Effects of Narratives on Demand for Low and High Ventilated Cigarettes and Substitution for Alternative Products

Study Overview
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Brief Summary
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This study will investigate the effects of narratives on demand for low and high ventilated cigarettes and substitution for alternative products in the Experimental Tobacco Marketplace.

Detailed Description
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An important aim of tobacco control is to reduce demand for the most harmful products. One product feature that could be changed to benefit public health is cigarette filter ventilation. A recent review examined the effects of cigarette filter ventilation and concluded that filter ventilation, by changing how a cigarette burns, yields more mutagens and carcinogens, and results in greater puff volume and possibly depth of inhalation, which has led to increases in peripheral lung adenocarcinomas. This study will use a novel method, the Experimental Tobacco Marketplace (ETM), to compare the impact of a narrative and a factsheet on the negative consequences of filter ventilation on tobacco product purchases. High-ventilated cigarette smokers will complete multiple scenarios in the ETM.

Official Title
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Effects of Narratives on Demand for Low and High Ventilated Cigarettes and Substitution for Alternative Products

Conditions
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Cigarette Smoking

Intervention / Treatment
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* Behavioral: High-ventilated cigarette alone
* Behavioral: Low-ventilated cigarette alone
* Behavioral: High- and low-ventilated cigarette with high-ventilated cigarettes increasing in price
* Behavioral: Low- and high-ventilated cigarette with high-ventilated cigarettes increasing in price
* Behavioral: Usual, high- and low-ventilated cigarette with usual cigarettes increasing in price.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Provide informed consent Be at least 21 years of age or older Provide a breath sample for measuring carbon monoxide (CO ≥ 8 ppm) Stable tobacco use patterns for at least three months Be willing to sample the study cigarettes (high- and low-ventilated cigarettes) Report smoking a high-ventilated cigarette (>= 20% ventilation) Report smoking at least 10 cigarettes per day Exclusion Criteria: Have plans to move out of the area Have a serious or unstable physical or mental health condition Taking a tobacco cessation medication or medication that interferes with nicotine metabolism, motivation or reinforcement Report concrete, immediate plans to alter/quit using their usual nicotine products at the beginning of the study

Ages Eligible for Study
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Minimum Age: 21 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Crossover Assignment
Interventional Model Description: Participants will complete five ETM conditions, which include six trials assessing different cigarette prices: a) high-ventilated cigarette alone, b) low-ventilated cigarette alone, c) high- and low-ventilated cigarette with high-ventilated cigarettes increasing in price, d) high- and low-ventilated cigarette with low-ventilated cigarettes increasing in price, and e) usual, high- and low-ventilated cigarette with usual cigarettes increasing in price.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Narratives<br>High-ventilated cigarette smokers will be exposed to a narrative about the negative consequences of smoking ventilated cigarettes and all of the conditions described in the intervention section. | Behavioral: High-ventilated cigarette alone<br>* High-ventilated cigarettes are the only available cigarettes in the Experimental Tobacco Marketplace which increases in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Low-ventilated cigarette alone<br>* Low-ventilated cigarettes are the only available cigarettes in the Experimental Tobacco Marketplace which increases in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: High- and low-ventilated cigarette with high-ventilated cigarettes increasing in price<br>* High- and low ventilated cigarettes are available in the Experimental Tobacco Marketplace with high-ventilated cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Low- and high-ventilated cigarette with high-ventilated cigarettes increasing in price<br>* Low- and high-ventilated cigarettes are available in the Experimental Tobacco Marketplace with low-ventilated cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Usual, high- and low-ventilated cigarette with usual cigarettes increasing in price.<br>* Usual cigarette, low- and high-ventilated cigarettes are available in the Experimental Tobacco Marketplace with usual cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>|
| Experimental: Fact sheet<br>High-ventilated cigarette smokers will be exposed to fact sheet about the negative consequences of smoking ventilated cigarettes and all of the conditions described in the intervention section. | Behavioral: High-ventilated cigarette alone<br>* High-ventilated cigarettes are the only available cigarettes in the Experimental Tobacco Marketplace which increases in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Low-ventilated cigarette alone<br>* Low-ventilated cigarettes are the only available cigarettes in the Experimental Tobacco Marketplace which increases in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: High- and low-ventilated cigarette with high-ventilated cigarettes increasing in price<br>* High- and low ventilated cigarettes are available in the Experimental Tobacco Marketplace with high-ventilated cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Low- and high-ventilated cigarette with high-ventilated cigarettes increasing in price<br>* Low- and high-ventilated cigarettes are available in the Experimental Tobacco Marketplace with low-ventilated cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Usual, high- and low-ventilated cigarette with usual cigarettes increasing in price.<br>* Usual cigarette, low- and high-ventilated cigarettes are available in the Experimental Tobacco Marketplace with usual cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>|
| Experimental: Control<br>High-ventilated cigarette smokers will be not be exposed to any messages and will complete all of the conditions described in the intervention section. | Behavioral: High-ventilated cigarette alone<br>* High-ventilated cigarettes are the only available cigarettes in the Experimental Tobacco Marketplace which increases in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Low-ventilated cigarette alone<br>* Low-ventilated cigarettes are the only available cigarettes in the Experimental Tobacco Marketplace which increases in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: High- and low-ventilated cigarette with high-ventilated cigarettes increasing in price<br>* High- and low ventilated cigarettes are available in the Experimental Tobacco Marketplace with high-ventilated cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Low- and high-ventilated cigarette with high-ventilated cigarettes increasing in price<br>* Low- and high-ventilated cigarettes are available in the Experimental Tobacco Marketplace with low-ventilated cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>Behavioral: Usual, high- and low-ventilated cigarette with usual cigarettes increasing in price.<br>* Usual cigarette, low- and high-ventilated cigarettes are available in the Experimental Tobacco Marketplace with usual cigarettes increasing in price across trials. Other nicotine/tobacco products are available in the Experimental Tobacco Marketplace at market price. Note that all participants will complete all the specified conditions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Nicotine/tobacco products substitution | Participants will complete purchasing trials in an Experimental Tobacco Marketplace (ETM) with cigarettes increasing in price (cigarette type depending on condition). Other product prices will remain at market price. The degree to which other nicotine/tobacco products substitute for usual, high-and-low ventilated cigarettes prices will be assessed. To obtain estimates of substitution of price-constant products in the different ETM conditions, the investigators will use ordinary least squares regression to model the relationship of the price-manipulated product to predict total quantity purchased of the price-constant product. | 1 day | 
| Cigarette demand | Participants will complete purchasing trials in an Experimental Tobacco Marketplace (ETM) with cigarettes increasing in price (cigarette type depending on condition). Other product prices will remain at market price. The degree to which other nicotine/tobacco products substitute for usual, high-and-low ventilated cigarettes prices will be assessed. To obtain dependent measures of demand, participants' purchasing of the price-manipulated commodity in the ETM task will be fit to a modified exponential equation to quantify the relationship between the price of each commodity and purchasing: Q=Q0*10k(exp(-αQ0C)-1) where Q is purchasing of the commodity, C is the price, Q0 is the derived initial purchasing without cost constraints (demand intensity), k is the span of the function in logarithmic units, and α is the demand elasticity. | 1 day |