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Behavioral Research in Regulatory Tobacco Science

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 21836

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Special Issue Editors

Dr. Elizabeth G. Klein

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Guest Editor

College of Public Health, Ohio State University, Columbus, OH, USA
Interests: Policy as a prevention strategy; health communications

Dr. Amanda J. Quisenberry

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Assistant Guest Editor

Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA
Interests: tobacco regulatory science; behavioral economics; experimental research
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In 2009, the Food and Drug Administration (FDA) acquired the authority to regulate the manufacture, marketing, and distribution of tobacco products in order to protect public health and established within the FDA a new Center for Tobacco Products. Research that can provide a scientific foundation for this Center is needed to inform tobacco regulatory policy, which includes an important role for biobehavioral science research. The goal of this Special Issue is to publish robust and innovative studies in behavioral science that highlight the importance of health behavior, health theory, health education, behavioral economics, communications, and other areas informative to this field. Behavioral science studies that include randomized controlled trials and other interventions, longitudinal studies, and biobehavioral research (such as virtual reality, eye tracking, ecological momentary analysis, fMRI, etc.) across the diversity of combustible and non-combustible tobacco products are welcomed. Priority populations, including sexual and gender minorities, youth and young adults, racial and ethnic minorities are encouraged. Studies that use health theory-informed designs coupled with robust, regulatory-focused research questions are especially welcomed for this Special Issue.

Disclaimer: We will not accept research funded in part or full by any tobacco companies in this Special Issue. For more details, please check: https://0-www-mdpi-com.brum.beds.ac.uk/1660-4601/15/12/2831/htm.

Dr. Liz Klein
Dr. Amanda Quisenberry
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Communications
Policy
Behavioral economics
Health theory

Published Papers (10 papers)

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Research

18 pages, 742 KiB

Open AccessArticle

Effects of Vaping Prevention Messages on Electronic Vapor Product Beliefs, Perceived Harms, and Behavioral Intentions among Young Adults: A Randomized Controlled Trial

by Andrea C. Villanti, Olivia A. Wackowski, S. Elisha LePine, Julia C. West, Elise M. Stevens, Jennifer B. Unger and Darren Mays

Int. J. Environ. Res. Public Health 2022, 19(21), 14182; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph192114182 - 30 Oct 2022

Viewed by 2323

Abstract

Youth have been the focus of electronic vapor product (EVP) prevention efforts though young adults had similar increases in current EVP use from 2015–2019. This study tested messages to reduce EVP use in young adults. Eight messages on vaping related harms and addictiveness combined with themes on social use and flavors were selected for inclusion in an online randomized controlled trial. Vermont young adults aged 18–24 (n = 569) were randomized to view the eight vaping prevention messages (n = 295) or eight messages on sun safety (n = 274). After completing baseline measures, participants viewed study messages and completed measures on message perceptions and perceived message effectiveness (PME), EVP-related beliefs, and EVP-related harm perceptions. Participants completed EVP-related beliefs and harm perception measures again at 1-month follow-up, as well as measures on tobacco and EVP-related behavioral intentions and behavior (ever and past 30-day use). Intervention participants reported positive impacts on vaping-related message responses. However, findings suggested no effect of vaping prevention messages on EVP-related beliefs, harm perceptions, or behaviors in the full sample. Exploratory analyses in the intervention condition showed that greater PME was associated with lower odds to intent to try cigarettes in the next year at follow-up. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

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12 pages, 1197 KiB

Open AccessArticle

Analyzing Trajectories of Acute Cigarette Reduction Post-Introduction of an E-Cigarette Using Ecological Momentary Assessment Data

by Alexandra Guttentag, Tuo-Yen Tseng, Donna Shelley and Thomas Kirchner

Int. J. Environ. Res. Public Health 2022, 19(12), 7452; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19127452 - 17 Jun 2022

Cited by 2 | Viewed by 1950

Abstract

Electronic cigarettes (ECs) may hold great potential for helping smokers transition off combustible cigarettes (CCs); however, little is known about the patterns that smokers follow when using an EC as a CC-substitute in order to ultimately reduce and quit smoking. Our primary aim in this study was to evaluate whether common patterns of CC use exist amongst individuals asked to substitute an EC for at least half of the CCs they would normally smoke. These patterns may elucidate the immediate switching and reduction behaviors of individuals using ECs as a reduction/cessation tool. This analysis uses data from a randomized controlled trial of 84 adult smokers assigned to receive either 4.5% nicotine or placebo (0% nicotine) EC. Participants were advised to use the EC to help them reach a 50% reduction in cigarettes-per-day (CPD) within 3 weeks. Longitudinal trajectory analysis was used to identify CPD reduction classes amongst the sample; participants clustered into four distinct, linear trajectories based on daily CC use during the 3-week intervention. Higher readiness to quit smoking, prior successful quit attempts, and lower baseline CC consumption were associated with assignment into “more successful” CC reduction classes. ECs may be a useful mechanism to promote CC reduction. This study demonstrates that a fine-grained trajectory approach can be applied to examine switching patterns in the critical first weeks of an attempt. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

