PROJECT SUMMARY – PROJECT 4
The tobacco product landscape changed drastically in the last decade with the proliferation of non-combustible
tobacco products like e-cigarettes (ECs) and new oral nicotine pouches (ONPs). ECs are the most used tobacco
product among adolescents and young adults (AYA) and ONP sales are climbing rapidly. The tobacco industry
has a long history of manipulating three dimensions of nicotine (concentration, form, and isomer) to improve
a product's sensory experience and nicotine delivery. Additionally, the industry has a history of creating a product
graduation strategy whereby some products (defined along their nicotine dimensions) are “starter” for novice
users and others are “robust” for longer-term users. Further, the tobacco industry pairs their products with specific
marketing strategies designed to increase product appeal. The goal of Project 4 (P4) is to provide a
comprehensive understanding of how industry strategies across the nicotine dimensions impact product
perceptions, use behaviors, and dependence among AYA in the natural environment. Participants will be a
national sample of recent initiators (within 6 months) of ECs and ONPs (N = 2000; ages 13-23). We will observe
trends among these AYAs overall, and also among priority populations the tobacco industry has historically
targeted including those who are lesbian, gay, bisexual, transgender, or queer (LGBTQ+), those with mental
health disorders, and rural residents. Participants will be followed over a 2-year period; this prospective
observational study will consist of surveys every 6 months, paired with 3 ecological momentary assessment
(EMA) bursts, to characterize perceptions, use, and marketing exposures. Aim 1 will determine how ECs and
ONPs are perceived over time and across nicotine dimensions in terms of liking, risk perceptions, and social
acceptability. Aim 2 will identify patters of escalation in use of ECs and ONPs across the nicotine dimensions.
Aim 3 will determine which nicotine dimensions are most predictive of nicotine dependence. P4 supports The
Ohio State University's Tobacco Center for Regulatory Science overall integrative theme “Flipping the Script”:
Using the Industry's Nicotine Playbook to Maximize Public Health by examining the impact of ECs and
ONPs, defined by their nicotine characteristics and categorization as starter vs. robust, and perceptions of
marketing in the real world. With strong ecological validity, P4 provides naturalistic observations of youth
behavior to complement the controlled laboratory and experimental assessments that are used in P1-3.
Integration across projects will directly inform premarket tobacco product applications and substantial
equivalence reviews, modified risk tobacco product decisions, and product standards. P4 addresses FDA
scientific domains of Addiction, Behaviors, and Marketing.
Public Health Relevance Statement
Data not available.
NIH Spending Category
No NIH Spending Category available.
Project Terms
3-DimensionalAddressAdolescent and Young AdultAdultAgeBehaviorCategoriesCharacteristicsCigaretteClassificationComplementDataDependenceDimensionsDisparityEcological momentary assessmentElectronic cigaretteEnsureEnvironmentEquityEvaluationEvolutionFosteringGoalsHarm ReductionIndustryIsomerismLaboratoriesLaboratory StudyLesbian Gay Bisexual TransgenderManufacturerMarketingMental disordersModified Risk Tobacco ProductMonitorNicotineNicotine DependenceObservational StudyOhioOralOutcomeParticipantPatternPerceptionPersonsPopulationProliferatingPublic HealthRecording of previous eventsRegulationResearchRiskSalesSaltsSamplingScienceSensorySmokeless TobaccoSmokerSurveysTimeTobaccoTobacco IndustryTobacco useUnited States Food and Drug AdministrationUniversitiesWithdrawalYouthaddictionbasecravingdesignelectronic cigarette useexperienceimprovednovelpopulation healthprospectivequeerrisk perceptionrural dwellerssmokeless tobacco usersocialtobacco advertisingtobacco productstobacco usertrend
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