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Olson CK, Sherwood N, Berkane M, Gilligan K, McKinney WJ. Perceptions, intentions, and actual use of a consumer nicotine gum. Harm Reduct J 2023; 20:132. [PMID: 37700314 PMCID: PMC10498549 DOI: 10.1186/s12954-023-00864-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/30/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Little is known about perceptions, use intentions, and behaviors of adults regarding nicotine gum that is marketed and regulated as a consumer product rather than as a medicinal nicotine replacement therapy (NRT). METHODS Survey data were collected from a Qualtrics online panel (N = 1000) of adults who had never used a consumer nicotine gum, recruited based on smoking behavior, and from current and former purchasers of one commercially available nicotine gum product (LUCY Chew and Park), recruited via emails to a customer database (N = 500). In addition to descriptive cross-sectional analyses, logistic regression was used to estimate the probability of intent to try and of product appeal among these different groups. RESULTS Among online panel respondents, individuals who smoked with and without plans to quit showed high intention to try the product (odds ratios 15.6 [95% CI 9.3, 27.6] and 9.8 [95% CI 5.8, 17.3] respectively, compared to people who formerly smoked) and persons who had never smoked showed low intentions to try. These results stood regardless of flavor. Among current and former purchasers of the study product, 43.4% of persons who had smoked cigarettes regularly indicated they were motivated to try the product "to help me quit smoking." Only 0.6% of young adult consumers of the nicotine gum (aged 21-30) had not tried tobacco products previously. CONCLUSIONS Consumer nicotine gum does not appear to attract those who have never used a tobacco product and the results for young adults suggest minimal appeal to youth. The study product was used primarily by individuals who currently smoke and/or use e-cigarettes but who wished to quit or reduce consumption. These results suggest that a consumer nicotine gum may reduce harm by substituting for higher-risk products such as combustible cigarettes.
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Affiliation(s)
- Cheryl K Olson
- Cheryl K. Olson, Sc.D., LLC, 633 Elm Street, San Carlos, CA, 94070, USA.
| | - Neil Sherwood
- Neil Sherwood Consulting, Avenue Alfred Cortot 21, Nyon, 1260, Switzerland
| | - Maia Berkane
- Kevin D. Oden & Associates, LLC, 505 Montgomery Street, San Francisco, CA, 94111, USA
| | - Karin Gilligan
- McKinney Regulatory Science Advisors, LLC, 4940 Old Main Street, Unit 603, Henrico, VA, 23231, USA
| | - Willie J McKinney
- McKinney Regulatory Science Advisors, LLC, 4940 Old Main Street, Unit 603, Henrico, VA, 23231, USA
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Edwards SH, Hassink MD, Taylor KM, Vu AT. Quantitative measurement of harmful and potentially harmful constituents, pH, and moisture content in 16 commercial smokeless tobacco products. Regul Toxicol Pharmacol 2022; 133:105199. [PMID: 35662636 DOI: 10.1016/j.yrtph.2022.105199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/02/2022] [Accepted: 05/28/2022] [Indexed: 11/24/2022]
Abstract
Smokeless tobacco products expose adult and youth tobacco users to various addictive and carcinogenic constituents that can cause long-term nicotine dependence and oral cancers. In this study, nicotine, benzo[a]pyrene (B[a]P), N'-nitrosonornicotine (NNN), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), acetaldehyde, crotonaldehyde, formaldehyde, moisture, and pH levels in 16 smokeless tobacco products were measured on a wet-weight basis (wwb). In addition, change in analytical variability with increasing replicate measurements was assessed. Total nicotine in the products varied from 6.2 to 35.5 mg/g. The percentage of total nicotine in the unprotonated form ranged from 0.1 to 62%; whereas, product moisture varied from 7.4 to 57%. The quantities of harmful and potentially harmful constituents (HPHCs) range from 0.46 to 179.9 ng/g for B [a]P, 270-12206 and 81-20716 ng/g for NNN and NNK, respectively, and 0.33-6.85 and 0.13-5.67 μg/g for acetaldehyde and formaldehyde, respectively. This study shows wide variation in smokeless tobacco product HPHC quantities. The results also show that analytical variability stabilizes after seven replicate measurements.
