Differences in switching away from cigarettes and JUUL use characteristics among adult menthol and nonmenthol smokers who purchased the JUUL System

Goldenson, Nicholas I.; Augustson, Erik; Shiffman, Saul

doi:10.1016/j.drugalcdep.2021.109238

Cited by 6 publications

(8 citation statements)

References 32 publications

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“…Menthol HTP varieties had greater reach than nonmenthol, demonstrated by their uptake and use by AS who prefer smoking menthol or non-menthol cigarettes. This nding contrasts with switching studies, subjective sensory response research, and behavioral economic research of other inhaled tobacco products (i.e., combusted cigarettes and electronic cigarettes) where preference for menthol cigarettes is typically congruent with menthol preference for other tobacco products (31,34,35).…”

Section: Discussionmentioning

confidence: 57%

Switching Behavior and Changes in Smoking Behavior by Menthol Cigarette Preference and Menthol Heated Tobacco Product Use Among Adults Who Smoke Cigarettes: An Actual Use Study

Karelitz,

He,

Becker

et al. 2024

Preprint

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Background: Heated tobacco products (HTPs) deliver nicotine with significantly lower toxicant exposure relative to combustible cigarettes. HTPs may serve as viable tobacco harm reduction options for adults who smoke (AS) but are not able or willing to stop consuming nicotine-containing products. There is limited information on switching away from or reducing combusted cigarette consumption among AS provided with HTPs, and none assessing differences due to menthol cigarette preference or menthol HTP use. Methods: In a six-week actual use study of HTP, AS ages 21-64 (n=615) who were not planning to quit smoking combusted cigarettes were offered free choice of HTPs (one non-menthol and two menthol varieties) to use ad libitum. Preference for smoking menthol or non-menthol cigarettes was assessed upon study entry (374 menthol; 241 non-menthol). The number of HTP sticks and combusted cigarettes consumed were measured daily. Complete switching was defined as reporting consuming zero combusted cigarettes while continuing to use the HTP research product in Week 6. Results: Overall, 247 participants completely switched to HTP, corresponding to 21.1% of all those enrolled at baseline (n=1173) or 40.2% of the analytic sample (n=615). Among the analytic sample, we observed greater switching among AS who preferred menthol versus non-menthol cigarettes (46.8% vs 29.9%). Probability of switching increased with greater proportional use of menthol versus non-menthol HTPs. Non-menthol cigarette-preferring AS had greater increases in switching when using proportionally more menthol than non-menthol HTPs; switching remained consistently high among menthol-preferring AS. Among participants who did not switch and continued smoking at Week 6, preference for menthol cigarettes and use of proportionally greater menthol versus non-menthol HTPs were each associated with greater reductions in cigarette consumption. Conclusions: HTP use facilitated switching away from or reducing consumption of combusted cigarettes among AS, especially when using menthol HTPs. Most AS used menthol HTPs, regardless of their incoming preference for smoking menthol or non-menthol cigarettes. Availability of HTPs in menthol and non-menthol varieties offers an increased tobacco harm reduction opportunity over non-menthol only by providing AS with smoke-free alternatives that they find appealing, reduce toxicant exposure, and can effectively support their transition away from combusted cigarettes.

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Section: Discussionmentioning

confidence: 57%

Switching Behavior and Changes in Smoking Behavior by Menthol Cigarette Preference and Menthol Heated Tobacco Product Use Among Adults Who Smoke Cigarettes: An Actual Use Study

Karelitz,

He,

Becker

et al. 2024

Preprint

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“…Accounting for baseline cigarette consumption was important in understanding the relationship between relative risk perceptions and subsequent switching. The role of CPD in this association is complex: on one hand, smokers with higher CPD are less likely to switch (24), but on the other hand, these heavier smokers perceive greater risk reduction in switching to JUUL, which makes them more likely to switch.…”

Section: Discussionmentioning

confidence: 99%

“…smoking behavior, more frequent JUUL use, and greater satisfaction with and dependence on JUUL were positively associated with later switching (24). Risk perceptions have not yet been examined in the ADJUSST study.…”

mentioning

confidence: 97%

Relative Risk Perceptions of Switching to JUUL vs. Continued Smoking and Subsequent Switching away from Cigarettes: A Longitudinal Observational Study

