstinence when using e-cigarettes during a quit attempt was 65 days (SD = 104). In the multivariable model, greater frequency of e-cigarette use when quitting and abruptly switching to e-cigarettes from cigarettes (vs. gradually reducing) were significantly associated with longer durations of abstinence (p < .001). Preference for non-tobacco (relative to tobacco) flavors and nicotine concentration were not associated with duration of abstinence, although preference for rechargeable pod and mod device types (vs. cig-a-likes) was associated with longer durations of abstinence. Patterns of e-cigarette use were related to abstinence duration, which may provide guidance for adults who are using e-cigarettes to quit smoking to encourage complete substitution and maximize smoking cessation. Findings indicate that non-tobacco e-cigarette flavors and nicotine strength are not related to longer durations of cessation success for adults, which may inform tobacco regulatory policies limiting these constituents to protect public health. This study provides important new information about the characteristics of e-cigarettes used during an attempt to quit smoking among adults across the United States and identifies factors associated with quitting success. Patterns of e-cigarette use were associated with longer durations of abstinence. In contrast, few e-cigarette characteristics were associated with abstinence. Although preference for some pod and mod device types was associated with longer abstinence duration compared to earlier cig-a-like devices, preference for non-tobacco (vs. tobacco) flavor and nicotine concentration were not associated with abstinence. Findings may help inform guidance for adults using e-cigarettes to quit smoking and support tobacco regulatory policies.

National longitudinal tobacco product cessation rates among US adults from the PATH Study: 2013–2019 (waves 1–5)

ObjectiveTo report on longitudinal tobacco product cessation rates, by product type, among adults (ages 18+ years) in the USA between 2013 and 2019.MethodsThe Population Assessment of Tobacco and Health Study,...

Using an experimental tobacco marketplace to pilot test the substitutability of JUUL e-cigarettes and other alternative nicotine and tobacco products for conventional cigarettes among vulnerable populations

The Experimental Tobacco Marketplace (ETM) is an online research marketplace where increasing the cost of cigarettes is used to investigate the substitutability of other fixed-price tobacco products such as electronic nicotine delivery systems (ENDS). The ETM is useful for modeling effects of potential policy changes on use of various concurrently available products. To our knowledge, the ETM has not been used to investigate substitutability of newer generation e-cigarettes or populations at increased risk for smoking, heavy smoking, nicotine dependence, and smoking-attributable adverse effects. In the current pilot study, participants were 30 adult daily smokers with socioeconomic disadvantage or comorbid psychiatric conditions (substance-use disorder or mental illness). In each session, cigarette prices increased ($0.12, $0.25, $0.50, $1.00. and $2.00 per cigarette) while prices for alternative products remained fixed. Across three ETM sessions, either all products, all products except little cigars and cigarillos (LCCs), or all products except ENDS (JUUL e-cigarettes) were available. Linear regression was performed on individual participant data using log-transformed cigarette price to determine demand and substitution. Cigarette demand decreased as price increased across sessions (significantly non-zero slopes, ps ≤ 0.0001). When all products were available, ENDS substitution increased as cigarette price increased (significantly non-zero slope, p = .016). When LCCs were unavailable, ENDS again were a significant substitute (p = .008). When ENDS were unavailable, LCCs did not substitute (ps ≥ 0.48). In all sessions, participants rarely purchased other products (e.g., snus). Overall, ENDS were the most robust substitute for cigarettes, further underscoring the potential importance of ENDS availability on the impact of tobacco regulatory policies.

Marketing claims on websites of brick-and-mortar vape shops in the Greater Los Angeles area.