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Affiliation(s)
- Selvin H Edwards
- Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Avenue, Document Control CenterBuilding 71, Room G335, Silver Spring, MD, 20993-002, USA.
| | - Matthew D Hassink
- Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Avenue, Document Control CenterBuilding 71, Room G335, Silver Spring, MD, 20993-002, USA
| | - Kenneth M Taylor
- Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Avenue, Document Control CenterBuilding 71, Room G335, Silver Spring, MD, 20993-002, USA
| | - An T Vu
- Center for Tobacco Products, Food and Drug Administration, 10903 New Hampshire Avenue, Document Control CenterBuilding 71, Room G335, Silver Spring, MD, 20993-002, USA
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Noh JW, Kim MH, Lee Y, Kwon YD, Kim KB, Lee HJ, Yoo KB. Association between smokeless tobacco use and cigarette smoking amount by age. BMC Public Health 2022; 22:505. [PMID: 35292000 PMCID: PMC8922879 DOI: 10.1186/s12889-022-12929-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/07/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The use of smokeless tobacco has increased worldwide among young people. This study aimed to investigate the association between smokeless tobacco use and cigarette smoking amount in adult smoker groups stratified by age. METHOD 2013-2015 National Health Interview Survey was used. A total of 19,635 subjects were included in our analysis. Propensity score matching was used to adjust for selection and any other bias. Generalized estimating equation was used to analyze the association between smokeless tobacco use and cigarette smoking amount by age. RESULTS All 580 smokeless tobacco users were matched to 2,900 non-smokeless tobacco users. Among those who were aged under 30, smokeless tobacco use was positively associated with the number of cigarettes used per day. Smokeless tobacco users who were aged under 30 and tried quitting smoking used more cigarettes than those who did non-smokeless tobacco users. CONCLUSIONS The present study revealed that among those who were aged under 30, smokeless tobacco use was positively associated with the number of cigarettes used per day. This study could contribute to understand the behaviors and tendencies of smoking in young adulthood and to establish effective smoking cessation methods for their age.
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Affiliation(s)
- Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, 220710 Korea
| | - Min-Hee Kim
- Department of Physical Therapy, Eulji University, Seongnam, Republic of Korea
| | - Yejin Lee
- Department of Public Health, Graduate School, Korea University, Seoul, 02841 Republic of Korea
| | - Young Dae Kwon
- Department of Humanities and Social Medicine, College of Medicine and Catholic Institute for Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyoung-Beom Kim
- Department of Health Administration, Dankook University, Yongin, Republic of Korea
| | - Hae-Jeung Lee
- Department of Food & Nutrition, Gachon University, Seongnam, Republic of Korea
| | - Ki-Bong Yoo
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, 220710 Korea
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Male D, Kansabe S, Lukwata H, Rubanga A, Siddiqi K, Bauld L, McNeill A, Dobbie F. Smokeless Tobacco in Uganda: Perceptions among Tobacco Control Stakeholders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3398. [PMID: 35329084 PMCID: PMC8950400 DOI: 10.3390/ijerph19063398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/27/2022] [Accepted: 03/11/2022] [Indexed: 12/10/2022]
Abstract
The use and sale of smokeless tobacco (SLT) is prohibited in Uganda under the Tobacco Control Act (TCA), 2015. Nonetheless, SLT products remain available, and there are limited and inconsistent data on SLT users. Additionally, the perceptions of tobacco control stakeholders on SLT are unknown, making it difficult to determine barriers to enforcing the ban. This study examined perceptions of tobacco control stakeholders regarding SLT in Uganda. Qualitative semi-structured interviews were conducted with stakeholders who were purposively selected from ministries, semi-autonomous government agencies and Civil Society Organizations. Interviews explored knowledge, attitudes, perceptions of SLT appeal, and user demographics. Data were analysed using Nvivo V.12 software. Participants demonstrated a general lack of awareness of SLT product types and the extent of their use. They believed SLT use was increasing among females and minors and was as harmful to health and the economy as smoking. SLT products were thought to be cheaper than cigarettes and to appeal to minors. Discreet use was thought to help users overcome the cultural aversion towards tobacco use among women and youth in Uganda. There is an urgent need to strengthen the implementation of the SLT ban whilst also increasing efforts to reduce tobacco smoking.
