Effects of tobacco cut and nicotine form on the abuse liability of moist snuff

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PROJECT ABSTRACT For decades, the tobacco industry has manipulated moist snuff (i.e., dip) to become as appealing and addictive as possible. These manipulations have resulted in moist snuff accounting for 90% of the smokeless tobacco (SLT) market share in the United States and have slowed progress in reducing the prevalence of SLT use. The public health burden of the tobacco industry’s actions has not been equitable; males living in Appalachian regions of the United States continue to use SLT at high rates, leading to regional inequities in cardiovascular disease, cancer, and poor oral health. The goal of this research is to identify local, state, and/or federal regulations for moist snuff that reduce its addiction potential. This research will evaluate two features of moist snuff that are key targets of manipulation from the tobacco industry and drivers of its addiction potential: length of tobacco cut (long vs. fine) and nicotine form (low vs. high levels of nicotine in the free-base form). Finer tobacco cuts and higher levels of free-base nicotine (FBN) result in faster, greater nicotine delivery. Building on the PI’s areas of expertise and providing crucially-needed training, evaluations of tobacco cut and nicotine form will be done epidemiologically, using analytical chemistry, and using experimental human laboratory methods. For the epidemiological evaluation, we will complete a secondary data analysis of recent population-based cohorts to evaluate associations between level of SLT dependence and product characteristics (i.e., cut, flavor, brand) of moist snuff used by adolescents and adults in Appalachian Ohio. For the analytical chemistry evaluation, we will quantitate the levels of total nicotine and FBN present in moist snuff products used by adolescent and adult participants in our Appalachian Ohio cohorts; these characteristics of products will be compared according to level of SLT dependence of the user as well as other product features (e.g., tobacco cut and flavor). For the human laboratory evaluation, we will use a 2x2 within-subjects cross-over design to test how moist snuff use (amount and duration), nicotine delivery, and appeal differ according to variations in cut (long vs. fine) and level of FBN (low vs. high). We will also evaluate whether the association between style of moist snuff and outcomes varies according to level of SLT dependence. Participants will be adults who live in Appalachian Ohio and are daily moist snuff users. Altogether, this research will provide a foundation for understanding the characteristics of moist snuff used in Appalachia—where the burden of SLT use remains stubbornly high—and the effects that regulations on tobacco cut and nicotine form could have on reducing health inequities in this region. The conduct of this research and implementation of the proposed training plan will also provide the PI, a promising scientist with strong foundations in epidemiology and biostatistics, Appalachian health disparities research, and other areas of tobacco regulatory science with needed training in addiction research, tobacco product evaluation, and human laboratory experimental designs.