Introduction Coronavirus Disease 2019 (COVID-19) is a public health crisis, but its effects on tobacco users remain ill-defined. This report aimed to assess the relationship between tobacco product-specific risk perceptions for COVID-19 and changes in tobacco use since the start of the pandemic. Methods A sample (n=776) of past-30 day exclusive smokers (n=238), exclusive e-cigarette users (n=143), and dual users (n=395) residing in the US and aged 18 or older was collected using Mechanical Turk from April 27 to June 8, 2020. Adjusted associations between tobacco product-specific COVID-19 risk perceptions (i.e. risk that smokers/vapers are at for COVID-19 relative to non-smokers/non-vapers) and changes in tobacco use since the pandemic began were assessed using partial proportional odds models. Results A majority of those who used cigarettes (63.7%) and e-cigarettes (56.1%) felt that the risk of COVID-19 was greater for users of their tobacco product than for non-users. Twenty-four percent of smokers had increased their cigarette use since the start of the pandemic and 28.0% had decreased. Similarly, 27.3% of e-cigarette users had increased their e-cigarette use since the start of the pandemic and 23.8% had decreased. Higher risk perceptions for COVID-19 were associated with reductions in tobacco use since the pandemic began for exclusive e-cigarette users and dual users. Conclusions These findings provide support that tobacco product-specific COVID-19 risk perceptions may be an important correlate of changes in tobacco use during the pandemic. Targeted information to inform tobacco users regarding their risks for COVID-19 is needed during this public health crisis.

Open-system electronic nicotine delivery systems (ENDS) permit modifications to device characteristics such as power, potentially increasing nicotine and toxicant delivery. Limiting liquid nicotine concentration may carry unintended consequences by prompting users to increase device power to increase nicotine delivery. This study examined the abuse liability of ENDS across nicotine concentration and power settings. In a clinical laboratory study, n = 19 exclusive ENDS users and n = 13 dual ENDS/cigarette users, aged 21-55 completed four Latin-square ordered conditions that varied by liquid nicotine concentration (10 mg/ ml [low], 30 mg/ml [high]) and device power (15 watts [low], 30 watts [high]), that were followed by a fifth own brand (OB) condition. A progressive ratio task (PRT) using bar presses to earn ENDS puffs was used to assess abuse liability and compare between conditions using mixed effects linear regressions. The low played equal role in conceptualization, data curation, funding acquisition, investigation, methodology, project administration, resources, supervision, validation and writing of review and editing. Caroline O. Cobb played equal role in conceptualization, data curation, funding acquisition, investigation, methodology, project administration, resources, supervision, validation and writing of review and editing.

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Objective: In this paper, we characterize how potential policies restricting access to tobacco products may impact use behaviors among adult, past 30-day, smokers and e-cigarette users. Methods: We conducted an online experiment with 820 smokers, e-cigarette users, and dual users (April 27-June 8, 2020). We randomized participants to one of 4 hypothetical access scenarios: (1) tobacco retail stores open + pharmacies open (TOPO); (2) tobacco stores open but favorite brand unavailable + pharmacies open (TOPO-NFB); (3) tobacco stores closed + pharmacies open (TCPO); and (4) tobacco stores closed + pharmacies closed (TCPC). Outcomes (measured on 0-100 visual analog scales) included the likelihood of quitting, reducing, switching brands or products, and finding another source of tobacco products. Seemingly unrelated regressions tested for associations between access scenarios and prospective tobacco use behaviors. Results: Participants in the TCPO and TOPO-NFB scenarios were more likely to reduce use, switch brands/products, and find another source (ps < .001) than those in the TOPO scenario. Dual and flavored product users were more likely to switch products (ps < .01). Conclusions: When tobacco retailers are closed, tobacco users may be more likely to quit and/or reduce use compared to when retailers are open. However, access restrictions could prompt users to switch tobacco brands/products or sources.