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Affiliation(s)
- Denis Male
- Department of Food Technology and Nutrition, School of Food Technology Nutrition and Bioengineering, College of Agricultural and Environmental Sciences, Makerere University, Kampala P.O. Box 7062, Uganda;
| | - Shirley Kansabe
- Department of Food Technology and Nutrition, School of Food Technology Nutrition and Bioengineering, College of Agricultural and Environmental Sciences, Makerere University, Kampala P.O. Box 7062, Uganda;
| | - Hafsa Lukwata
- Mental Health Division, Ministry of Health, Kampala P.O. Box 7272, Uganda;
| | - Alexander Rubanga
- International Affairs Unit, Uganda Revenue Authority, Kampala P.O. Box 7279, Uganda;
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, Seebohm Rowntree Building, Heslington, York YO10 5DD, UK;
| | - Linda Bauld
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH8 9AG, UK;
| | - Ann McNeill
- Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London SE5 8BB, UK;
| | - Fiona Dobbie
- Usher Institute, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH8 9AG, UK;
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Pillitteri JL, Shiffman S, Sembower MA, Polster MR, Curtin GM. Assessing comprehension and perceptions of modified-risk information for snus among adult current cigarette smokers, former tobacco users, and never tobacco users. Addict Behav Rep 2020; 11:100254. [PMID: 32467843 PMCID: PMC7244929 DOI: 10.1016/j.abrep.2020.100254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/05/2020] [Accepted: 01/21/2020] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Snus, a low nitrosamine smokeless tobacco product, presents less risks to health than cigarettes. Effectively communicating such risk information could facilitate smokers switching completely to snus, thereby benefiting public health. METHODS This study assessed comprehension and perceptions of modified-risk information regarding snus. Adult cigarette smokers, former tobacco users, and never tobacco users (N = 3,922) from a US internet panel viewed an advertisement stating that smokers who switched completely to snus could greatly reduce risk of lung cancer, respiratory disease, heart disease, and oral cancer. Respondents answered questions regarding the modified-risk information and rated perceived risks of snus relative to cigarettes and other smokeless tobacco products. RESULTS Across the four diseases mentioned in the advertisement, most respondents (49.7%-68.6%, across tobacco user groups) understood that snus presents less risk than cigarettes but is not completely safe. Some indicated snus presents the same risk as cigarettes; this was highest for oral cancer (33.7%-42.02%) and lowest for lung cancer (15.4%-23.1%) and respiratory disease (15.6%-23.4%). Majorities understood snus is addictive (77.7%-87.9%), quitting all tobacco is the best option for smokers (83.6%-93.1%), and non-users of tobacco should not use snus (80.4%-87.8%). Only 2.1%-5.8% indicated smokers would receive a health benefit if they continued to smoke while using snus. CONCLUSIONS The modified-risk information, conveying that snus presents less risk than cigarettes but is not completely safe, was understood by majorities of respondents. Differential risk beliefs across diseases suggest responses were shaped not only by the modified-risk information, but also by intuitions and pre-existing beliefs about tobacco products.
