Article Text

Effect of a ‘tobacco-free nicotine’ claim on intentions and perceptions of Puff Bar e-cigarette use among non-tobacco-using young adults
  1. Julia Chen-Sankey1,2,
  2. Ollie Ganz1,3,
  3. Andrew Seidenberg4,
  4. Kelvin Choi2
  1. 1 Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, New Jersey, USA
  2. 2 Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA
  3. 3 Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, New Jersey, USA
  4. 4 Division of Cancer Control and Population Sciences, Behavioral Research Program, National Cancer Institute, Bethesda, Maryland, USA
  1. Correspondence to Dr Julia Chen-Sankey, Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA; jc.sankey{at}


Introduction Puff Bar disposable e-cigarettes are now marketed with a ‘tobacco-free nicotine’ claim. We assessed the effect of this claim on non-tobacco-using young adults’ perceptions of and intentions of using Puff Bar.

Methods We conducted an online randomised between-subjects experiment among non-tobacco-using young adults (ages 18–29 years; n=1822). Participants viewed depictions of Puff Bar e-cigarettes with the claim that the product contains ‘tobacco-free nicotine’ (experimental group; n=909) or simply ‘nicotine’ (control group; n=913). Multivariable regressions were used to assess the associations between experimental conditions and Puff Bar use intentions, harm perceptions, use expectancies and perceived relative use of Puff Bar versus other e-cigarettes, controlling for participant characteristics.

Results Compared with the control group, the experimental group who saw the ‘tobacco-free nicotine’ claim reported higher intentions of using Puff Bar (coefficient=0.17, p<0.001). The experimental group had a lower likelihood of perceiving Puff Bar use as ‘extremely or very harmful’ (OR=0.63, p<0.001) and ‘strongly or somewhat’ agreeing with the negative expectancy of using Puff Bar (OR=0.67, p<0.001). Additionally, the experimental group reported being ‘much more or more likely’ to use Puff Bar over other e-cigarettes (OR=1.67, p<0.001).

Discussion Puff Bar’s tobacco-free nicotine claim may increase non-tobacco-using young adults’ intentions of using Puff Bar and reduce harm perceptions and negative expectancy towards using Puff Bar. The claim may also prompt the use of Puff Bar over other e-cigarette brands and types. These findings are concerning given the health effects and regulations for tobacco-free nicotine products are not immediately clear.

  • advertising and promotion
  • electronic nicotine delivery devices
  • nicotine

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  • Contributors Concept and design—JC-S. Acquisition, analysis or interpretation of data—all authors. Drafting of the manuscript—JC-S, OG and AS. Critical revision of the manuscript for important intellectual content—all authors. Statistical analysis—JC-S and KC. Obtained funding—JC-S and KC. Administrative, technical or material support—JC-S and KC. Supervision—JC-S and KC.

  • Funding This study was funded by NCI and FDA grant number R00CA242589 (PI: JC-S). KC was supported by the Division of Intramural Research, National Institute on Minority Health and Health Disparities. AS was supported by the National Cancer Institute. OG was supported in part by NCI and Food and Drug Administration (FDA) Center for Tobacco Products (CTP) under U54CA229973. JC-S and OG were supported in part by the Rutgers Cancer Institute of New Jersey under P30CA07270.

  • Disclaimer Comments and opinions expressed belong to the authors and do not necessarily represent the views of the US Government, National Institutes of Health, National Cancer Institute, National Institute on Drug Abuse, National Institute on Minority Health and Health Disparities or the US FDA.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.