C-FLASH (Cigarillo Flavor and Abuse Liability, Attention, and Substitution in youtH)
Condition: Smoking Behaviors
Study type: Interventional

Summary: 
      The purpose of this research is to understand how flavor affects young adult's perceptions of
      little cigar or cigarillo use.
    

Detailed description: 
      The overall goal of this study is to examine and better understand adolescent and young adult
      perceptions, visual attention, use intentions and purchasing behaviors among users and
      non-users of cigarillos.

      Supplemental Aim 1: Consists of evaluation of the differences in perceptions of flavors on
      appeal, purchasing and risk perceptions of cigarillo products between young adult sexual and
      gender minorities (SGM) and heterosexual females. A convenience sample of SGM females will be
      recruited using online social media platforms with targeted advertising. From the parent
      survey (or Aim 1), an existing sample of female heterosexual cigarillo users will be
      leveraged. Both samples will receive the same survey, Aim 1, to compare perceptions of
      appeal, risk, and purchasing across cigarillos and other tobacco products.

      Aim 1 of this study is exploratory and will consist of an online survey. Findings from Aim 1
      will inform the questions asked about advertising and product use in Aim 2 and 3. Both Aim 2
      and 3 are randomized sections. Participants in Aim 2 are either tobacco users or non-users.
      Participants will be asked to view a series of tobacco related images. The sequence of those
      images is randomized. In Aim 3, participants will be randomized in terms of the options they
      are presented within the Experimental Tobacco Marketplace (ETM) (i.e. which tobacco items
      they can purchase and at what price).

      Supplemental Aim 3 consists of evaluating the differences in the abuse liability/addictive
      potential of flavored versus unflavored cigarillos and the substitutability of flavored
      versus unflavored disposable e-cigarettes between young adult sexual and gender minorities
      (SGM) and heterosexual females. SGM female cigarillousers will be recruited from participants
      of the Supplemental Aim 1 sample and be compared to heterosexual female participants of the
      parent study (or Aim 3). Both samples will receive the same questions and be exposed to the
      same ETM conditions tocompare perceptions of appeal of flavors and substitutability between
      cigarillos, e-cigarettes, and other tobacco products.
    

Intervention name(s): Aim 1: Online survey; Eye Tracking Activity; Eye tracking survey; Online Experimental Marketplace (ETM); Aim 3 survey; Cognitive Interviews
Intervention type(s): Other; Behavioral; Other; Behavioral; Other; Other
Intervention description(s): This survey will evaluate perceptions of flavors on appeal, purchasing and risk perceptions of cigarillo products among young adult and adolescent cigarillo users. This survey will be used to inform survey design for further aims.
As a proxy for biological verification of tobacco use status, data on brand, frequency, and pricing will be collected to confirm user status
Participants will rate the role of flavor and report perceptions of product appeal, health risk, advertising exposure and use intentions. Participants will also complete purchase and substitution tasks.; The eye tracking activity consists of a single in-person eye tracking activity that will take place in a private office where the participant will be seated in a chair within a typical viewing distance from a computer monitor equipped with an infrared camera on the monitor to capture precise eye movements. Participants will have their gaze monitored continuously by the camera on the computer monitor while a randomized set of stimuli (product advertisements) are viewed (n=30) for 10 seconds per image. Following each advertisement, an on-screen closed response question will re-center the participant's gaze for standardization prior to the next image; Participants will complete a survey using Qualtrics immediately after the eye tracking activity and one week following completion of the activity via email to measure recall of brand name, product flavors, perceptions of cigarillo harm, and tobacco use behaviors and intentions.; Administered online via Qualtrics
Participants are given an account balance for use during their assigned ETM based on their average weekly tobacco use calculated from previous interview. Participants will view all four price conditions and all four flavor conditions in random order for a total of 16 rounds
Cigarillo price conditions: 1) market price 2) ½ market price 3) 2X market price 4) 4X market price
Flavor condition: 1) flavored cigarillos and fruit-flavored disposable-cigarettes available 2) unflavored cigarillos and fruit-flavored ecigarettes available 3) flavored cigarillos and tobacco-flavored e-cigarettes available 4) unflavored cigarillos and tobacco-flavored e-cigarettes available.
Participants will purchase cigarillos with their account balance. During all ETM conditions, constant-priced alternative tobacco products (smokeless tobacco, nicotine lozenges, nicotine gum, and the nicotine patch) will be available in addition to the cigarillos and e-cigarettes.; Consists of:
A screener and demographic data collection.
A tobacco product withdrawal scale
Upon completion of the ETM, participants will be asked to respond to a quality assurance question regarding the conditions that varied. Participants will be shown a list of 8 possible conditions and must chose one of the three that varied in order to be eligible to receive compensation.
The tobacco product withdrawal scale again
Measurements of nicotine dependence and flavor preferences; Cognitive Interviews will be done in-person, using Zoom, or over the phone. Interviews will be video or audio recorded. . The participant will be given a select section of the survey questions from Aim 1. The survey will be uploaded to Qualtrics to reflect the way that survey would be conducted in Aim 1. With the survey questions in front of the participant on the computer screen, research personnel will ask probing questions about each one of the survey questions. If the participant is not able to participate in person or via Zoom, they will be allowed to be interview over the phone with access to the Qualtrics survey or a paper form. If the participant is unable to access the internet, the participant will be read the questions by research personnel. The participant will provide feedback about the questions and walk the research personnel through their thought process for approaching each survey question.
Allocation: Non-Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention