Exploring current smokers? interest in using smokeless tobacco products

描述(申请人提供)：新型无烟烟草产品仿制于巴氏杀菌的瑞典鼻烟，其烟草特有的亚硝胺含量非常低，健康风险似乎很低，目前在美国市场上可以买到。这些产品由包括菲利普莫里斯和RJ雷诺在内的制造商销售，不同于传统上在国内销售和使用的鼻烟和咀嚼产品。这些产品中的大多数都是在吸烟者无法吸烟的情况下(例如，公共室内区域)销售的。无烟烟草(ST)和香烟的双重使用越来越令人担忧，但吸烟者是否有兴趣将无烟产品用作吸烟的临时替代品，或是否愿意完全从香烟转向无烟烟草，人们知之甚少。从根本上改变尼古丁供应方式的决定可能至少部分取决于价格，特别是相对于香烟的价格--例如，以折扣提供的替代产品可能被视为或多或少具有吸引力。拟议的一系列研究试图使用互补的方法来解决这些问题，这些方法涉及价格与产品采用关系的不同方面，并考虑了其他中介和调节因素。第一项研究将使用基于网络的购买任务，使用行为经济学方法检查ST和香烟的需求曲线。目前的吸烟者(n=1008)将被随机分配到在完成购买任务之前观看或不观看产品广告，以检查营销对需求曲线特征的影响。交叉价格弹性也将通过联合展示两类产品进行评估，替代产品以固定价格提供(1美元)。第二组研究将使用经济学家常用的实验性拍卖方法，通过确定吸烟者在不同情景下的支付意愿，深入了解ST和香烟的相对价值。这与模拟(如目标1)不同，它涉及实际购买的真实产品，因此可以作为对给定产品感兴趣的更准确的指标。共有675名吸烟者将参加拍卖。拍卖的特点将是对提交给参与者的有关竞价产品的信息的类型和语气进行操纵。另一组参与者将有机会在竞标前试用该产品(骆驼鼻烟、Ariva、Commit)(试图模仿“免费样品”)。这项研究项目的最后一个组成部分是检查价格、可获得性和关于在当前吸烟者中使用ST替代香烟的信息的影响。参与者(N=240)将被随机分配到6种卷烟价格条件中的一种，ST产品(骆驼鼻烟、通用鼻烟、Ariva)以固定价格提供，并将在模拟零售环境中每周参与烟草产品的购买。一份广泛的基线问卷将提供关于潜在中介变量(估计的需求弹性)和调节变量(延迟折扣、尼古丁依赖、人口统计学)的信息。各种ST产品和香烟的可获得性将在不同的研究会议上被操纵，关于ST产品的信息的可用性也将被操纵。我们计划研究价格、可获得性和信息对观察到的ST产品替代香烟的程度的影响。结果测量包括每天消费的香烟和ST单位，唾液可替宁水平，肺泡一氧化碳水平，以及尼古丁依赖、渴求和戒断的指标。这套研究可能有助于梳理价格-产品关系的各个方面，从而更好地为公共政策辩论提供信息。

DESCRIPTION (provided by applicant): Novel smokeless tobacco products modeled on pasteurized Swedish snus, which is very low in tobacco-specific nitrosamines and appears to have low health risks, are now available in the US market. These products have been marketed by manufacturers, including Philip Morris and RJ Reynolds, and differ from the snuff and chew products traditionally sold and used domestically. Most of these products are marketed to smokers for situations when they are unable to smoke (e.g., public indoor areas). Dual use of smokeless tobacco (ST) and cigarettes is a growing concern, but relatively little is known about smokers' interest in using smokeless products as a temporary substitute for cigarette smoking or willingness to switch over completely from cigarettes to ST. A decision to radically change mode of nicotine delivery may depend at least in part on price, especially price relative to cigarettes-a substitute product offered at a discount may be viewed as more or less attractive, for example. The proposed series of studies attempts to address these questions using complementary approaches that address different aspects of the relationship of price to product adoption, considering other mediating and moderating factors. The first study will use a web-based purchase task to examine the demand curve for ST and cigarettes using behavioral economic methods. Current smokers (n=1008) will be randomly assigned to view or not view product advertisements before completing the purchase tasks, to examine the effect of marketing on characteristics of the demand curve. Cross-price elasticity will also be assessed by jointly presenting both classes of products, with the substitute offered at a fixed price ($1). A second set of studies using experimental auction methods commonly used by economists will be employed to gain insight into the relative value of ST and cigarettes by determining smokers' willingness to pay under different scenarios. Rather than a simulation (as in Aim 1), this involves the actual purchase of real products, and so may serve as a more accurate indicator of interest in a given product. A total of 675 smokers will take part in auctions. The auctions will feature a manipulation of the type and tone of information presented to participants about the products for bid. Another group of participants will be offered the opportunity try the product (Camel Snus, Ariva, Commit) prior to bidding (an attempt to mimic 'free sampling'). The final component of this research project is to examine the influence of price, availability, and information on substitution of ST for cigarettes in a population of current smokers. Participants (N=240) will be randomly assigned to one of 6 cigarette price conditions, with ST products (Camel Snus, General Snus, Ariva) offered at a fixed price, and will participate in weekly 'purchases' of tobacco products in a simulated retail environment. An extensive baseline questionnaire will provide information on potential mediating (estimated elasticity of demand) and moderating (delay discounting, nicotine dependence, demographics) variables. Availability of various ST products and cigarettes will be manipulated at different study sessions, as will the availability of information about ST products. We plan to examine the influence of price, availability, and information on the degree of observed substitution of ST products for cigarettes. Outcome measures include cigarettes and ST units consumed per day, saliva cotinine levels, alveolar CO levels, and indicators of nicotine dependence, craving, and withdrawal. The set of studies may help to tease apart the various aspects of the price-product relationship and so better inform public policy debates.