Behavioral economic assessment of abuse liability for Black & Mild cigar flavors among young adults.

Abstract

Cigars are available in a variety of flavors that may impact uptake and use, but little is known about how different flavors affect abuse liability. This study used 3 behavioral economic tasks to examine abuse liability of Black & Mild cigars differing in flavor among young adult cigarette smokers. Participants were 25 cigar-naïve young adults (aged 18–25 years) who smoked ≥5 cigarettes/day. In 5 Latin square-ordered laboratory visits, participants completed 3 abuse liability tasks (drug purchase task, cross-price purchase task, and multiple-choice procedure) for each of 4 cigar flavors (original, cream, wine, or apple) and own-brand cigarettes. In the drug purchase task, relative to own-brand cigarettes, all cigar flavors were associated with lower abuse liability using most measures (intensity, breakpoint, maximum total tobacco expenditure for 1 day [ps < .05]), although only wine-flavored cigars scored significantly lower using 1 measure (price at maximum total tobacco expenditure for 1 day). When cigars and cigarettes were available concurrently in the cross-price purchase task, all cigar flavors functioned as substitutes for cigarettes. Using the multiple-choice procedure, crossover points for wine- (mean = $0.61) and apple-flavored cigars (mean = $0.71) were significantly lower than own-brand cigarettes (mean = $0.86) and original-flavored cigars (mean = $1.00); no significant differences existed between own-brand cigarettes and original-flavored cigars. Thus, whereas abuse liability may be highest for participants’ own-brand cigarette, young adult smokers may be willing to use flavored cigars. Furthermore, abuse liability varies by cigar flavor, with original- and cream-flavored cigars appearing to have the highest abuse liability. Characterizing flavors and flavor additives in cigars represent an important tobacco regulatory target.

What influences demand for cigars among African American adult cigar smokers? Results from a hypothetical purchase task.

“…Nonetheless, our work provides initial evidence that should be repeated using larger samples and scope for a richer understanding of the demand for cigar products to better inform more equitable tobacco regulatory policies. Future studies could also use similar purchase tasks to compare cigar abuse liability amongst other racial/ethnic groups as well as assess the abuse liability of other cigar product characteristics among AA cigar smokers, notably flavors (Bono et al, 2020; Reed et al, 2020; Zvorsky et al, 2019).…”

“…Understanding which user characteristics are associated with greater abuse liability for cigars is essential for developing policies, regulations, and product standards that promote public health. Abuse liability refers to the likelihood of non-medical drug use leading to dependence and being influenced by characteristics of the drug or drug delivery system itself and that of the individual, social and policy environment (Bono et al, 2020). Demand indices from hypothetical purchase tasks are associated with abuse liability (Zvorsky et al, 2019).…”

Acute effects of flavored Black and mild cigars among young adult cigarette smokers.

“…Participants completed measures of subjective effects immediately before the first 10-puff bout and 5, 15, 30, and 45 min after each bout. Behavioral economic indices of abuse liability, assessed 45 min after the second bout, are discussed elsewhere (Bono et al, 2022).…”

The interaction of nicotine concentration and device power on electronic nicotine delivery system (ENDS) abuse liability among exclusive ENDS users and dual users of ENDS and combustible cigarettes.

“…Chi-square tests and Fisher’s exact tests were used to identify differences in baseline characteristics between exclusive and dual users. For each PRT outcome, differences between experimental ENDS conditions and the OB ENDS condition were assessed using mixed effects linear regressions with robust standard errors, a flexible and efficient approach (Gueorguieva & Krystal, 2004) that has been used in other studies comparing the abuse liability of tobacco products (Barnes et al, 2017; Bono et al, 2020; Karelitz & Perkins, 2021). Pairwise differences between each experimental ENDS condition were then assessed with Wald tests.…”