Date of Award
2024
Document Type
Thesis
Degree Name
Master of Arts (MA)
Department
Psychology
First Advisor
Elias Klemperer
Abstract
Combusted tobacco is the leading cause of preventable death in the United States. A national policy under consideration by the Food and Drug Administration Center for Tobacco Products (FDA CTP) could establish a nicotine-limiting standard for cigarettes. Such a standard could cause people who smoke and are unable to stop using nicotine to migrate to other products. Identifying the conditions that result in substitution with non-combusted vs combusted nicotine products is important because non-combusted nicotine products are substantially less harmful than combusted products. In the United States, little cigars and cigarillos (LCCs) are the most popular non-cigarette combusted product and e-cigarettes are the most popular non-combusted product, but the extent to which they could substitute for cigarettes in the content of a nicotine limiting standard when both are available on the market remains unclear. A prior pilot study (Nighbor et al., 2022) used the experimental tobacco marketplace (ETM; a paradigm to assess tobacco product substitutability and demand) and, contrary to the authors’ hypothesis, found that LCCs did not function as a substitute for cigarettes but that e-cigarettes did. The present study aimed to replicate and extended Nighbor et al. (2022) using the ETM in Amazon Mechanical Turk to recruit a larger sample. Participants (N = 145, 70.3% female, 82.1% White) were recruited using Amazon MTurk. Participants made hypothetical purchases for seven day’s nicotine products using their average weekly expenditure at five price points for cigarettes ($0.25, $0.50, $1, $2, $4 per cigarette) in three marketplaces: (1) all products (e-cigarettes, LCCs, nicotine gum/lozenges [NRT], snus, chewing tobacco, and nicotine pouches), (2) all products except e-cigarettes, and (3) all products except LCCs. Significant positive Spearman’s correlations between demand for a product and log-transformed cigarette price indicated substitution. Cigarette demand decreased as price increased across all sessions (all p<.001). In the marketplace with all products available, demand increased for e-cigarettes (rs=0.28, p<.0001), LCCs (rs=0.08, p=.02), nicotine replacement therapy (NRT; rs=0.24, p<.0001), and chewing tobacco (rs=0.10, p=.01) as cigarette price increased, indicating substitutability. In the marketplace with no e-cigarettes, demand increased for LCCs (r=0.19, p<.0001) and all other products except snus (all other save snus p<.05; snus p=0.13) as cigarette price increased. In the marketplace with no LCCs, demand increased for e-cigarettes (r=0.28, p<.0001) as well as all other products except snus (all other p<.05; snus p=) as cigarette price increased. Both combusted and non-combusted products served as substitutes for cigarettes. Given the immense harm potential of LCCs, even the small effect for LCC substitution observed in this study could translate to substantial harm at the population-level. As such, a nicotine-limiting standard should be applied to all combustible nicotine products to encourage substitution to harm-reductive products.
Language
en
Number of Pages
74 p.
Recommended Citation
Feinstein, Marc Jerome, "Investigating The Substitutability Of Little Cigars And Cigarillos (lccs) And E-Cigarettes For Cigarettes Using The Experimental Tobacco Marketplace" (2024). Graduate College Dissertations and Theses. 1924.
https://scholarworks.uvm.edu/graddis/1924