Nicotine & Tobacco Research最新文献

Introduction: Nicotine pouches are the fastest-growing oral smokeless tobacco or nicotine product category in the United States, and there are concerns about their potential appeal to youth. Few studies have surveilled discussions about nicotine pouches on TikTok, an audiovisual platform popular among youth. To address this gap, this study conducted a content analysis of TikTok posts related to the leading nicotine pouch brand, ZYN.

Aims and methods: Publicly available posts (N = 665) from 10 ZYN-related hashtags were collected from the TikTok Application Programming Interface (API) between January 2023 and February 2024. The number of likes, comments, shares, and plays was collected for each post and the number of followers for each account profile was recorded. Posts were coded for themes such as product marketing and use, health warnings, and demographics.

Results: The most prevalent theme was humor (n = 581, 87.4%), followed by product use (n = 378, 56.8%), and branded merchandise (n = 378, 56.8%). Young people (ie persons in the video who appeared younger than 30) were identified in 48.3% (n = 321) of posts, and 61.5% (n = 409) of posts featured people who appeared to be male. Cessation (n = 12, 1.8%) was an uncommon theme. Most posts came from noncommercial accounts (n = 420, 63.1%), followed by commercial accounts (n = 158, 23.8%), and content creators/influencers (n = 87, 13.1%).

Conclusions: This study showed that ZYN-related posts on TikTok often featured pro-tobacco themes, such as humor and product use, while rarely mentioning anti-tobacco themes such as cessation. Future research should examine the relationship between exposure to pro-tobacco content on TikTok and tobacco-related attitudes and behaviors.

Implications: This study highlighted the potential role of TikTok in normalizing tobacco and nicotine product use, and in particular ZYN product use, including among youth. While increased enforcement of online tobacco control policies can help reduce exposure to ZYN-related content in youth, prevention programs and interventions that incorporate tobacco-related digital media literacy are needed to inoculate adolescents and young adults from the pro-tobacco content found online.

Introduction: Nicotine pouches have the potential to be used for tobacco harm reduction. Pouches can currently be sold in brightly coloured packaging with conceptual flavor and nicotine descriptors, which may appeal to youth. Therefore, the UK government are considering packaging regulations. We examined the impact of standardized packaging, limiting flavor names and standardizing nicotine descriptors on appeal and harm perceptions of nicotine pouches among adults.

Methods: A 2024 Prolific Academic online experiment among UK Adults (N = 2,967) was used. Participants were randomized to one of four packaging conditions: (1) branded, (2) standardized with usual descriptors, (3) standardized with limited flavor descriptors, and (4) standardized with limited flavor and standardized nicotine descriptors. Logistic regressions examined associations between packaging conditions and (a) no interest in trying the products displayed and (b) harm perceptions relative to cigarettes.

Results: There were no significant differences in reporting no interest in trying nicotine pouches in branded compared to standardized packaging with usual descriptors, standardized packaging with limited flavor descriptors, and standardized packaging with limited flavor and nicotine descriptors. When stratified by vaping/smoking status, participants who currently vaped had lower odds of reporting no interest in standardized packaging with limited flavor descriptors, compared to branded. There were no significant differences in harm perceptions by packaging condition.

Conclusions: Overall, standardizing packaging, limiting flavor descriptors, and standardizing nicotine descriptors had little effect on adults' interest in trying nicotine pouches or their perceptions of relative harm. There were, however, some differences by vaping status.

Introduction: Nicotine pouches (NPs) are an emerging nicotine delivery system. Understanding nicotine and toxicant exposure among NP users compared with users of other tobacco products and non-users is critical for informing public health strategies.

Methods: Data (n = 4527) were drawn from the Population Assessment of Tobacco and Health Study Wave 7 (2022-2023). Participants were classified into four mutually exclusive groups: non-tobacco users, exclusive NP users, exclusive e-cigarette users, and exclusive cigarette smokers. Geometric mean concentrations of biomarkers from urinary nicotine metabolites, minor tobacco alkaloids, and heavy metals were compared across groups using general linear model adjusted for demographics and current marijuana use.

Results: Despite having higher levels of nicotine metabolites than non-tobacco users (eg, cotinine, 2137.2 vs. 0.2 ng/mg creatinine, p < .0001), exclusive NP users showed no significant differences in levels of metals or minor tobacco alkaloids (p > .05). Exclusive NP users had comparable levels of nicotine metabolites to exclusive cigarette smokers (p > .05), but significantly higher concentrations of certain nicotine metabolites than exclusive e-cigarette users (eg, TNE-2: 27.3 vs. 7.0, p = .02). Meanwhile, exclusive NP users exhibited lower levels of anabasine (0.6 vs. 9.3 ng/mg creatinine, p < .0001), anatabine (0.4 vs. 14.7 ng/mg creatinine, p < .0001), and lead (0.2 vs. 0.4 ng/mg creatinine, p = .003) than exclusive cigarette smokers and lower levels of lead (p = .02) than exclusive e-cigarette users.