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Affiliation(s)
- Janine L. Pillitteri
- PinneyAssociates, Inc., 201 North Craig Street, Suite 320, Pittsburgh, PA 15213, United States
| | - Saul Shiffman
- PinneyAssociates, Inc., 201 North Craig Street, Suite 320, Pittsburgh, PA 15213, United States
| | - Mark A. Sembower
- PinneyAssociates, Inc., 201 North Craig Street, Suite 320, Pittsburgh, PA 15213, United States
| | | | - Geoffrey M. Curtin
- RAI Services Company, 401 North Main Street, Winston-Salem, NC 27101, United States
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Felicione NJ, Ozga-Hess JE, Ferguson SG, Dino G, Kuhn S, Haliwa I, Blank MD. Cigarette smokers' concurrent use of smokeless tobacco: dual use patterns and nicotine exposure. Tob Control 2020; 30:24-29. [PMID: 32051253 DOI: 10.1136/tobaccocontrol-2019-055345] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The concurrent use of cigarettes with other tobacco products, such as smokeless tobacco (SLT), is increasingly common. Extant work with cigarette smokers who also use SLT is based heavily on retrospective reports and between-group comparisons. The purpose of this study was to assess prospectively the patterns of dual users' product use and nicotine exposure on days when cigarettes were smoked exclusively (single use) versus concurrently with SLT (dual use). DESIGN Forty-six dual cigarette-SLT users recorded their product use in real time via ecological momentary assessment for a 2-week longitudinal design. They responded to questions about situational factors (eg, location, mood) using this same diary, and collected saliva samples each night for later cotinine measurement. At the end of this 2-week period, users reported on their reasons for and beliefs about SLT use. RESULTS Cotinine levels were significantly higher on dual versus single use days (mean±SEM=374.48±41.08 ng/mL vs 300.17±28.13 ng/mL, respectively; p<0.01), and the number of cigarettes logged was higher on dual versus single use days (11.13±0.98 vs 9.13±1.11, respectively; p<0.01). Product use was distinguished by situational factors, with the strongest predictor being location of use. Moreover, the most common reason for initiating (56.52%) and continuing (67.39%) SLT use was to circumvent indoor smoking restrictions. CONCLUSIONS Results support the idea of product supplementation rather than replacement among this convenience sample of dual users. For smokers whose primary motivation for SLT use involves situations where they would otherwise be tobacco free, the potential benefits of clean indoor air laws may be diminished.
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Affiliation(s)
| | - Jenny E Ozga-Hess
- Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Stuart G Ferguson
- School of Medicine, University of Tasmania Faculty of Health, Hobart, Tasmania, Australia
| | - Geri Dino
- Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, West Virginia, USA.,WV Prevention Research Center, West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - Summer Kuhn
- Health Sciences and Technology Academy, West Virginia University, Morgantown, West Virginia, USA
| | - Ilana Haliwa
- Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Melissa D Blank
- Psychology, West Virginia University, Morgantown, West Virginia, USA .,WV Prevention Research Center, West Virginia University School of Public Health, Morgantown, West Virginia, USA
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Pericot-Valverde I, Elliott RJ, Priest JS, Barret T, Yoon JH, Miller CC, Okoli CTC, Haliwa I, Ades PA, Gaalema DE. Patterns of tobacco use among smokers prior to hospitalization for an acute cardiac event: Use of combusted and non-combusted products. Prev Med 2019; 128:105757. [PMID: 31254538 PMCID: PMC7248643 DOI: 10.1016/j.ypmed.2019.105757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/30/2019] [Accepted: 06/21/2019] [Indexed: 10/26/2022]
Abstract
Use of tobacco products before or after a cardiac event increases risk of morbidity and mortality. Unlike cigarette smoking, which is generally screened in the healthcare system, identifying the use of other tobacco products remains virtually unexplored. This study aimed at characterizing the use of other non-combusted tobacco products in addition to combusted products among cardiac patients and identifying a profile of patients who are more likely to use non-combusted products. Patients (N = 168) hospitalized for a coronary event who reported being current cigarette smokers completed a survey querying sociodemographics, cardiac diagnoses, use of other tobacco products, and perceptions towards these products. Classification and regression tree (CART) analysis was used to identify which interrelationships of participants characteristics led to profiles of smoking cardiac patients more likely to also be using non-combusted tobacco products. Results showed that non-combusted tobacco product use ranged from 0% to 47% depending on patient characteristic combinations. Younger age and lower perception that cigarette smoking is responsible for their cardiac condition were the strongest predictive factors for use of non-combusted products. Tobacco product use among cardiac patients extends beyond combusted products (13.7% non-combusted product use), and consequently, screening in health care settings should be expanded to encompass other tobacco product use. This study also characterizes patients likely to be using non-combusted products in addition to combusted, a group at high-risk due to their multiple product use, but also a group that may be amenable to harm reduction approaches and evidence-based tobacco treatment strategies.
