STUDIES IN TOBACCO HARM REDUCTION: THE ROLE OF CONTEXT IN SUBJECTIVE EFFECTS AND BEHAVIORAL RESPONSES TO A REDUCED EXPOSURE TOBACCO PRODUCT

Open Access
Author:
Edwards, Beth Q.
Graduate Program:
Biobehavioral Health
Degree:
Doctor of Philosophy
Document Type:
Dissertation
Date of Defense:
September 27, 2007
Committee Members:
  • Lynn T Kozlowski, Committee Chair
  • Laura Klein, Committee Chair
  • Frank Martin Ahern, Committee Member
  • William T Ross, Committee Member
Keywords:
  • tobacco
  • harm reduction
Abstract:
Cigarette smoking remains one of the most important and preventable causes of morbidity and mortality. Tobacco harm reduction has been recognized as one component of a comprehensive tobacco control effort. Potential reduced exposure tobacco products (PREPs), particularly low-nitrosamine smokeless tobacco products, have attracted attention as promising harm reduction products. However, there is little research to date to support a viable role for these products within tobacco harm reduction efforts. The current study included two trials of smokers’ evaluations and use of a low nitrosamine smokeless tobacco product. Both trials employed a between-subjects design and all participants were screened to ensure eligibility. In the first trial, participants were randomly assigned to evaluate information emphasizing harm reduction (n=20) or convenience factors (n=20) and to evaluate the tobacco product. In the second trial, all participants evaluated the product during 3 lab sessions. Participants were randomly assigned to an experimental (n=21) or control (n=19) condition at the end of the 1st session. Participants in the experimental group tried the tobacco product daily for 5 days until the 2nd lab session; those in the control group had no additional use of the tobacco until the 2nd lab session. Between lab sessions 2 and 3, all participants were free to use the tobacco product if they chose, but use was not required. Participants recorded all their tobacco use between lab sessions. Findings from trial one revealed no statistically significant differences in evaluations of information emphasizing harm reduction potential versus convenience factors of a non-smoked tobacco. Further, results from the 2nd trial demonstrated a statistically significant improvement in overall evaluations of the product by itself and compared to cigarettes regardless of experimental condition. However, participants in the control condition demonstrated a small but significant decrease in smoking when they were free to use the trial tobacco outside the lab. The majority of participants stated they would try the tobacco product again, primarily when smoking was not permitted and to cut down on smoking. The contribution of this dissertation research is presented, followed by a discussion of the findings and suggestions for future research.