Early Subjective Sensory Experiences with “Cigalike” E-cigarettes Among African American Menthol Smokers: A Qualitative Study

Smiley, Sabrina L; DeAtley, Teresa; Rubin, Leslie F; Harvey, Emily; Kierstead, Elexis C.; Hooper, Monica Webb; Niaura, Raymond; Abrams, David B.; Pearson, Jennifer

doi:10.1093/ntr/ntx102

Cited by 12 publications

(8 citation statements)

References 38 publications

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“…Our results generally contrast with a previous study of AA adults switching from smoking to first generation ECs which found that the majority (73%) reported an unsatisfactory experience [ 14 ]. One of the most important distinguishing characteristics between first generation cigalikes and fourth generation NSPS ECs is the nicotine salt formulation which provides more efficient nicotine delivery [ 20 , 26 ].…”

Section: Discussioncontrasting

confidence: 99%

“…Racial and ethnic disparities in exclusive switching to ECs could exacerbate the burden of tobacco-related death and disease among disadvantaged populations [ 13 ]. A previous prospective qualitative study of AA people who smoked menthol cigarettes switching to first generation cigalikes found that the majority (73%) reported an unsatisfactory experience [ 14 ]. More information on the experience of ECs among AA and Lx individuals who smoke is needed to evaluate the viability of ECs as a harm reduction strategy.…”

Section: Introductionmentioning

confidence: 99%

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“It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

et al. 2021

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Background Electronic cigarettes are a harm reduction strategy for individuals who smoke cigarettes who cannot or do not want to quit using FDA-approved cessation methods. Identifying perceived facilitators and barriers to switching among people who smoke cigarettes is critical to optimizing health impact. This is particularly important for the most dominant e-cigarette device, nicotine salt pod electronic cigarettes. We investigate the experience using pod electronic cigarettes among African American and Latinx individuals who smoke, the two largest racial/ethnic minority groups who experience significant health disparities. Methods From July 2018 to May 2019, adults who smoked cigarettes, age 21 + (N = 114; M age = 44.6, 59.6% male, 52.6% African American from Kansas City, 47.4% Latinx from San Diego) received JUUL-brand electronic cigarettes (referred to hereafter as JUUL) for 6 weeks and answered interview questions at week six. We inquired what they liked and disliked about using JUUL, what helped with switching and made switching difficult, future intentions for continued JUUL use, and how JUUL compared to past smoking reduction methods. Responses were coded into themes by independent raters. Theme frequencies were analyzed separately by race/ethnicity and week 6 use trajectory (exclusive JUUL use, dual JUUL and cigarette use, exclusive cigarette use). Results Clean/smell was the aspect of using JUUL most commonly liked (23%), followed by convenience (19%). Coughing/harshness was a more common barrier to switching for African American (44%) than Latinx (9%), and for continuing cigarette use (56%) than for those who exclusively switched or dually used JUUL and combustible cigarettes (15–21%). Most (78% African American; 90% Latinx) reported that the benefits of using JUUL outweighed barriers, and this varied by JUUL use trajectory: 94% exclusive switch, 86% dual use, and 42% continued cigarette use. The majority said they would continue using JUUL to replace cigarettes (83% African American; 94% Latinx) and that JUUL worked better than other methods to reduce cigarettes (72%). Conclusion African American and Latinx individuals who smoked experience using pod electronic cigarettes was generally positive. Understanding facilitators and impediments to switching to electronic cigarettes among racial/ethnic minority people who smoke can inform harm reduction interventions and reduce tobacco-related health disparities. Trial Registration ClinicalTrials.gov Identifier: NCT03511001 posted April 27, 2018.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

et al. 2021

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“…53 Appeal is complex and encompasses attractiveness of the product, sensory characteristics, and subjective satisfaction as well as cost, accessibility, and marketing practices. 40,54–56 A product with minimal appeal will not be adopted or used extensively (e.g., over-the-counter NRT 57,58 ). NNPs must be sufficiently appealing to encourage a larger portion of smokers to switch from the high- to the low-harm products.…”

Section: A New Frameworkmentioning

confidence: 99%

“…NNPs must be sufficiently appealing to encourage a larger portion of smokers to switch from the high- to the low-harm products. 54 Dependence (y-axis) refers to the potential for the product to provide satisfaction and induce a degree of addiction, which is a function both of its pharmacological and its subjective rewarding and sensory properties. Dependence can reflect a response to withdrawal and to enjoying, liking or needing nicotine’s well-documented desirable effects, like improved alertness, concentration, mood and memory.…”

