Article Text
Abstract
Introduction Cigarillos dominate the US cigar market, and young adults largely drive use. While young adults prefer flavoured to non-flavoured cigarillos, especially those flavoured to taste like fruit or other sweets, the factors that underlie this preference have received little attention. We sought to determine if key indicators of abuse liability, the rewarding and reinforcing effects, are greater for sweet versus non-flavoured cigarillos.
Methods Young adults (18–24 years old) completed three laboratory visits assessing the subjective rewarding value (exposure paradigm), relative reinforcing value (computerised choice task) and absolute reinforcing value (ad libitum cigarillo smoking session) of sweet-flavoured versus non-flavoured cigarillos. General linear regression models were fit with the appropriate family link for each outcome measure.
Results Young adults rated sweet-flavoured cigarillos as more rewarding (estimated marginal mean (EMM) =4.52, 95% CI 4.00 to 5.03) than the non-flavoured cigarillo (EMM=3.31, 95% CI 2.80 to 3.83; B=1.20, 95% CI 0.80 to 1.60, p<0.001). The reinforcing value of sweet-flavoured cigarillos, measured by break point, was higher relative to non-flavoured cigarillos (6.34 out of 10), especially among young adults with a preference for flavoured cigarillos (B=1.94, 95% CI 0.71 to 3.18, p=0.003). Young adults took 1.9 times the number of puffs (35.75 vs 19.95) from sweet-flavoured cigarillos compared with non-flavoured cigarillos (Rate Ratio =1.94, 95% CI 1.30 to 2.90, p<0.001).
Conclusions Sweet flavouring increases the abuse liability of cigarillos among young adults as reflected in greater liking, motivation to use and actual use. Banning sweet flavouring in cigarillos may diminish their use in young adults.
Trial registration number CT.gov (NCT05092919).
- Addiction
- Nicotine
- Non-cigarette tobacco products
Data availability statement
No data are available.
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Data availability statement
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Footnotes
Twitter @MatthewDavStone
Contributors JA-M was the principal investigator responsible for the conduct of the study and its conceptualisation. As guarantor, JA-M accepts full responsibility for the work, had access to the data, and controlled the decision to publish. JA-M wrote the majority of the manuscript with assistance from DM, FK and OK, including critical review and revision. MDS conducted the analyses, interpreted the results and drafted the results section. WBP critically reviewed and revised the manuscript. All authors approved the manuscript.
Funding Research reported in this publication was supported in part by the National Institute on Drug Abuse (NIDA) of the National Institutes of Health (NIH) and the US Food and Drug Administration (FDA) Center for Tobacco Products under Award Number R21DA050789.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.