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13 pages, 639 KiB

Open AccessArticle

Dissonance in Young Adult Cigarillo Users’ Categorization of Concept Flavored and Unflavored Products

by Catherine C. Osborn, Jessica P. Suratkal, Stephanie N. Pike Moore, Sarah Koopman Gonzalez, Kymberle L. Sterling, Amanda J. Quisenberry, Elizabeth G. Klein and Erika S. Trapl

Int. J. Environ. Res. Public Health 2022, 19(12), 7219; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19127219 - 13 Jun 2022

Cited by 2 | Viewed by 1695

Abstract

This study asks young adult cigarillo users to categorize their preferred flavor in order to examine user consensus and potential methodological and regulatory implications of flavor name-based categorization systems. Young adult (21–28 years) cigarillo users (n = 426) named and categorized their favorite cigarillo flavor into one of seven categories: Fruit, Sweet and Candy, Mint, Alcohol, Menthol, Tobacco, and Other. Flavor responses were coded as characterizing (ex: Grape, Wine) or concept (ex: Jazz, Diamond) flavors. Variation within and between categories was assessed, including the presence of concept flavors and the placement of flavors in multiple categories. Of the 66 unique flavor names provided, participants placed 20 (30.1%) in more than one flavor category. Most of the Tobacco (76.9%) and Other (69.2%) flavor names appeared in multiple categories. The majority of flavor names in the Tobacco (69.2%) and Other (61.5%) categories were concept flavors. Concept flavors were placed in multiple categories (45.0%) twice as often as characterizing flavors (23.9%). This study has identified dissonance among cigarillo users’ flavor categorizations, particularly for concept flavored and unflavored products. Flavor names may obscure how and whether a product is flavored. Research on and regulation of flavored tobacco products should classify products by flavor additives rather than by name alone. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

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12 pages, 309 KiB

Open AccessArticle

Factors Associated with Quit Interest and Quit Attempts among Young Adult JUUL Users

by Mahmood A. Alalwan, Jill M. Singer and Megan E. Roberts

Int. J. Environ. Res. Public Health 2022, 19(3), 1403; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph19031403 - 27 Jan 2022

Cited by 6 | Viewed by 1734

Abstract

Despite reports suggesting young people are interested in quitting e-cigarettes, little work has examined predictors of quit outcomes. This study aimed to identify factors associated with quit outcomes among JUUL e-cigarette users in a longitudinal sample of young adults. We assessed undergraduate past-30-day JUUL users during autumn 2018 (N = 225); Our outcomes included short-term quit attempts and interest (spring 2019), and long-term quit attempts (spring 2020). We used logistic regression to examine the associations between our outcomes and JUUL use characteristics, other tobacco use, and sociodemographic factors. Findings indicated 76% of users were interested in quitting JUUL, and more than 40% reported a quit attempt. Quit outcomes were not related to sociodemographics. Short-term quit outcomes were more likely among freshmen and less likely among recent cigarillo users. Heavy JUUL users were more likely to report short- and long-term quit attempts, but JUUL device owners were less likely to report short- and long-term quit attempts. Higher nicotine dependence reduced the likelihood of a long-term quit attempt. There is a need for policy level actions that address tobacco control among this population. Findings suggest a range of unique factors that can inform such policies and programs to curb young adult e-cigarette use. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

12 pages, 333 KiB

Open AccessArticle

Integrating Self-Report and Psychophysiological Measures in Waterpipe Tobacco Message Testing: A Novel Application of Multi-Attribute Decision Modeling

by Elise M. Stevens, Andrea C. Villanti, Glenn Leshner, Theodore L. Wagener, Brittney Keller-Hamilton and Darren Mays

Int. J. Environ. Res. Public Health 2021, 18(22), 11814; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211814 - 11 Nov 2021

