The effect of context on the importance of nicotine-content in choices between cigarettes and e-cigarettes

摘要 香烟是危害最大的烟草产品。虽然不是香烟毁灭性的直接原因 健康后果，尼古丁强化使戒烟变得困难。为了有益于自己的健康，人们 吸烟的人可以从危害较小的非燃烧来源中寻找尼古丁的强化作用。尽管 替代产品的广泛可获得性，包括电子烟，可以与香烟类尼古丁相匹配 送货时，大多数尼古丁消费者仍在使用传统香烟。试图确保最有害的 烟草产品并不同时是最强的，美国食品和药物管理局已经 表示有兴趣制定产品标准，将香烟中的尼古丁含量限制在非常低的水平。 来自随机对照试验的现有证据表明，这样的标准将减少，但不会消除， 在吸烟者中加强香烟的使用。尼古丁减少吸烟的程度 吸烟可能取决于替代品的强化价值，但对人们如何吸烟知之甚少 吸烟的人预计，与其他尼古丁来源相比，非常低的尼古丁香烟具有增强价值。 基于价值的决策，一种神经经济学的选择概念化，表明了 非常低的尼古丁香烟和电子烟可能会波动，这取决于特定的加权重要性 在选择产品特性的时候。因此，我们大致假设，个人的价值观 产品属性依赖于上下文。参与者将在香烟和电子烟之间做出一系列选择 香烟在不同的语境操纵下，研究语境如何通过以下方式改变产品偏好 影响产品类型、尼古丁含量和风味的相对重要性。在Aim 1中，一个在线样本 每天吸烟的人将完成相同离散选择实验的6个版本，其中假设 社会环境和使用禁令是分开操纵的。我们预测当着某人的面 否则，或者在禁止吸烟和允许使用电子烟的环境中，将 产生选择模式，其中产品类型是最具影响力/预测性的选择属性。在目标2中， 每天吸烟并经常使用电子烟的人将在实验室完成两个离散的选择实验 基础设置：戒烟0.5小时后一次，戒烟12小时后一次。 戒烟。我们预测，相对于0.5小时的禁欲，12小时的禁欲会产生选择模式 其中电子烟的尼古丁含量对选择的影响更大。对产品的细致入微的理解 不同背景下对特征的重视将有助于监管机构预测香烟尼古丁的影响 减少与各种潜在的电子烟法规相结合。使用Repeat收集和分析数据 离散选择实验将建立该方法的新应用，非常适合于研究 个人、情景和产品层面的特征有助于烟草和尼古丁的使用模式。

ABSTRACT Cigarettes are the most harmful tobacco products. Though not directly responsible for cigarettes’ devastating health consequences, nicotine reinforcement makes quitting smoking difficult. To benefit their health, people who smoke could seek out nicotine’s reinforcing effects from less harmful, non-combusted sources. Despite the wide availability of alternative products, including e-cigarettes that can closely match cigarette-like nicotine delivery, the majority of nicotine consumers still use traditional cigarettes. To try to ensure the most harmful tobacco products are not simultaneously the most reinforcing, the Food and Drug Administration has expressed interest in a product standard that would limit nicotine content in cigarettes to very low levels. Existing evidence from randomized control trials suggests such a standard would reduce, but not eliminate, cigarette reinforcement among people who smoke. The extent to which nicotine reduction reduces cigarette smoking may depend on the reinforcing value of alternatives, yet relatively little is known about how people who smoke anticipate the reinforcing value of very low nicotine cigarettes relative to other nicotine sources. Value based decision making, a neuroeconomic conceptualization of choice, suggests the relative value of very low nicotine cigarettes and e-cigarettes could fluctuate, depending on the weighted importance of specific product characteristics at the time of choice. Accordingly, we broadly hypothesize that the values of individual product attributes are context-dependent. Participants will make series of choices between cigarettes and e- cigarettes under different context manipulations to examine how context can change product preferences by impacting the relative importance of product type, nicotine content, and flavor. In Aim 1, an online sample of people who smoke daily will complete 6 versions of the same discrete choice experiment, where hypothetical social setting and use-prohibitions are manipulated separately. We predict being in the presence of someone else or being in an environment where cigarette smoking is prohibited and e-cigarette use is allowed will produce choice patterns where product type is the attribute most influential/predictive of choice. In Aim 2, people who smoke daily and use e-cigarette regularly will complete two discrete choice experiments in a lab based setting: once after 0.5hr cigarette and e-cigarette abstinence, and once after 12-hr cigarette and e- cigarette abstinence. We predict 12-hr abstinence, relative to 0.5-hr abstinence, will produce choice patterns where e-cigarette nicotine content is more influential in choice. A nuanced understanding of how product characteristics are valued across contexts will help regulators anticipate the effects of cigarette nicotine reduction combined with various potential e-cigarette regulations. Collecting and analyzing data using repeated discrete choice experiments will establish a new application of the method, well suited for investigating how person-, situation- and product-level features contribute to tobacco and nicotine use patterns.