Conclusions: NP users have substantially elevated nicotine exposure without a corresponding rise in selected tobacco alkaloids or metals. Findings from objective biomarker measures could inform harm reduction strategies and shape regulatory policies concerning emerging nicotine products.

Implications: Nicotine pouches (NPs) are gaining popularity in the United States. The long-term health effects of nicotine pouch use remain unknown, and this national study offered early evidence into the scope of toxicant exposure associated with nicotine pouch use. Exclusive nicotine pouch users exhibited higher levels of nicotine metabolites but lower concentrations of anabasine and lead compared to cigarette smokers, indicating that NPs may serve as a potential harm-reduction strategy for combustible cigarette smokers. Findings from this study add to the current field of tobacco regulatory science and may inform future efforts to evaluate their effectiveness in smoking cessation or substitution.

This commentary highlights the aggressive advertising strategies being used to market oral nicotine pouches, including through online media, motorsport sponsorships, and out-of-home adverts. We underscore the need for balanced policy measures that maintain access to reduced harm alternatives for existing tobacco and nicotine users while minimizing exposure to youth and nonusers.

Introduction: Oral nicotine products (ONPs) are emerging as a new nicotine delivery method, with varied types and flavors such as sweeteners and cinnamon. This study evaluates how sucrose, saccharin, and cinnamaldehyde influence nicotine preference, shedding light on the potential appeal of ONPs and how they may impact on harm reduction.

Methods: For oral choice behavior studies, we utilized a four-bottle choice (BC) test in male and female adult Sprague-Dawley rats. We first examined most common sucrose (1%) and saccharin (0.32%) concentrations as sweet solutions, and quinine (0.01%) as a bitter solution, to determine 4BC sensitivity and ability to distinguish between sweet and bitter tastes. We then performed dose-response analyses with sucrose (0.01%, 0.1%, and 1%), saccharin (0.032%, 0.1%, and 0.32%), and cinnamaldehyde (0.0005%, 0.005%, and 0.05%), in comparison to water in 4BC. Lastly, we tested nicotine (10 µg/mL) choice behaviors in the presence of sweeteners and/or cinnamaldehyde.

Results: Female and male rats significantly preferred sucrose (1%) and saccharin (0.1% and 0.32%) but not cinnamaldehyde. Moreover, rats differentiated sweet and bitter solutions with the highest preference for saccharin. Sucrose increased nicotine preference in females, but cinnamaldehyde increased nicotine preference in males. Saccharin increased nicotine preference in females, but not in males. Additionally, the combination of cinnamaldehyde and saccharin increased nicotine preference in females.

Conclusions: We found differential preferences among the test solution concentrations with the highest sweetener concentrations being most preferred. Sweetness value of the nicotine solution played a major role on nicotine preference in females but not in males.

Implications: Understanding how sweeteners and flavor additives affect oral nicotine choice behavior and nicotine preference in ONPs can guide the development of targeted harm reduction strategies and regulatory policies. By identifying which additives enhance product appeal and potentially influence addiction, this research can inform the creation of safer ONP formulations. This research also supports the utility of evidence-based guidelines for ONP use.

Introduction: This study applied a novel tobacco regulatory science paradigm to characterize inter-product variation in the appeal and sensory features of emerging commercial and therapeutic oral nicotine products (ONPs) among young adults who vape e-cigarettes.

Aims and methods: Twenty-three young adults without ONP experience who use e-cigarettes completed a single-blind, single-visit remote lab study. Participants rated appeal and sensory characteristics during 5-minute standardized self-administrations of eight ONPs (four fruits and four mints) from various brands (Lucy, Rouge, Solace, Nicorette, On!, and Velo). Participants were randomized between-subjects to ONP type (pouches or gum).

Results: Gum ONPs were rated sweeter (B = 19.5, 95% Confidence Interval (CI) = 4.3, 34.7), stronger in flavor (B = 25.6, 95% CI = 12.2, 39.0), and lower in tingling sensation (B = -14.0, 95% CI = -27.8, -0.2) than pouches. Fruit-flavored ONPs were sweeter (B = 12.9, 95% CI = 6.1, 19.7) and caused less burning (B = -12.0, 95% CI = -19.5, -4.5) than mint. Product type × flavor interactions found that gum versus pouch enhanced sweetness and flavor strength more for fruit than mint, while pouch versus gum increased burning and harshness more for mint. Nicorette White Ice was most appealing, while Rogue Fruit and Nicorette Mint were less so. Appeal correlated with most types of sensory experiences (rs = -0.33-0.54), except for tingling and burning.

