Impact of a reduced nicotine standard and menthol cigarette ban on reinforcing properties of cigarette smoking among Sexual and Gender Minority (SGM) young adults

项目总结/文摘

PROJECT SUMMARY/ABSTRACT This administrative supplement (NOT-OD-20-032) addresses the appeal and abuse liability of menthol and non-menthol very low nicotine cigarettes (VLNCs) among young adult (YA; ages 18-26) sexual and gender minority (SGM) menthol smokers. Although non-menthol cigarette use has declined among YAs, there has been an increase in menthol cigarette use. Menthol smoking is also higher among SGM adult smokers relative to non-SGM individuals. Results from our recent study across the state of Oklahoma revealed that 46% of sexual minority YAs reported menthol cigarette use compared to 30% of heterosexual YAs. Further, SGM menthol smokers are significantly less likely to want to quit smoking. The appeal of menthol cigarettes may enhance nicotine ingestion and could be one reason for the lower desire to quit among SGM menthol smokers. The parent grant uses a multi-method laboratory design to assess appeal and abuse liability of menthol and non-menthol VLNCs using laboratory and ecological momentary assessment (EMA), as well as an Experimental Tobacco Marketplace (ETM) which will allow us to model how reinforcement of one product may lead to quitting or substitution of other tobacco products as a function of different product standards. This administrative supplement will include a new specific aim (Aim 4) to compare differences between SGM and non-SGM YAs on menthol cigarette reinforcement and tobacco purchasing behavior in the context of a reduced nicotine standard, using the same laboratory, EMA, and ETM methodologies proposed in the parent grant. Specifically, this new aim has three sub-parts: Aim 4a will assess relative reinforcement of menthol and non-menthol VLNCs among SGM participants, and whether menthol reinforcement, measured in the laboratory, differs across SGM and non-SGM YAs. Aim 4b will assess relative reinforcement of menthol and non-menthol VLNCs among SGM participants measured in the natural environment (via EMA), and whether menthol reinforcement differs across SGM and non-SGM YAs. Aim 4c will examine differences between SGM and non-SGM YAs on tobacco purchasing behavior, in the context of a menthol flavor ban and a reduced nicotine standard using an ETM paradigm. Taken together, while the parent grant focuses on the factors that underlie menthol appeal among YA smokers more broadly, this administrative supplement will focus on factors that underlie menthol appeal specifically in a disparate and high-risk group of SGM tobacco users. No data exist on the ways in which SGM YAs may be differentially influenced by menthol and non-menthol VLNCS, product characteristics that can be regulated by FDA. We believe this new study aim, which focuses on a vulnerable group of tobacco users who have disproportionately high rates of menthol cigarette use, will allow for a stronger study conclusion and a more informed foundation for future FDA actions related to menthol in cigarettes or other tobacco products. Finally, because of the disproportionately high use of tobacco among SGM individuals and FDA's intention to bring VLNCs to the market, there is an urgent need to understand how future mandated market-wide reductions in cigarette nicotine levels may have downstream impacts on cigarette smoking and appeal in this particular sub-group of SGM YAs.