The impact of menthol and mint e-liquid bans on menthol cigarette smokers

项目摘要 吸烟导致近30%的癌症相关死亡。3 占美国市场份额的三分之一，少数族裔吸烟比例过高。1烟草控制 针对烟草中薄荷醇香料的政策可能会产生重大的公共卫生后果，特别是在 黑人吸烟者烟草监管的一个关键挑战是权衡潜在政策的风险和收益 在不同的人群中（即，4.旨在防止暴力侵害妇女行为的政策之间出现紧张关系。 青少年和年轻成人（AYA）烟草开始和那些旨在减少目前烟草危害的人 用户.具体而言，旨在减少AYA vaping的薄荷醇口味电子液体限制可能无意中 鼓励薄荷香烟吸烟者改用潜在危害较小的产品。使用电子烟或 电子烟在AYA和具有尼古丁荚的电子烟装置中急剧增加（例如，JUUL）占 大部分的AYA使用。5，6这些设备有许多电子液体口味，包括薄荷醇和薄荷， 薄荷是AYA中流行的口味。2，7食品和药物管理局和许多州已经 宣布打算限制所有口味的电子液体，包括薄荷醇和薄荷，以减少AYA vaping。 或者，像JUUL这样的电子烟设备可能是无法吸烟的成年吸烟者的理想替代产品。 戒烟。从减少危害的角度来看，让吸烟者远离燃烧的烟草 将香烟（卷烟）转化为非燃烧产品（电子烟）可能会对公共卫生产生净积极影响。 薄荷醇电子液体的可用性对于鼓励薄荷醇香烟吸烟者转向电子液体可能是重要的。 香烟，但薄荷电子液体，这是吸引AYA，可能是不必要的，以方便切换。包括 薄荷电子液体在香料禁令，但允许薄荷电子液体留在市场上作为潜在的替代品 为薄荷醇吸烟者提供的产品可能是一种最佳的政策方法。行为经济学是一个理想的框架 回答这个问题，因为它适用于经济结构，如产品替代，以个人 决策的我们建议进行实验室研究和实地评估，以确定如何将薄荷醇和 薄荷电子液体在电子液体香料禁令或销售限制影响烟草产品的购买和使用 薄荷醇香烟吸烟者（N=80; 40名黑人，40名白色）。在实验课上，参与者将完成 实验烟草市场（ETM）任务，一个行为经济学任务，他们接受帐户 余额到网上商店，并可以购买薄荷香烟在不断上升的成本或购买电子液体，非薄荷 香烟，或尼古丁替代口香糖在固定成本。他们将在三个市场下完成任务 条件：（1）仅烟草电子液体可用，（2）薄荷醇和烟草电子液体可用，以及（3）薄荷醇， 薄荷和烟草电子烟在现场评估期间，通过评估使用情况来验证产品选择 在ETM任务期间购买的产品。该提案将告知政策制定者禁止 薄荷醇和薄荷电子烟液将促进薄荷醇香烟吸烟者转向电子烟。

PROJECT SUMMARY Cigarette smoking contributes to nearly 30% of all cancer-related deaths.3 Menthol cigarettes comprise almost one-third of the U.S. market share and are disproportionately smoked by racial minorities.1 Tobacco control policies targeting menthol flavoring in tobacco could have significant public health outcomes, especially among black smokers. One key challenge of tobacco regulation is weighing the risks and benefits of potential policies across different populations (i.e., users and non-users).4 Tension arises between policies intended to prevent adolescent and young adult (AYA) tobacco initiation and those intended to reduce harm among current tobacco users. Specifically, menthol flavored e-liquid restrictions aimed at reducing AYA vaping may unintentionally discourage menthol cigarette smokers from switching to potentially less harmful products. E-cigarette use or vaping has increased dramatically among AYA and vaping devices with nicotine pods (e.g., JUUL) account for a large proportion of AYA use.5,6 These devices are available in many e-liquid flavors including menthol and mint, with mint being a popular flavor among AYA.2,7 The Food and Drug Administration and many states have announced intentions to limit all flavored e-liquids, including menthol and mint, in an effort to reduce AYA vaping. Alternatively, vaping devices, like JUUL, may be ideal substitution products for adult smokers who are unable to quit using nicotine. From a harm reduction perspective, moving smokers away from combusted tobacco (cigarettes) to non-combusted products (e-cigarettes) will likely result in a net positive public health impact.8 The availability of menthol e-liquids may be important for encouraging menthol cigarette smokers to switch to e- cigarettes, but mint e-liquids, which are appealing to AYA, may be unnecessary to facilitate switching. Including mint e-liquids in flavor bans but allowing menthol e-liquids to remain on the market as potential substitution products for menthol smokers may be an optimal policy approach. Behavioral economics is an ideal framework for answering this question because it applies economic constructs, such as product substitution, to individual decision-making. We are proposing a lab study and field assessment to determine how including menthol and mint e-liquids in e-liquid flavor bans or sales restrictions affects tobacco product purchasing and use among menthol cigarette smokers (N=80; 40 black, 40 white). At lab sessions, participants will complete the Experimental Tobacco Marketplace (ETM) task, a behavioral economics task in which they receive account balances to an online store and can buy menthol cigarettes at escalating costs or buy e-liquids, non-menthol cigarettes, or nicotine replacement gum at fixed costs. They will complete the task under three marketplace conditions: (1) only tobacco e-liquids available, (2) menthol and tobacco e-liquids available, and (3) menthol, mint, and tobacco e-liquids available. During a field assessment, product choice is validated by assessing use of products purchased during the ETM task. This proposal will inform policy-makers about the impact banning menthol and mint e-liquids will have on facilitating menthol cigarette smokers switching to e-cigarettes.