Conclusions: Nicotine gums may offer a more pleasant sensory experience than pouches for young adults who use e-cigarettes, with variation across brand/flavor variants.

Implications: Results indicate that gum ONPs and fruit flavors may offer greater appeal and a more pleasant sensory experience than pouch ONPs and mint flavors for young adults who use e-cigarettes and are ONP-naïve, with heterogeneity in user experience across some brand/flavor variants. This study also introduces a method for assessing the appeal and sensory features of ONPs, which can inform regulatory efforts and strategies to reduce nicotine dependence among young adults who use e-cigarettes.

Introduction: Flavored oral tobacco-free pouches (ONPs) are novel products that resemble traditional oral tobacco-containing pouches (OTPs) in design and route of administration. However, ONPs contain nicotine, various additives, and a filler material rather than tobacco leaves. Our study compares nicotine content, release, and form, along with selected flavoring content, between brands of ONPs and OTPs.

Methods: A convenience sample of flavored ONPs (n = 10 brands) and OTPs (n = 7 brands) was purchased between 2021 and 2023. Total nicotine content in the pouches, nicotine released over 1 hour, isomer ratio (R:S-nicotine), and 33 flavoring chemicals were measured using chromatography methods. Nicotine form (the proportion of nicotine in the protonated versus freebase forms) was calculated after measuring the pH.

Results: Although ONPs contained, on average, 50% less nicotine than OTPs (6.4 ± 3.5 vs. 12.3 ± 8.2 mg/pouch, p < .001), they released similar amounts of nicotine within 5 minutes (ONPs 6.5 ± 3.9 vs. OTPs 7.6 ± 3.9 mg/pouch, p = .422). The nicotine used in ONPs compared to OTPs was primarily freebase (63.4%±25.2% vs. 47.2%±34.4%, p = .223). Two ONPs contained racemic nicotine, suggesting their synthetic source. Menthol was the most frequently used flavoring chemical in both ONPs and OTPs. Triacetin was the most concentrated flavoring in ONPs (12.7 ± 12.7 mg/pouch) and methyl salicylate the most in OTPs (25.1 ± 1.8 mg/pouch).

Conclusions: ONPs have a similar nicotine release profile as OTPs but contain a high fraction of the freebase nicotine and a wide range of flavorings. The presence of freebase nicotine and flavorings in ONPs may contribute to differential abuse liability of those novel products compared to OTPs.

Implications: This is the first non-industry study to compare nicotine content, release, form, and select flavoring composition between multiple ONPs and OTPs. These findings have implications if any future modified risk claims for ONPs are considered. Although nicotine content was significantly higher in OTPs than in ONPs, the amount of nicotine released from the pouch was very similar between ONPs and OTPs. While many flavoring chemicals present in ONPs and OTPs are generally recognized as safe for oral consumption, their potential oral health risk in ONP and OTP users has not been evaluated and therefore must be monitored and assessed.

Introduction: Social media (SM) are major marketing platforms for e-cigarette product promotion, particularly among youth. While prior studies have established associations between self-reported SM e-cigarette marketing exposure and youth e-cigarette use susceptibility, the strength of inferences based on these studies is limited by potential biases associated with self-reported measures. We use state-level rates of tweets promoting e-cigarettes as an exogenous indicator of potential exposure to e-cigarette marketing on social media, enabling us to examine the effects of digital promotion on youth susceptibility to e-cigarette use.

Methods: The Population Assessment of Tobacco and Health Study (2018-2019) data were linked with state-level commercial e-cigarette tweet rates. Tweets were classified as promoting e-cigarette products using machine learning. Monthly commercial tweet rates per 100 000 state residents were linked to respondents. Multivariable logistic regression was used to assess associations between tweet rates and e-cigarette susceptibility, controlling for demographic and behavioral covariates.

Results: Of 1489 youth aged 14-17 who have not heard or used e-cigarettes, 32.1% reported susceptibility to e-cigarettes. Youth residing in states with commercial tweet rates above the 90th percentile had 63% higher odds of e-cigarette susceptibility (OR: 1.633; 95% CI: 1.099, 2.426), compared to those at or below the median tweet rate. Other associated factors included sexual orientation, cannabis use, having a tobacco user in the home, and being White (vs. Black).

Conclusions: Greater potential exposure to commercial e-cigarette content on X/Twitter is associated with increased odds of youth susceptibility to e-cigarette use. These findings underscore the need for enhanced regulation and monitoring of SM marketing to mitigate youth exposure and e-cigarette uptake.