Cited by 2 | Viewed by 1465

Abstract

Background: Waterpipe (i.e., hookah) tobacco smoking (WTS) is one of the most prevalent types of smoking among young people, yet there is little public education communicating the risks of WTS to the population. Using self-report and psychophysiological measures, this study proposes an innovative message testing and data integration approach to choose optimal content for health communication messaging focusing on WTS. Methods: In a two-part study, we tested 12 WTS risk messages. Using crowdsourcing, participants (N = 713) rated WTS messages based on self-reported receptivity, engagement, attitudes, and negative emotions. In an in-lab study, participants (N = 120) viewed the 12 WTS risk messages while being monitored for heart rate and eye-tracking, and then completed a recognition task. Using a multi-attribute decision-making (MADM) model, we integrated data from these two methods with scenarios assigning different weights to the self-report and laboratory data to identify optimal messages. Results: We identified different optimal messages when differently weighting the importance of specific attributes or data collection method (self-report, laboratory). Across all scenarios, five messages consistently ranked in the top half: four addressed harms content, both alone and with themes regarding social use and flavors and one addiction alone message. Discussion: Results showed that the self-report and psychophysiological data did not always have the same ranking and differed based on weighting of the two methods. These findings highlight the need to formatively test messages using multiple methods and use an integrated approach when selecting content. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

10 pages, 305 KiB

Open AccessArticle

Associations between Cognitive and Affective Responses to Tobacco Advertisements and Tobacco Use Incidence: A Four-Year Prospective Study among Adolescent Boys

by Brittney Keller-Hamilton, Hayley Curran, Elise M. Stevens, Michael D. Slater, Bo Lu, Megan E. Roberts and Amy K. Ferketich

Int. J. Environ. Res. Public Health 2021, 18(21), 11666; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111666 - 06 Nov 2021

Cited by 1 | Viewed by 1723

Abstract

Exposure to tobacco advertisements is associated with initiation of tobacco use among youth. The mechanisms underlying this association are less clear. We estimated longitudinal associations between youths’ cognitive and affective responses to advertisements for cigarettes, e-cigarettes, and smokeless tobacco (SLT) and initiation of these products. N = 1220 Ohio-residing boys of ages 11–16 were recruited into a cohort in 2015 and 2016. Participants completed surveys every six months for four years. Surveys assessed cognitive and affective responses to tobacco advertisements (which included health warnings) and tobacco use after an advertisement viewing activity. We used mixed-effects Poisson regression models with robust standard errors to estimate risk of initiating use of each tobacco product according to participants’ cognitive (i.e., memorability of health risks) and affective (i.e., likability of advertisement) responses to advertisements for that product. No associations between affective responses to advertisements and tobacco use outcomes were detected in adjusted models. However, finding health risks memorable was associated with reduced risk of ever smoking initiation (aRR = 0.57; 95% CI: 0.34, 0.95) and a reduced risk of ever SLT initiation that approached statistical significance (aRR = 0.61; 95% CI: 0.36, 1.05). Measures to increase saliency of health risks on cigarette and SLT advertisements might reduce use among youth. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

11 pages, 805 KiB

Open AccessArticle

Longitudinal Impact of Depressive Symptoms and Peer Tobacco Use on the Number of Tobacco Products Used by Young Adults

by Caroline North, C. Nathan Marti and Alexandra Loukas

Int. J. Environ. Res. Public Health 2021, 18(21), 11077; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182111077 - 21 Oct 2021

Cited by 2 | Viewed by 1954

Abstract

We examined the role of depressive symptoms in the longitudinal trajectory of the number of tobacco products used across young adulthood, ages 18–30 years, and whether peer tobacco use exacerbated the effects of the depressive symptoms. Participants were 4534 initially 18–25-year-old young adults in the Marketing and Promotions Across Colleges in Texas project (Project M-PACT), which collected data across a 4.5-year period from 2014 to 2019. Growth curve modeling within an accelerated design was used to test study hypotheses. Elevated depressive symptoms were associated with a greater number of tobacco products used concurrently and at least six months later. The number of tobacco-using peers moderated the association between depressive symptoms and the number of tobacco products trajectory. Young adults with elevated depressive symptoms used a greater number of tobacco products but only when they had a greater number of tobacco-using peers. Findings indicate that not all young adults with depressive symptoms use tobacco. Having a greater number of tobacco-using peers may facilitate a context that both models and encourages tobacco use. Therefore, tobacco prevention programs should aim to include peer components, especially for young adults. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

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11 pages, 2528 KiB

Open AccessArticle

Tailored Cigarette Warning Messages: How Individualized Loss Aversion and Delay Discounting Rates Can Influence Perceived Message Effectiveness

by Hollie L. Tripp, Justin C. Strickland, Melissa Mercincavage, Janet Audrain-McGovern, Eric C. Donny and Andrew A. Strasser

Int. J. Environ. Res. Public Health 2021, 18(19), 10492; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph181910492 - 06 Oct 2021

