ObjectivesThis study assessed the awareness and use of traditional and novel tobacco products and dual use of cigarettes with electronic nicotine delivery systems (ENDS) among USA adults.MethodsData were obtained from the 2014 Tobacco Products and Risk Perceptions Survey of a probability sample of 5717 USA adults conducted June–November, 2014.ResultsUse of ENDS varied by demography and by cigarette and other tobacco use. Adults aged 25–34, non-heterosexual adults, and those reporting poorer health reported higher rates of current ENDS use. Current cigarette smokers had much greater odds of ENDS ever use than never smokers, with one-half of all cigarette smokers having used ENDS and 20.7 % currently using them. However, 22.0 % of current ENDS users were former cigarette smokers, and 10.0 % were never cigarette smokers.ConclusionsPatterns of ENDS use are evolving rapidly and merit continued surveillance. Nearly 10 % of adult ENDS usage is among never smokers. The public health challenge is how to enhance the potential that ENDS can replace combusted tobacco products without expanding nicotine use among youth, long-term ex-smokers, and other vulnerable populations.Electronic supplementary materialThe online version of this article (doi:10.1007/s00038-015-0761-0) contains supplementary material, which is available to authorized users.

Results-56% of respondents reported seeing anti-tobacco advertisements at least once a week during the preceding three years. The average eVectiveness rating for all advertisements recalled on a 0-10 scale was 7.29, and did not diVer by smoking status group. Advertisements eliciting strong negative emotions (sadness and fear) were rated most eVective by quitters, non-smokers, and by smokers who at baseline were planning to quit soon. Humorous, entertaining advertisements were seen as ineVective by all groups. Conclusion-The Massachusetts antitobacco campaign achieved high levels of penetration into the population and was well received by both smokers and non-smokers. The results suggest that advertisements depicting suVering as a result of tobacco use may be instrumental in promoting cessation or reinforcing the decision to quit. Further research is needed to lend additional support to the link between perceived eVectiveness and smoking behaviour change.

IntroductionAlthough heated tobacco products (HTP) have been on and off the commercial market for the past three decades (eg, Premier, Eclipse and Accord), they have not received widespread consumer acceptance as an alternative to combustible cigarettes. This may change with recent product innovations, shifts in consumer preferences and the tobacco market landscape and a US regulatory environment that may permit an internationally available HTP to be sold in the USA, possibly with a reduced exposure or risk statement. This study examined the extent of awareness and use of HTP in the USA and assessed the characteristics of those aware of and using these products.MethodsData came from the 2016 and 2017 Tobacco Products and Risk Perceptions Surveys of national probability samples of US adults, conducted online during September–October 2016 (n=6014) and August– September 2017 (n=5992). Weighted χ2 tests and regression analyses examined changes in awareness and use of HTP between 2016 and 2017 and characteristics associated with awareness and use.ResultsFrom 2016 to 2017, awareness of HTP among US adults increased from 9.3% to 12.4% (p<0.001), ever use increased from 1.4% to 2.2% (p=0.005) and current use increased two fold, from 0.5% to 1.1% (p=0.004). Men and adults under age 45 years had higher rates of awareness than women and those 45 and older, respectively. Non-white adults, cigarette smokers and both current and former users of electronic nicotine delivery systems were more likely to be using HTP.ConclusionsAwareness and use of HTP in the USA are increasing. These products are more familiar to men and younger adults and may be being used disproportionately by racial/ethnic minorities. With increases in HTP availability and the potential for reduced-risk claims ahead, surveillance of patterns and consequences of use by both smokers and non-smokers is needed.

Objective This study examines little cigar and cigarillo (LCC) adult user characteristics, perceived addictiveness, use and importance of flavors, intentions to continue use, and reasons for use to inform prevention efforts and regulatory policy. Methods Data come from the 2014 Tobacco Products and Risk Perceptions Survey of a national probability sample of 5717 US adults, conducted online, June–November, 2014. The analytic sample consisted of 141 current LCC users. Results Current LCC smokers were more likely to be male, younger, black or Hispanic, lower SES, current cigarette smokers, and to report poorer health than non-smokers. Perceived addictiveness was low overall, with 73.6% considering themselves “not at all” addicted, although female LCC users and dual users of cigarettes were more likely to consider themselves addicted to LCCs. Use of flavored LCCs was widespread. Flavors were cited as important reasons for use, especially among younger users, as were favorable comparisons with affordability and burn time of cigarettes. Conclusions Most LCC users do not perceive themselves addicted to LCCs. Users report being influenced most by flavorings and affordability, indicating that appropriate regulations and education to improve health perceptions could help reduce use of these harmful products.

Introduction: Information on chemical composition of the new oral "spitless" smokeless tobacco products is scarce, and it is not clear whether there is some variability as a function of purchase place or time due to either unintended or intended manufacturing variations or other conditions. Methods:We analyzed tobacco-specific N-nitrosamines (TSNA) and nicotine in Marlboro Snus, Camel Snus, and dissolvable Camel products Orbs, Sticks, and Strips that were purchased in various regions of the country during the summer of 2010.

introduction: Analysis of novel smokeless tobacco products purchased in Round I of the New Product Watch (NPW)-a national tobacco monitoring network-demonstrated that some tobacco constituents vary not only across various brands but also regionally and over time within the same product. In this study, we analyzed snus and dissolvable tobacco products that were purchased in Round II of the NPW.

Background In the United States, new regulations require the collection of information on tobacco constituents by brand and variety and publication of this information in a way not likely to be misconstrued by consumers. Understanding of such information becomes increasingly important as new tobacco products come onto the market and modifications are made to reduce the toxicity of some products. This pilot study assessed current knowledge of tobacco control professionals regarding relative harmfulness of several tobacco products, and evaluated an online educational intervention aimed at improving understanding of variations in nicotine and tobacco specific N-nitrosamines (TSNAs). Methods Fifty-two tobacco control professionals participated in an online intervention which presented and discussed the results of constituent analyses of Camel Snus and Marlboro Snus compared to several conventional smokeless tobacco. Comparisons to cigarettes were also discussed. Pre- and post-test questions assessed understanding of the concepts. Results Pretest responses demonstrated that 31% did not know that cigarettes are more harmful than smokeless tobacco; 50% or more did not know that smokeless products higher in nicotine are likely to be more effective substitutes for cigarettes; that TSNAs are the major carcinogens in tobacco and that the new snus products tend to be lower in TSNAs than conventional spit tobacco. After participating in the intervention, knowledge increased on all points except one on which pretest results showed 100% correct. Conclusions Public education campaigns are urgently needed for tobacco control professionals, and then for consumers to increase awareness and understanding of the continuum of risk among tobacco products.

This survey study examines the changing attitudes regarding the perceived harm of electronic nicotine delivery systems (ENDS) among smokers, nonsmokers, and ENDS users from 2017 to 2018.