Nicotine & Tobacco Research最新文献

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.

Introduction: This study examines the prevalence and correlates of receipt and use of discount coupons for cigarettes, cigars, smokeless tobacco, and e-cigarettes, reasons for coupon use, and likelihood of future tobacco product purchases among U.S. adults who use tobacco.

Methods: Data were from the National Panel of Tobacco Consumer Studies (TCS Panel), a nationally representative sample of U.S. adults who use cigarettes, cigars, and smokeless tobacco. TCS Panel members (n = 3922) were invited to participate in a survey in 2020; 1989 participants (57% weighted) completed it. Weighted prevalence estimates with 95% confidence intervals (CIs) and logistic regression models were calculated.

Results: An estimated 41.7% of U.S. adults who use cigarettes, cigars, and smokeless tobacco received a coupon for a tobacco product in the past 12 months; of those, 78.7% redeemed them. Most received cigarette coupons (34.3%), followed by smokeless tobacco (8.8%), e-cigarette (6.1%), and cigar (4.4%) coupons. Coupon use is high among recipients: cigarettes (76.8%), smokeless tobacco (63.9%), cigars (60.3%), and e-cigarettes (37.1%). Many provided contact information to sign up for coupons (31.6%)-the strongest predictor of coupon receipt (odds ratio [OR] = 5.45) and coupon use (OR = 1.94).

Conclusions: Coupon use and receipt is common among adults who use tobacco; they often receive and use coupons for multiple tobacco products, illustrating how tobacco companies cross-market products. Findings suggest tobacco companies' efforts to reach customers and keep them engaged through discount offers are largely successful.

Implications: Providing contact information is the strongest single factor determining tobacco coupon receipt and use, suggesting tobacco companies are largely successful at building relationships with consumers through electronic apps or other means and at keeping consumers engaged by regularly offering discount and coupons. Many who use tobacco receive and use coupons for tobacco products that they may not currently use, perhaps prompting progression to new product initiation.

Introduction: Accurate measurement is critical for understanding the population health impact of nicotine pouches, yet precise, standardized measures of nicotine pouch use are lacking, possibly driving disparate prevalence estimates across studies. We implemented a split sample survey experiment to assess the impact of including a product image when asking about nicotine pouches.

Methods: We randomized an online sample of US adults ages 18-45 (N = 2130) recruited through the February 2023 wave of the Rutgers Omnibus Study to view either a text-only or text-plus-image description of oral nicotine pouches before being asked about awareness of the products. Participants who endorsed awareness were then asked about their use and the brands they had tried. We calculated the prevalence of awareness, ever, and current use of nicotine pouches and used chi-square tests to assess differences in responses to each question by survey condition.

Results: Participants in the image condition were more likely than those in the text condition to report awareness (40.6% vs 31.5%, p < .001) and ever use (7.2% vs 5.2%, p = .044). Among those reporting nicotine pouch use, 5.9% in the text-only condition, compared to 0% in the image condition, listed a smokeless tobacco brand as one they tried, suggesting they were misclassified by the text-only question.

Conclusion: Inclusion of product imagery can improve nicotine pouch measurement accuracy in surveys, while text-only measures may misestimate the prevalence of awareness and use. Differences in nicotine pouch prevalence estimates may be explained in part by differences in survey measures, highlighting a need to harmonize measures across studies.

Implications: In this first study to evaluate nicotine pouch measurement methods, findings suggest that existing surveillance and research efforts may be undermined by misclassification. Text-only measures of nicotine pouch awareness and use may produce biased prevalence estimates, and inclusion of product imagery can improve nicotine pouch measurement accuracy in surveys.

Introduction: Filtered cigars are a class of tobacco products that can be consumed similarly as conventional cigarettes. Here we have compared tobacco smoke condensates prepared from the 1C2 reference filtered cigar with those from the 1R6F reference cigarette with respect to effects on cell proliferation and viability and AhR-mediated gene expression.

Methods: Tobacco smoke condensates were prepared using ISO, Health Canada Intense (HCI) or Cigar Smoking regimens and certain HPHCs were measured. Cell proliferation and viability assays were performed on immortalized human bronchial or oral epithelial cell lines. AHR-mediated gene expression was measured using a mouse hepatoma cell line engineered to express luciferase under control of the AHR promoter.

Results: Comparison of different smoking regimens found that the HCI regimen produces higher TPM levels, and higher AhR-mediated gene expression and toxicity when normalized to filler weight. Condensates from 1C2 reference filtered cigars resulted in higher AhR-mediated gene expression and reduced cell viability when compared with condensates prepared under the same conditions from the 1R6F reference cigarettes, again when normalized to filler weight.

Conclusions: Our results indicate that this reference filtered cigar is somewhat more toxic than the reference cigarette with the HCI regimen being most toxic. Our findings also suggest that some commercial filtered cigars may have at least as strong toxic effects as conventional cigarettes.

Implications: This study indicates that, if compared by filler weight, the 1C2 reference filtered cigar is more toxic than the 1R6F reference cigarette. Since these products were manufactured based on commercial products and at least some consumers of filtered cigars inhale smoke from these products into the lung, this suggests that some filtered cigars will be at least as harmful to consumers as conventional cigarettes.