Cited by 3 | Viewed by 2169

Abstract

Current text-only cigarette warning labels (long-term, loss-framed messages) may not motivate positive changes in smoking behavior. The current project was a cross-sectional study examining the effects of tailored cigarette warnings on perceived message effectiveness (PME) in adult smokers (n = 512) conducted using Amazon Mechanical Turk (M-Turk) in January–February 2020. Participants were an average age of 40.7 (SD = 11.6), with the majority of the sample being female (62.2%) and White (88.9%). Participants reported smoking an average of 14.6 cigarettes/day (SD = 9.2) with an average FTND score of 4.6 (SD = 2.2). Participants were asked to complete a tobacco use history questionnaire, and mixed gambles and delay discounting tasks before random assignment to one of five message groups. The groups were based on a 2 (gain versus loss framing) ×2 (short-term versus long-term framing) between-subject design; a fifth group served as the control group. All experimental messages reported higher PME scores than the control (p values < 0.001, Cohen’s d = 1.88–2.48). Participants with shallower delayed reward discounting and lower loss aversion rates reported higher total PME scores, p values < 0.05. Our findings also suggest that loss aversion rates vary widely among smokers and that individuals are more responsive to messages congruent with their behavioral economic profile. Specifically, smokers who viewed messages congruent with their loss aversion and delay discounting rates reported higher PME scores than those who viewed incongruent messages (p = 0.04, Cohen’s d = 0.24). These preliminary findings suggest that anti-smoking campaigns may best impact smokers by tailoring messages based on individual loss aversion and delay discounting rates versus a one-size-fits-all approach. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

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13 pages, 674 KiB

Open AccessArticle

Estimating the Impact of Tobacco Parity and Harm Reduction Tax Proposals Using the Experimental Tobacco Marketplace

by Roberta Freitas-Lemos, Diana R. Keith, Allison N. Tegge, Jeffrey S. Stein, K. Michael Cummings and Warren K. Bickel

Int. J. Environ. Res. Public Health 2021, 18(15), 7835; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18157835 - 23 Jul 2021

Cited by 3 | Viewed by 2733

Abstract

Taxes are a demonstrably effective method to suppress tobacco use. This study examined the effects of the tobacco parity (i.e., imposing taxes equally on all tobacco products) and the harm reduction (i.e., applying taxes in proportion to the products’ levels of harm) tax proposals on demand and substitution across products. A crowdsourced sample of cigarette smokers (n = 35) completed purchasing trials with increasing tax magnitudes across different tax tiers in the Experimental Tobacco Marketplace in a repeated-measures design. Products were placed in three tax tiers (high, medium, and no tax) according to each proposal’s goal. The results indicated that total nicotine (mg) purchased was not significantly different between the proposals, with higher taxes yielding lower demand. However, as taxes increased, the tobacco parity proposal decreased the purchasing of all tobacco products and increased the purchasing of medicinal nicotine (i.e., the no tax tier). Conversely, the harm reduction proposal resulted in greater purchases of electronic nicotine delivery systems and smokeless tobacco (i.e., the medium tax tier). These findings support tobacco taxation as a robust tool for suppressing purchasing and suggest that differential taxation in proportion to product risk would be an effective way to incentivize smokers to switch from smoked to unsmoked products. Further studies should investigate the unintended consequences of their implementation. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

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12 pages, 330 KiB

Open AccessArticle

Associations between Black and Mild Cigar Pack Size and Demographics and Tobacco Use Behaviors among US Adults

by Ollie Ganz, Jessica L. King, Daniel P. Giovenco, Mary Hrywna, Andrew A. Strasser and Cristine D. Delnevo

Int. J. Environ. Res. Public Health 2021, 18(12), 6628; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126628 - 20 Jun 2021

Cited by 8 | Viewed by 2534

Abstract

Pack size is an important pricing strategy for the tobacco industry, but there is limited data on how users differ based on preferred pack size for cigar products. Using data from Wave 4 of the Population Assessment of Tobacco and Health Study, this study identified differences in adult cigar user characteristics based on pack size purchasing behavior among users of a top cigar brand, Black and Mild. Weighted chi-square tests were used to examine the associations between Black and Mild pack size and sociodemographic, cigar and other substance use characteristics. Overall, our study found that users of Black and Mild cigars differ by demographic, cigar and other tobacco use characteristics based on preferred pack size, with smaller packs appealing to younger, female, less-experienced and less-established smokers, and larger packs appealing to older, male, more experienced, and more dependent cigar smokers. Dual use of cigarettes and cigars was also higher among users of smaller packs. While this study is cross-sectional, findings suggest that minimum packaging laws for cigars may impact younger adults who are purchasing smaller pack sizes and likely experimenting with new cigar products and styles. Full article

(This article belongs to the Special Issue Behavioral Research in Regulatory Tobacco Science)

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