Section: A New Frameworkmentioning

confidence: 99%

Managing nicotine without smoke to save lives now: Evidence for harm minimization

Abrams

Glasser

Villanti

et al. 2018

Preventive Medicine

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Tobacco control has made strides in prevention and cessation, but deaths will not decline rapidly without massive behavior change. Currently, inhaled smoke from combusting tobacco is chiefly responsible for prematurely killing 7.2 million people worldwide and 530,000 in the United States annually. An array of noncombustible nicotine products (NNPs) has emerged and has disrupted the marketplace. Saving lives more speedily will require societal acceptance of locating a "sweet spot" within a three-dimensional framework where NNPs are simultaneously: 1. Less toxic, 2. Appealing (can reach smokers at scale), and 3. Satisfying (adequate nicotine delivery) to displace smoking. For this harm minimization framework to eliminate smoking, a laser focus on "smoking control" (not general tobacco control) is needed. By adopting these economically viable NNPs as part of the solution, NNPs can be smoking control's valued ally. Synthesis of the science indicates that policy and regulation can sufficiently protect youth while speeding the switch away from smoking. Despite some risks of nicotine dependence that can be mitigated but not eliminated, no credible evidence counters the assertion that NNPs will save lives if they displace smoking. But scientific evidence and advocacy has selectively exaggerated NNP harms over benefits. Accurate communication is crucial to dispel the misperception of NNPs harms and reassure smokers they can successfully replace smoking cigarettes with NNPs. Saving more lives now is an attainable and pragmatic way to call for alignment of all stakeholders and factions within traditional tobacco control rather than perpetuate the unrealized and unrealizable perfection of nicotine prohibition.

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“…For example, some participants explicitly stated a preference for cigarettes and were willing to go outside to use them, but not e-cigarettes. This suggests that if smokers perceive that e-cigarettes cannot outcompete traditional cigarettes on nicotine delivery, taste, and ‘whole body’ satisfaction, then they may not switch to e-cigarettes 23 , and they may not comply with indoor smoke-free policies that prohibit e-cigarette use.…”

Section: Discussionmentioning

confidence: 99%

"I pulled out my e-cigarette right there and I was puffing": An exploratory analysis of adult daily smokers' experiences using e-cigarettes in smoke-free places

Smiley¹,

Kierstead²,

Harvey³

et al. 2018

Tob. Induc. Dis.

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INTRODUCTION Evidence indicates that one reason cigarette smokers value e-cigarettes is the ability to use them in places where smoking is not permitted. We sought to: 1) explore adult daily smokers’ experiences using e-cigarettes in the context of smoke-free places; and 2) describe smokers’ perceptions of bystanders’ reactions. METHODS Twenty adult daily smokers in Washington, DC initiated e-cigarettes for three weeks and completed in semi-structured interviews at the end of each week. All interviews (n=60) were digitally-recorded, transcribed verbatim, imported into NVivo 10.0, and analyzed using thematic analysis methodology. RESULTS The sample had a mean age of 37.9 years and 18 participants reported having smoked their first cigarette by age 18. Common themes included descriptions of: 1) uncertainty about whether smoke-free policies included e-cigarettes; 2) using e-cigarettes in smoke-free places (e.g. restaurants, workplace, public transit-bus and rail); 3) approaches to e-cigarette use in smoke-free places as part of a complex decision-making process, ranging from testing and establishing the social and spatial boundaries of e-cigarette use, to confining e-cigarette use to inside their home; and 4) favorable, unfavorable, and impartial reactions from bystanders facilitated or impeded e-cigarette use, indicating social approval/social disapproval. CONCLUSIONS Results suggest a continuum of factors, including smoke-free policies and reactions from bystanders may facilitate or impede e-cigarette use among smokers in environments where a smoke-free imperative is well-established. As e-cigarette use evolves, study findings indicate the importance of the social environment and how it could affect those switching from cigarettes to e-cigarettes.

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Early Subjective Sensory Experiences with “Cigalike” E-cigarettes Among African American Menthol Smokers: A Qualitative Study

Cited by 12 publications

References 38 publications

“It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

“It is the One Thing that has Worked”: facilitators and barriers to switching to nicotine salt pod system e-cigarettes among African American and Latinx people who smoke: a content analysis

Managing nicotine without smoke to save lives now: Evidence for harm minimization

"I pulled out my e-cigarette right there and I was puffing": An exploratory analysis of adult daily smokers' experiences using e-cigarettes in smoke-free places

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