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Affiliation(s)
- Irene Pericot-Valverde
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Departments of Psychiatry, University of Vermont, Burlington, VT, United States of America; School of Health Research, Clemson University, Greenville, SC, United States of America.
| | - Rebecca J Elliott
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Departments of Psychiatry, University of Vermont, Burlington, VT, United States of America
| | - Jeff S Priest
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Biostatistical Unit, University of Vermont, Burlington, VT, United States of America
| | - Trace Barret
- Division of Cardiology, University of Vermont, Burlington, VT, United States of America
| | - Jin H Yoon
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Science at Houston, Houston, TX, United States of America
| | - Charles C Miller
- Department of Cardiothoracic and Vascular Surgery, University of Texas Health Science at Houston, Houston, TX, United States of America
| | - Chizimuzo T C Okoli
- College of Nursing, University of Kentucky, Lexington, KY, United States of America
| | - Ilana Haliwa
- Department of Behavioral Neuroscience, West Virginia University, Morgantown, WV, United States of America
| | - Philip A Ades
- Division of Cardiology, University of Vermont, Burlington, VT, United States of America
| | - Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT, United States of America; Departments of Psychiatry, University of Vermont, Burlington, VT, United States of America
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Fisher MT, Tan-Torres SM, Gaworski CL, Black RA, Sarkar MA. Smokeless tobacco mortality risks: an analysis of two contemporary nationally representative longitudinal mortality studies. Harm Reduct J 2019; 16:27. [PMID: 30975137 PMCID: PMC6458834 DOI: 10.1186/s12954-019-0294-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 03/19/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Assessments supporting smokeless tobacco (SLT) disease risk are generally decades old. Newer epidemiological data may more accurately represent the health risks associated with contemporary US-based SLT products, many of which contain lower levels of hazardous and potentially hazardous chemicals compared to previously available SLT products. METHODS Data from two longitudinal datasets (National Longitudinal Mortality Study-NLMS, and the National Health Interview Survey-NHIS) were analyzed to determine potential associations between SLT use and/or cigarette smoking and all-cause and disease-specific mortality. Mortality hazard ratios (HR) were estimated using a Cox proportional hazards regression model applied to various groups, including never users of any tobacco or SLT product, and current and former SLT users and/or cigarette smokers. RESULTS The two datasets yielded consistent findings with similar patterns evident for the specific causes of death measured. All-cause mortality risk for exclusive SLT users was significantly lower than that observed for exclusive cigarette smokers and dual SLT/cigarette users. Similar trends were found for mortality from diseases of the heart, chronic lower respiratory diseases, and malignant neoplasms. Mortality risk for lung cancer in exclusive cigarette smokers was increased by about 12-fold over never-tobacco users but was rarely present in exclusive SLT users in either survey (NHIS, < 5 cases/1,563 observations; NLMS, 3 cases/1,863 observations). While the data in the surveys are limited, SLT use by former cigarette smokers was not associated with an increase in the lung cancer risk HR compared to that by former cigarette smokers who never used SLT. CONCLUSIONS Emerging epidemiological data provides a new perspective on the health risks of SLT use compared to risks associated with cigarette smoking. HR estimates derived from two current US datasets, which include data on contemporary tobacco products, demonstrate a clear mortality risk differential between modern SLT products and cigarettes. Cigarette smokers had an increased overall mortality risk and risk for several disease-specific causes of death, while SLT users consistently had lower mortality risks.
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Affiliation(s)
- Michael T. Fisher
- Regulatory Affairs, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219 USA
| | | | | | - Ryan A. Black
- Regulatory Affairs, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219 USA
| | - Mohamadi A. Sarkar
- Regulatory Affairs, Altria Client Services LLC, 601 East Jackson Street, Richmond, VA 23219 USA
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Wackowski OA, Ray AE, Stapleton JL. Smokers' perceptions of risks and harm from snus relative to cigarettes: A latent profile analysis study. Addict Behav 2019; 91:171-174. [PMID: 30501991 PMCID: PMC6358499 DOI: 10.1016/j.addbeh.2018.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Revised: 11/07/2018] [Accepted: 11/13/2018] [Indexed: 01/30/2023]
Abstract
INTRODUCTION Certain types of smokeless tobacco (SLT) products, particularly snus, carry fewer health risks than cigarette smoking and might be able to serve as harm-reduction products for smokers. However, studies frequently find that smokers misperceive SLT and snus to be as or more harmful than smoking. This perception is often measured with a single general harm question, and research on underlying risk perceptions is limited. METHODS Using a sample of 256 current smokers, we utilized Latent Profile Analysis to examine response profiles to items that assessed perceived risk of specific health outcomes (lung cancer, heart disease, oral cancer) from snus relative to cigarettes, along with the typical single item measure of overall harm from snus compared to cigarettes. RESULTS Three smoker response profiles emerged. Almost half (44.9%) of smokers perceived snus to be as or more risky than cigarettes for all three specific health outcomes (group 1), while over one third (38.3%) had an elevated perceived risk for oral cancer only (group 2). About 17% of smokers perceived snus to have lower risks for lung cancer only (group 3). Across each profile, perceived risk was highest for oral cancer. CONCLUSIONS If smokers are to consider snus for harm-reduction, efforts may be needed to better inform smokers about their lower relative risks, including for particular health outcomes of interest. This study also suggests that smokers may vary in their level of need for information to correct their relative risk misperceptions.