INTRODUCTIONBrick-and-mortar vape shops have increased in recent years, but there is limited research on the types of marketing claims consumers are exposed to on their websites – a dominant channel for marketing electronic nicotine delivery systems (ENDS). We investigated the websites of vape shop retailers in the Greater Los Angeles Area to describe their ENDS marketing claims.METHODSData collection occurred between 25 March and 20 June 2020. Of the 104 brick-and-mortar vape shops identified, 37 were found to have active websites. Rules were established to analyze website content. ENDS Marketing Claims were coded as the presence or absence of: 1) a direct claim of ENDS as a quitting aid; 2) a disclaimer that ENDS are not approved as smoking cessation devices (i.e. ENDS products are not FDA-approved for smoking cessation); 3) a direct claim of ENDS as healthier/safer than combustible cigarettes; and 4) direct claims regarding social benefits, including that ENDS are less expensive, can be used in more places, are cleaner or less messy/smelly, and are more socially accepted than combustible cigarettes.RESULTSSmoking cessation-related benefits were claimed most frequently (43%), followed by health-related claims (30%), and disclaimers that ENDS are not approved as smoking cessation devices (24%). More than half (56.4%) of websites had an age restriction, requiring the user to click on a box to state that they were aged ≥21 years to view the site. None required proof or outside verification of age.CONCLUSIONSBrick-and-mortar vape shops in the Greater Los Angeles Area are marketing ENDS on their websites as a healthier alternative to smoking cigarettes. Although half of the websites had an age gate popup that consumers see when they enter the website, action is needed to better enforce age restriction on access to vape shop websites. Utility for smoking cessation was claimed most frequently, followed by the claims of healthier alternatives to smoking cigarettes, and disclaimers that ENDS are not approved as smoking cessation devices. We discuss implications for tobacco regulatory policy.

Centering racial justice for Black/African American and Indigenous American people in commercial tobacco product regulation

Although overall health in the United States (US) has improved dramatically during the past century, long-standing health inequities, particularly the unequal and unjust burden of tobacco-related disease and death among racialized populations, persist. A considerable gap exists in our understanding of how commercial tobacco product regulations and policies cause and/or exacerbate race-based health inequities among Black/African American (B/AA) and Indigenous American people. The purpose of this paper is to 1) describe how existing US commercial tobacco regulatory policies may contribute to structural racism and undermine the full benefits of tobacco prevention and control efforts among B/AA and Indigenous American groups; and 2) initiate a call to action for researchers and regulators of tobacco products to examine policies using an equity lens. These actions are imperative if empirically-informed regulation of commercial tobacco products is to address health equity.

The Illegal Experimental Tobacco Marketplace I: Effects of Vaping Product Bans.

Banning vaping products may have unintended outcomes, such as increased demand for illegal products. This study experimentally examined the effects of a vaping ban and a flavored vaping ban on the probability of purchasing illicit vaping products, and factors affecting purchasing from a hypothetical illegal marketplace. A crowdsourced sample of exclusive cigarette smokers, exclusive e-cigarette users, and frequent dual users (n = 150) completed hypothetical purchasing trials in an Experimental Tobacco Marketplace under three conditions (no ban, vaping ban, and flavored vaping ban). Participants chose to purchase in a hypothetical legal experimental tobacco marketplace (LETM) or illegal experimental tobacco marketplace (IETM). Vaping products were available in each marketplace depending on the condition. Other tobacco products were always available in the LETM. A hypothetical illicit purchase task with five fine amounts assessed the effect of monetary penalties. Participants from all groups were more likely to purchase from the IETM when product availability in the LETM was more restricted, with e-cigarette users being most affected. The likelihood of purchasing illegal products was systematically decreased as monetary penalties associated with the IETM increased, with e-cigarette users showing greater persistence in defending their illicit purchases. Restricting vaping products from the marketplace may shift preference towards purchasing vaping products in the illegal marketplace. Nevertheless, penalties imposed on consumer's behavior might be effective in preventing illicit trade. The IETM is a methodological extension that supports the utility and flexibility of the ETM as a framework for understanding the impact of different tobacco regulatory policies. This study suggests that limiting or banning vaping products as a possible strategy to reduce the adverse effects of vaping products could result in some tobacco-users seeking banned products from illegal sources. Monetary fines were shown to reduce illegal purchases. Therefore, policymakers should consider implementing strategies that may mitigate illegal purchases.

