Subjective Effects and Behavioral Intentions of Cigarettes, E-Cigarettes, and Heated Tobacco Products Among Black and White Adults Who Smoke.

INTRODUCTION

For adults who smoke (AWS) but are unable to quit, transitioning to less harmful nicotine products such as electronic cigarettes (e-cigarettes) and heated tobacco products (HTPs) may be a viable option for reducing exposure to tobacco-related toxicants. While the use of e-cigarettes and HTPs has proliferated among White AWS, little is known about the acceptability of these products among Black AWS.

METHODS

Twenty-two Black (n = 12) and White (n = 10) AWS completed a randomized crossover study of their usual brand cigarette (UBC), an e-cigarette (menthol or tobacco flavored 5% JUUL), and an HTP (menthol or tobacco flavored IQOS). At each visit, nicotine-deprived AWS completed a standardized 10-puff bout of the product followed by a 50-minute ad-libitum smoking/vaping session. Puff topography was measured throughout. At the end of each session, subjective effects and behavioral intentions were assessed.

RESULTS

UBC were rated as more pleasurable and satisfying compared to HTP (ps < 0.05) but the three products were rated similarly on the other subjective effects items (ps < 0.05). Participants reported greater behavioral intentions for UBC than HTP (ps < 0.05) but not e-cigarette. Within the 10-puff bout, cigarettes showed a lower flow rate relative to e-cigarettes and HTP (p < 0.001) and e-cigarettes showed a greater maximum puff volume compared to cigarettes (p = 0.017).

DISCUSSION: Some subjective effects and most behavioral intention items showed a preference for cigarettes compared to HTP. There were no significant differences between the other products. Research is required to investigate how these findings translate to real world use and uptake among Black AWS.