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Affiliation(s)
- Olivia A Wackowski
- Center for Tobacco Studies, Department of Social and Behavioral Health Sciences, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA.
| | - Anne E Ray
- Center for Tobacco Studies, Department of Social and Behavioral Health Sciences, Rutgers School of Public Health, 683 Hoes Lane West, Piscataway, NJ 08854, USA
| | - Jerod L Stapleton
- Rutgers Cancer Institute of New Jersey, Department of Medicine, Rutgers University, 195 Little Albany Street, New Brunswick, NJ 08901, USA
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10
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Parker MA, Villanti AC, Quisenberry AJ, Stanton CA, Doogan NJ, Redner R, Gaalema DE, Kurti AN, Nighbor T, Roberts ME, Cepeda-Benito A, Higgins ST. Tobacco Product Harm Perceptions and New Use. Pediatrics 2018; 142:peds.2018-1505. [PMID: 30397167 PMCID: PMC6317771 DOI: 10.1542/peds.2018-1505] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/10/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5839992833001PEDS-VA_2018-1505Video Abstract BACKGROUND: Researchers in several studies have examined correlations between tobacco harm perceptions and tobacco use in youth, but none have prospectively addressed the association between harm perceptions and subsequent new use across multiple noncigarette products. METHODS Product-specific absolute and relative harm perceptions for cigarettes, electronic cigarettes (e-cigarettes), cigars, pipes, hookah, and smokeless tobacco were collected at wave 1 (W1) (2013-2014) among youth in the nationally representative US Population Assessment of Tobacco and Health Study (12-17 years of age; n = 10 081). At wave 2 (W2) (2014-2015), product-specific new use was calculated. Adjusted relative risks were used to estimate if harm perceptions at W1 predicted W2 new tobacco use. RESULTS The proportion of youth who endorsed "a lot of harm" was highest for cigarettes (84.8%) and lowest for e-cigarettes (26.6%); the proportion of youth who thought products were "more harmful" than cigarettes was highest for cigars (30.6%) and lowest for e-cigarettes (5.1%). Among youth who had not used those products at W1, product-specific new use at W2 ranged from 9.1% (e-cigarettes) to 0.6% (pipes). Youth who believed that noncombustible tobacco products posed "no or little harm" at W1 were more likely to have tried those products at W2 (P < .05). Youth who viewed e-cigarettes, hookah, and smokeless tobacco as "less harmful" than cigarettes at W1 were more likely to try those tobacco products at W2 (P < .05). CONCLUSIONS Low harm perceptions of noncigarette tobacco products predict new use of these products by youth within the next year. Targeting product-specific harm perceptions may prevent new tobacco use among youth.
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Affiliation(s)
- Maria A. Parker
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Andrea C. Villanti
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Amanda J. Quisenberry
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | - Cassandra A. Stanton
- Center for Evaluation and Coordination of Training
and Research in Tobacco Regulatory Science, Westat, Rockville, Maryland;,Department of Oncology, Georgetown University Medical
Center, Washington, District of Columbia; and
| | - Nathan J. Doogan
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | - Ryan Redner
- Rehabilitation Institute, Southern Illinois
University, Carbondale, Illinois
| | - Diann E. Gaalema
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Allison N. Kurti
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Tyler Nighbor
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
| | - Megan E. Roberts
- Center of Excellence in Regulatory Tobacco Science,
The Ohio State University, Columbus, Ohio
| | | | - Stephen T. Higgins
- Tobacco Center on Regulatory Science, University of
Vermont, Burlington, Vermont
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