Barriers to Tobacco Control in China: A Narrative Review

This research chooses the method of narrative literature review to analyze the barriers in implementing tobacco regulatory policies in China and explore the strategies that can overcome these challenges. China is the world’s largest producer and consumer of tobacco products. Although the prevalence of cigarette smoking declined from 34.5% to 27.7% between 1984 and 2015, the reduction over the 30 years has been slow. Therefore, effective tobacco regulatory policies are necessary. However, as the tobacco industry is one of the major sources of government revenue and an indispensable part of the national economy, the implementation of tobacco regulatory policies faces many challenges. In terms of the institutional dimension, the ambiguous attitude of national institutions and tobacco companies’ development strategies impede the enforcement of tobacco policies. In addition, the primary economic barrier to tobacco control is the unwillingness of the government to raise value-added tax on tobacco. Finally, the social customs of exchanging individual cigarettes and gifting packaged cigarettes among adults and juveniles in China hinder the implementation of tobacco regulatory policies. In this case, a combined strategy of top-down and bottom-up approaches can remove these barriers, such as using the authoritative power to control tobacco use and raising non-smokers’ awareness of smoking risks and public education.

Reducing tobacco use among women of childbearing age: Contributions of tobacco regulatory science and tobacco control.

Tobacco use has unique, adverse health consequences for reproductive-aged women, particularly should these women become pregnant. Thus, successful efforts to reduce tobacco use among this population have strong potential to improve public health and reduce health disparities. The present review examines contributions to reducing tobacco use among women of childbearing age spanning the domains of tobacco regulatory science and tobacco control from the passage of the Family Smoking Prevention and Tobacco Control Act in 2009 through September 2019. In the domain of tobacco regulatory science, such efforts include research conducted by various National Institutes of Health/Food and Drug Administration (FDA)-supported Tobacco Centers of Regulatory Science, epidemiological surveillance studies, as well as studies examining the potential impact of tobacco regulatory policies currently under consideration by the FDA (e.g., reduced nicotine content cigarettes, health warning labels). Tobacco control efforts within this same 10-year timeframe include developments in pharmacological and psychosocial approaches to promoting tobacco cessation, mHealth interventions, and tobacco control policy. Emerging issues pertinent to ongoing efforts to reduce tobacco use within the domains of both tobacco regulatory science and tobacco control are also reviewed, including e-cigarettes, comorbid health conditions, course of tobacco and other drugs of abuse, and obstacles to the dissemination and implementation of evidence-based treatment and policy. Although the past decade has seen numerous important contributions to reducing tobacco use among reproductive-aged women within both domains, existing obstacles must be surmounted to continue reducing tobacco use and protecting health among this population. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Correlates of youth vaping flavor preferences.

Among youth who use electronic nicotine delivery systems (ENDS), e-cigarettes are often the first tobacco product tried. Flavor is a common reason for experimentation with e-cigarettes. This study assessed flavor preferences and the choice of ENDS as an initial product among youth by selected demographic characteristics. The analysis sample included 1549 participants who had ever tried ENDS, drawn from a national online survey of youth aged 13-18 in 2017. Fruit was the most common favorite flavor among ENDS users, followed by menthol/mint/wintergreen. Preference for flavor varied by age, sex and racial/ethnic background. ENDS were the tobacco products most likely to be tried first, particularly among participants under age 17. Those who preferred fruit flavor were twice as likely to have tried ENDS first, compared to those with other flavor preferences, while those who preferred menthol/mint/wintergreen flavor were half as likely to have tried ENDS first. Our findings support an association between flavor and ENDS use. Our research supports previous findings indicating that: 1) flavor is one of the primary reasons for experimentation with ENDS among youth; 2) fruit flavor is strongly associated with use of ENDS as the first tobacco product; and 3) preference of fruit flavor varies by age, sex and racial/ethnic background. These findings have relevance for developing targeted messages for specific youth audiences and implications for tobacco regulatory policies. In addition to January 2020 federal regulations, the authors recommend tighter restrictions, specifically that the marketing and sale of all e-cigarette flavors other than tobacco be eliminated.