Selya¹,

Shiffman²

2023

Preprint

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Background: Evidence indicates that electronic nicotine delivery systems (ENDS) pose lower risk than cigarettes; however, many smokers misperceive ENDS to be equally ormore harmful, possibly deterring them from switching. This study examines whether relative risk perceptions of JUUL vs. smoking are associated with subsequent switching, among smokers who recently initiated JUUL use. Methods: N=16,996 current established smokers who recently purchased a JUUL Starter Kit were followed 6 times over 12 months. Relative risk perceptions were assessed using both direct and indirect measures (i.e., contrasting JUUL and smoking directly in questions, and deriving from separate absolute scales). Repeated-measures logistic regression examined switching across follow-up (no smoking in past 30 days) as a function of baseline risk perceptions, adjusting for demographics and baseline smoking behavior. Results: Perceiving JUUL as less harmful than smoking was associated with higher switching rates, using both direct (e.g., odds ratio [OR]=1.48 for “JUUL much less” vs. “more/much more harmful”) and indirect (OR=1.07, for each 10-unit increase in ratio; OR=1.51 for highest (6-100) vs. lowest (0 to <1) ratio categories) relative risk measures (all p<.0001). Among the subset smoking 10+ cigarettes per day, associations between risk perceptions and switching were more pronounced (OR=2.51 for “JUUL much less” vs. “more/much more harmful”; OR=1.81 for 6-100 vs. 0 to <1 ratio, both p<.0001). Conclusions: Smokers who perceive JUUL as less harmful than cigarettes have higher odds of switching. Future research should examine whether messaging which aligns relative risk perceptions with current evidence can facilitate switching, especially among heavier smokers.

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“…Accounting for baseline cigarette consumption was important in understanding the relationship between comparative risk perceptions and subsequent switching. The role of CPD in this association is complex: on one hand, smokers with higher CPD are less likely to switch [ 33 ], but on the other hand, these heavier smokers perceive greater risk reduction in switching to JUUL, which makes them more likely to switch.…”

Section: Discussionmentioning

confidence: 99%

“…A rich source of data for this question is the previously-described Adult JUUL Switching and Smoking Trajectories (ADJUSST) study [ 32 ] which enrolled a large national sample of adult established smokers who had first purchased a JUUL brand starter kit, and followed them over the subsequent year. Previous research on the ADJUSST study showed that, among established smokers, lighter baseline smoking behavior, more frequent JUUL use, and greater satisfaction with and dependence on JUUL were positively associated with later switching [ 33 ]. Risk perceptions have not yet been examined in the ADJUSST study.…”

Section: Introductionmentioning

confidence: 99%

Comparative risk perceptions of switching to JUUL vs. continued smoking and subsequent switching away from cigarettes: a longitudinal observational study

Selya,

Shiffman

2023

BMC Psychol

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Background Evidence indicates that electronic nicotine delivery systems (ENDS) pose lower risk than cigarettes; however, many smokers harbor misperceptions that ENDS are equally or more harmful, possibly deterring them from switching. This study examines whether comparative risk perceptions of JUUL vs. smoking are associated with subsequent switching, among smokers who recently purchased JUUL. Methods N = 16,996 current established smokers who recently purchased a JUUL Starter Kit were followed 6 times over 12 months. Comparative risk perceptions were assessed using both direct and indirect measures (i.e., contrasting JUUL and smoking directly in questions, and deriving from separate absolute scales). Repeated-measures logistic regression examined switching across follow-up (no smoking in past 30 days) as a function of baseline risk perceptions, adjusting for demographics and baseline smoking behavior. Results Perceiving JUUL as less harmful than smoking was associated with higher switching rates, using both direct (e.g., adjusted odds ratio [AOR] = 1.48 for “JUUL much less” vs. “more/much more harmful”) and indirect (AOR = 1.07, for each 10-unit increase in fraction; AOR = 1.51 for highest (6-100) vs. lowest (0 to < 1) fraction categories) comparative risk measures (all p < 0.0001). Among the subset smoking 10 + cigarettes per day, associations between risk perceptions and switching were more pronounced (AOR = 2.51 for “JUUL much less” vs. “more/much more harmful”; AOR = 1.81 for 6-100 vs. 0 to < 1 fraction, both p < 0.0001). Conclusions Smokers who perceive JUUL as less harmful than cigarettes have higher odds of switching. Future research should examine whether messaging which aligns comparative risk perceptions with current evidence can facilitate switching, especially among heavier smokers.

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Differences in switching away from cigarettes and JUUL use characteristics among adult menthol and nonmenthol smokers who purchased the JUUL System

Cited by 6 publications

References 32 publications

Switching Behavior and Changes in Smoking Behavior by Menthol Cigarette Preference and Menthol Heated Tobacco Product Use Among Adults Who Smoke Cigarettes: An Actual Use Study

Switching Behavior and Changes in Smoking Behavior by Menthol Cigarette Preference and Menthol Heated Tobacco Product Use Among Adults Who Smoke Cigarettes: An Actual Use Study

Relative Risk Perceptions of Switching to JUUL vs. Continued Smoking and Subsequent Switching away from Cigarettes: A Longitudinal Observational Study

Comparative risk perceptions of switching to JUUL vs. continued smoking and subsequent switching away from cigarettes: a longitudinal observational study

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