Smokers' behavioral intentions in response to a low-nicotine cigarette policy

Minal Patel; Alison F Cuccia; Lauren Czaplicki; Emily M Donovan; Bethany Simard; Lindsay Pitzer; Elizabeth C Hair; Barbara A Schillo; Donna M Vallone

doi:10.1016/j.drugalcdep.2019.107645

Smokers' behavioral intentions in response to a low-nicotine cigarette policy

Drug Alcohol Depend. 2019 Dec 1:205:107645. doi: 10.1016/j.drugalcdep.2019.107645. Epub 2019 Oct 18.

Authors

Minal Patel¹, Alison F Cuccia², Lauren Czaplicki³, Emily M Donovan⁴, Bethany Simard⁵, Lindsay Pitzer⁶, Elizabeth C Hair⁷, Barbara A Schillo⁸, Donna M Vallone⁹

Affiliations

¹ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA. Electronic address: mpatel@truthinitiative.org.
² Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA. Electronic address: acuccia@truthinitiative.org.
³ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA. Electronic address: lczaplicki@truthinitiative.org.
⁴ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA. Electronic address: edonovan@truthinitiative.org.
⁵ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA. Electronic address: bsimard@truthinitiative.org.
⁶ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA. Electronic address: lpitzer@truthinitiative.org.
⁷ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA. Electronic address: ehair@truthinitiative.org.
⁸ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA. Electronic address: bschillo@truthinitiative.org.
⁹ Truth Initiative Schroeder Institute, 900 G Street NW, Washington, D.C., 20001, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; Global Institute of Public Health, New York University, New York, NY 10012, USA. Electronic address: dvallone@truthinitiative.org.

PMID: 31704376
DOI: 10.1016/j.drugalcdep.2019.107645

Abstract

Introduction: Evidence suggests that reducing the nicotine concentration in cigarettes to sub-addictive levels would reduce use. Until a low-nicotine cigarette policy is enacted, population-level effects are unknown. This study examines the behavioral intentions of current U.S. cigarette smokers if a low-nicotine policy were implemented.

Methods: Data were drawn from a nationally representative probability-based panel and opt-in panel. Weighted logistic regressions examined likelihood to (1) smoke lower nicotine cigarettes, (2) quit using tobacco, (3) use e-cigarettes, (4) illegally buy high-nicotine cigarettes, and (5) smoke cigars, cigarillos, or little cigars (CLCCs) among smokers, controlling for demographics, tobacco products used, dependence, and intentions to quit cigarettes. Latent class analyses (LCA) characterized patterns of behavioral intentions.

Results: If a low-nicotine policy were implemented, most participants indicated a likelihood to smoke low-nicotine cigarettes (78.4%) or quit tobacco (61.9%), followed by use e-cigarettes (46.5%). Individuals with greater dependence had greater odds of intending to smoke low-nicotine cigarettes, use e-cigarettes, and illegally buy high-nicotine cigarettes. Current e-cigarette or CLCCs users had higher odds of intending to use these products. LCA revealed that individuals would 1) use low-nicotine cigarettes with low intentions to use other tobacco products or 2) use multiple tobacco products, including low-nicotine cigarettes.

Conclusions: A reduced nicotine standard for all combustible tobacco products is needed given that many tobacco users would likely intend to continue to use tobacco products. Differences in intentions by tobacco use and demographic characteristics indicate a need for additional cessation support and education around the harms of continued use of combustible tobacco.

Keywords: Behavioral intentions; Low-nicotine cigarettes; Policy; Tobacco use.

MeSH terms

Adult
Consumer Behavior / statistics & numerical data*
Electronic Nicotine Delivery Systems
Female
Humans
Intention*
Male
Middle Aged
Nicotine / analysis*
Policy
Smokers / psychology*
Smoking / psychology*
Smoking Cessation / methods*
Tobacco Products / analysis*
Young Adult

Substances

Nicotine