Evaluating the effect of switching to non-menthol cigarettes among current menthol smokers: an empirical study of a potential ban of characterising menthol flavour in cigarettes

IntroductionMenthol cigarette use remains a serious public health problem, prompting the consideration of tobacco regulatory efforts to ban menthol cigarettes. The current study uses a novel empirical design to model...

Clinical and Economic Outcomes Associated with Concurrent Use of Opioids and Benzodiazepines in the Elderly Medicare Population

Certain sub-populations (e.g., those living in poverty, racial/ethnic minorities, sexual minorities, and people with mental health conditions) experience profound tobacco-related health disparities. Ongoing surveillance of use of various combustible tobacco products by priority populations of cigarette smokers is needed, particularly in the changing U.S. tobacco regulatory landscape. In 2018 the FDA announced their consideration of a tobacco product standard that would limit the level of nicotine in combustible cigarettes, and such regulations should consider potential effects on tobacco-related disparities. If certain subgroups of cigarette smokers are also using other combustible products, they may be particularly likely to continue dual use or switch to exclusive use of those products if a nicotine reduction standard only applies to cigarettes. Accordingly, this study provided recent U.S. nationally representative data on use of other combustible tobacco products among current cigarette smokers by sociodemographic characteristics. Data were drawn from current cigarette smokers (n = 2559) in 2016 and 2017 U.S. nationally representative surveys. Associations between sociodemographic variables (poverty status, education, race/ethnicity, sexual orientation, and mental health status) with use of little cigars and cigarillos (LCCs), traditional cigars, and hookah were examined. Among current cigarette smokers, those living in poverty, racial/ethnic minorities, and those with mental health conditions were particularly likely to use LCCs. Racial/ethnic minority smokers were more likely to smoke traditional cigars. Non-heterosexual smokers, Hispanic smokers, and smokers with mental health conditions were particularly likely to use hookah. These findings have important implications for tobacco regulatory policy and other efforts to combat tobacco-related disparities.

E-cigarettes: Tobacco policy and regulation.

The purpose of this review is to describe current trends in e-cigarette use, provide an overview of the potential health risks and benefits, and discuss tobacco policy and regulatory considerations. E-cigarette use is popular among youth and adults, despite limited evidence about the long-term risks or benefits. Internationally there is wide variability in how e-cigarettes are classified, which has also led to large differences in regulations on these products. Regulatory policies that strike a balance between the potential benefit of these devices for adult smokers who are trying to quit smoking with reducing the appeal and addictive potential for youth are critically needed. Continued research on the health effects and consequences of e-cigarette use will be essential to inform e-cigarette product standards and tobacco regulatory policies as scientific research strives to keep pace with the ever-changing landscape of e-cigarette technology.

Metal concentrations in electronic cigarette aerosol: Effect of open-system and closed-system devices and power settings

