scholarly journals Antismoking Advertisements and Price Promotions and Their Association With the Urge to Smoke and Purchases in a Virtual Convenience Store: Randomized Experiment

10.2196/14143 ◽  
2019 ◽  
Vol 21 (10) ◽  
pp. e14143
Author(s):  
Lauren McCarl Dutra ◽  
James Nonnemaker ◽  
Brian Bradfield ◽  
Nathaniel Taylor ◽  
Jamie Guillory ◽  
...  
Keyword(s):  
Regression Models ◽  
Negative Relationship ◽  
Convenience Store ◽  
Significant Finding ◽  
Price Promotions ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Current Cigarette ◽  
Urge To Smoke ◽  
Former Smokers

Background Point of sale (POS) advertising is associated with smoking initiation, current smoking, and relapse among former smokers. Price promotion bans and antismoking advertisements (ads) are 2 possible interventions for combating POS advertising. Objective The purpose of this analysis was to determine the influence of antismoking ads and promotions on urges to smoke and tobacco purchases. Methods This analysis examined exposure to graphic (graphic images depicting physical consequences of tobacco use) and supportive (pictures of and supportive messages from former smokers) antismoking ads and promotions in a virtual convenience store as predictors of urge to smoke and buying tobacco products among 1200 current cigarette smokers and 800 recent quitters recruited via a Web-based panel (analytical n=1970). We constructed linear regression models for urge to smoke and logistic regression models for the odds of purchasing tobacco products, stratified by smoking status. Results The only significant finding was a significant negative relationship between exposure to supportive antismoking ads and urge to smoke among current smokers (beta coefficient=−5.04, 95% CI −9.85 to −0.22; P=.04). There was no significant relationship between graphic antismoking ads and urge to smoke among current smokers (coefficient=−3.77, 95% CI −8.56 to 1.02; P=.12). Neither relationship was significant for recent quitters (graphic: coefficient=−3.42, 95% CI −8.65 to 1.81; P=.15 or supportive: coefficient=−3.82, 95% CI −8.99 to 1.36; P=.20). There were no significant differences in urge to smoke by exposure to promotions for current smokers (coefficient=−1.06, 95% CI −4.53 to 2.41; P=.55) or recent quitters (coefficient=1.76, 95% CI −2.07 to 5.59; P=.37). There were also no differences in tobacco purchases by exposure to graphic (current smokers: coefficient=0.93, 95% CI 0.67 to 1.29; P=.66 and recent quitters: coefficient=0.73, 95% CI 0.44 to 1.19; P=.20) or supportive (current smokers: coefficient=1.05, 95% CI 0.75 to 1.46; P=.78 and recent quitters: coefficient=0.73, 95% CI 0.45 to 1.18; P=.20) antismoking ads or price promotions (current smokers: coefficient=1.09, 95% CI 0.86 to 1.38; P=.49 and recent quitters: coefficient=0.90, 95% CI 0.62 to 1.31; P=.60). Conclusions The results of this analysis support future research on the ability of supportive antismoking ads to reduce urges to smoke among current cigarette smokers. Research on urges to smoke has important tobacco control implications, given the relationship between urge to smoke and smoking cigarettes, time to next smoke, and amount smoked.

scholarly journals Antismoking Advertisements and Price Promotions and Their Association With the Urge to Smoke and Purchases in a Virtual Convenience Store: Randomized Experiment (Preprint)

2019 ◽  
Author(s):  
Lauren McCarl Dutra ◽  
James Nonnemaker ◽  
Brian Bradfield ◽  
Nathaniel Taylor ◽  
Jamie Guillory ◽  
...  
Keyword(s):  
Regression Models ◽  
Negative Relationship ◽  
Convenience Store ◽  
Significant Finding ◽  
Price Promotions ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Current Cigarette ◽  
Urge To Smoke ◽  
Former Smokers

