Differences in intention to use flavored oral nicotine products among young adult e-cigarette users and non-users

Abstract

New oral nicotine products (ONPs; nicotine pouches, gums, lozenges, and gummies), which are regulated as nonmedicinal tobacco products in the U.S., have flavors and other characteristics that previously attracted young adults to e-cigarettes. Whether young adults' interest in ONPs differs by e-cigarette use status and quit-vaping motivation is unknown but important for understanding the possible health impact of ONPs. It is particularly important to study if nonmedicinal ONPs attract e-cigarette users interested in quitting vaping, given that nicotine replacement (NRT) therapy uptake in young adults is low. In this study, ONP non-users (ages: 20-24) from California viewed digital images of 5 flavored ONPs (4 nonmedicinal and one NRT gum product) and reported intention to use each ONP (0-100 score). Main and interactive effects of Group (past-6-month e-cigarette non-users [n = 1,1388], e-cigarette users unmotivated to quit vaping [n = 168], and e-cigarette users motivated to quit vaping [n = 99]) and ONP type (nonmedicinal gum, nonmedicinal lozenge, gummy, pouch, and NRT gum) on use intention were tested. For each nonmedicinal ONP, use intention was higher in both e-cigarette user groups than non-users (ds = 0.47-0.59; Ps < 0.001), but did not differ between e-cigarette users with and without quit-vaping motivation (Ps ≥ 0.31). A Group × ONP type interaction was found, whereby higher use intention for e-cigarette users with vs without quit motivation was present for only gum NRT (Cohens d = 0.17; P =.01). Among young adults, e-cigarette users might be more inclined than e-cigarette non-users to try nonmedicinal ONPs regardless of quit-vaping motivation.

Fig. 1

Images of Oral Nicotine Products Displayed in Use Intention Rating Assessment.

Fig. 2

Mean (SE) intention to use oral nicotine products, by e-cigarette use and quit vaping motivation status^a,b. ^aOutcome was responses to “Would you use this product?” (0 “definitely not” to 100 “definitely yes”). ^bStatistical significance of pairwise contrast was estimated using Benjamini-Hochberg corrections for multiple testing (based on a 2-tailed corrected P-value at 0.05). *Significantly different from no e-cigarette use group for respective product type (p <.001). ^†Significanlty different from e-cigarette use without quit vaping motivation for respective product type (p =.01).