BackgroundElectronic cigarettes (E-cigarettes) generate aerosol containing metal contaminants. Our goals were to quantify aerosol metal concentrations and to compare the effects of power setting and device type (closed-system vs. open-system) on metal release. MethodsAerosol samples were collected from two closed-system devices (a cigalike and pod) and two open-system devices (mods). Each open-system device was operated at three different power settings to examine the effect of device power on metal release. Concentrations of 14 metals in e-cigarette aerosol collected via droplet deposition were measured using inductively coupled plasma mass spectroscopy. Aerosol metal concentrations were reported as mass fractions (μg/kg) in the e-liquid. ResultsFor open-system device 1 (OD1), median arsenic (As), chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), lead (Pb), antimony (Sb), tin (Sn), and zinc (Zn) concentrations increased 14, 54, 17, 30, 41, 96, 14, 81, 631, and 7-fold when the device power was increased from low (20 W) to intermediate (40 W) setting. When the power was further increased from intermediate (40 W) to high (80 W) setting, concentrations of As, Cr, Cu, Mn, Ni, and Sb did not change significantly. For open-system device 2 (OD2), Cr and Mn concentrations increased significantly when device power was increased from low (40 W) to intermediate (120 W) setting, and then decreased significantly when power was further increased from intermediate (120 W) to high (200 W) setting. Among the four devices, aerosol metal concentrations were higher for the open-system than the closed-system devices, except for aluminum (Al) and uranium (U). For Cr, median (interquartile range) concentrations (μg/kg) from the open-system devices were 2.51 (1.55, 4.23) and 15.6 (7.88, 54.5) vs. 0.39 (0.05, 0.72) and 0.41 (0.34, 0.57) for the closed-system devices. For Ni, concentrations (μg/kg) from the open-system devices were 793 (508, 1169) and 2148 (851, 3397) vs. 1.32 (0.39, 3.35) and 11.9 (10.7, 22.7) from the closed-system devices. Inhalation of 0% and 100% of samples from OD1, 7.4% and 88.9% from OD2 by typical e-cigarette users would exceed chronic minimum risk levels (MRL) of Mn and Ni, respectively. No MRL exceedance was predicted for the closed-system devices. A large fraction of users of OD1 (100%) and OD2 (77.8%) would be exposed to Ni levels higher than those from reference tobacco cigarette 3R4F. ConclusionsOur findings suggest that power setting and device type affect metal release from devices to aerosol which would subsequently be inhaled by users. Metal concentrations from open-system devices first increased with device power, and then leveled off for most metals. Open-system devices generate aerosol with higher metal concentrations than closed-system devices. These findings inform tobacco regulatory science, policy makers and health professionals on potential metal health risks associated with e-cigarette use, design and manufacturing.

Initial application of a human laboratory model for estimating the motivational substitutability of e-cigarettes for combustible cigarettes.

This pilot study tested a novel human laboratory model for estimating the extent to which electronic cigarettes (e-cigarettes) serve as motivational substitutes for combustible cigarettes. The model assesses 3 parameters of substitutability, including the: (a) increase in motivational reward value of e-cigarettes after tobacco deprivation; (b) reduction in the reward value of combustible cigarettes after e-cigarette administration; and (c) comparability of the withdrawal-suppressing effects of e-cigarettes versus combustible cigarettes. Dual users (daily smokers, vaped 4+ days/week, M age = 35.3) attended 4 visits after 16-h tobacco product abstinence. For 2 visits, participants completed withdrawal measures and a task assessing smoking's reward value preceded by either: satiation by vaping or sustained tobacco product deprivation. For 2 other visits, participants completed withdrawal measures and a task assessing vaping's reward value preceded by either: continued deprivation versus satiation by smoking. Tobacco product deprivation (vs. satiation by smoking) increased vaping's reward value, indicated by nonsignificantly greater likelihood of initiating vaping versus abstaining for money (d = -.26; adjusted p [padj] = .08) and more vaping episodes purchased (β = .22; padj = .08). Satiation by vaping (vs. deprivation) nonsignificantly reduced smoking initiation (d = .46; padj = .09) and significantly decreased number of cigarettes purchased (β = -.29; padj = .04). Relative to deprivation, vaping suppressed withdrawal-related negative affect, smoking and vape urge, and anhedonia (ds ≥ .54). The magnitude of vaping-induced and smoking-induced withdrawal suppression did not significantly differ for all outcomes other than smoking urge, which was more strongly reduced by smoking (d = -1.57) than vaping (d = -.64). Future application and extension of this model may advance tobacco regulatory science and policy addressing e-cigarette use among smokers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).