BACKGROUND Point of sale (POS) advertising is associated with smoking initiation, current smoking, and relapse among former smokers. Price promotion bans and antismoking advertisements (ads) are 2 possible interventions for combating POS advertising. OBJECTIVE The purpose of this analysis was to determine the influence of antismoking ads and promotions on urges to smoke and tobacco purchases. METHODS This analysis examined exposure to graphic (graphic images depicting physical consequences of tobacco use) and supportive (pictures of and supportive messages from former smokers) antismoking ads and promotions in a virtual convenience store as predictors of urge to smoke and buying tobacco products among 1200 current cigarette smokers and 800 recent quitters recruited via a Web-based panel (analytical n=1970). We constructed linear regression models for urge to smoke and logistic regression models for the odds of purchasing tobacco products, stratified by smoking status. RESULTS The only significant finding was a significant negative relationship between exposure to supportive antismoking ads and urge to smoke among current smokers (beta coefficient=−5.04, 95% CI −9.85 to −0.22; <italic>P</italic>=.04). There was no significant relationship between graphic antismoking ads and urge to smoke among current smokers (coefficient=−3.77, 95% CI −8.56 to 1.02; <italic>P</italic>=.12). Neither relationship was significant for recent quitters (graphic: coefficient=−3.42, 95% CI −8.65 to 1.81; <italic>P</italic>=.15 or supportive: coefficient=−3.82, 95% CI −8.99 to 1.36; <italic>P</italic>=.20). There were no significant differences in urge to smoke by exposure to promotions for current smokers (coefficient=−1.06, 95% CI −4.53 to 2.41; <italic>P</italic>=.55) or recent quitters (coefficient=1.76, 95% CI −2.07 to 5.59; <italic>P</italic>=.37). There were also no differences in tobacco purchases by exposure to graphic (current smokers: coefficient=0.93, 95% CI 0.67 to 1.29; <italic>P</italic>=.66 and recent quitters: coefficient=0.73, 95% CI 0.44 to 1.19; <italic>P</italic>=.20) or supportive (current smokers: coefficient=1.05, 95% CI 0.75 to 1.46; <italic>P</italic>=.78 and recent quitters: coefficient=0.73, 95% CI 0.45 to 1.18; <italic>P</italic>=.20) antismoking ads or price promotions (current smokers: coefficient=1.09, 95% CI 0.86 to 1.38; <italic>P</italic>=.49 and recent quitters: coefficient=0.90, 95% CI 0.62 to 1.31; <italic>P</italic>=.60). CONCLUSIONS The results of this analysis support future research on the ability of supportive antismoking ads to reduce urges to smoke among current cigarette smokers. Research on urges to smoke has important tobacco control implications, given the relationship between urge to smoke and smoking cigarettes, time to next smoke, and amount smoked.

scholarly journals Prevalence, Use Behaviors, and Preferences among Users of Heated Tobacco Products: Findings from the 2018 ITC Japan Survey

2019 ◽  
Vol 16 (23) ◽  
pp. 4630 ◽  
Author(s):  
Edward Sutanto ◽  
Connor Miller ◽  
Danielle M. Smith ◽  
Richard J. O’Connor ◽  
Anne C. K. Quah ◽  
...  
Keyword(s):  
Market Share ◽  
User Preferences ◽  
Web Survey ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Adult Participants ◽  
Current Cigarette ◽  
Former Smokers ◽  
Nationally Representative ◽  
Never Smokers

Heated tobacco products (HTPs), such as IQOS, glo, and Ploom TECH, with a variety of flavored tobacco-containing inserts, have reportedly achieved a significant market share in Japan. We analyzed data from Wave 1 of the ITC Japan Survey, a nationally representative web survey conducted in February to March 2018 among 4684 adult participants to estimate the prevalence of HTP use, describe characteristics of HTP users, and explore user preferences for HTP device and flavor. The overall prevalence of monthly HTP use was 2.7% (1.7% daily use). Virtually all HTP users were current cigarette smokers (67.8%) or former smokers (25.0%); only 1.0% of HTP users were never smokers. Among HTP users, IQOS was the most frequently reported brand used (64.5%), and menthol was the most common flavor reported (41.5%). IQOS was used more by younger respondents and those who reported daily use, while Ploom TECH was more popular among older respondents and non-daily HTP users. This is one of the first non-industry funded studies to explore the use of HTPs in Japan.

scholarly journals Polytobacco product use among current cigarette smokers in Hong Kong, China: results from population surveys (2015–17)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
S. L. Chau ◽  
M. P. Wang ◽  
Y. Wu ◽  
D. Y. T. Cheung ◽  
A. Kong ◽  
...  
Keyword(s):  
Control Policy ◽  
Tobacco Product ◽  
Cigarette Use ◽  
Related Factors ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Product Use ◽  
Younger Age ◽  
Current Cigarette ◽  
Age And Sex

Abstract Background Polytobacco product use is increasingly popular, but little is known about the prevalence, trend, and factors of such use particularly in non-western countries. Method A representative sample of 1139 current cigarette smokers aged 15+ (84.1% male) were telephone interviewed in Tobacco Control Policy-related Surveys in 2015–2017. Information collected included poly-tobacco use (PTU), smoking and socio-demographic characteristics. Associations of current PTU with related factors were analyzed using logistic regression with adjustment for confounders. Prevalence was weighted by age and sex of current cigarette users in the general population. Results Eighty-four point one percent (95% CI 81.4–86.6%) were exclusive cigarette smokers. Fifteen point nine percent (13.4–18.6%) were current polytobacco product users, 12.3% (10.2–14.8%) used one tobacco product and 2.52% (1.59–3.97%) used two tobacco products in addition to cigarette. Cigarette use with cigar was more common (6.28%, 4.75–8.27%), and the least used product with cigarette was e-cigarette (1.05%, 0.44–2.50%). The changes in overall prevalence of PTU by number of products use varied in 3 years. Current PTU was associated with being male (AOR 2.01, 95% CI 1.12–3.61), younger age (AORs range from 1.34–4.65, P for trend < .001) and less ready to quit (2.08, 1.09–3.97). Conclusions Prevalence of PTU increased slowly by year, one tobacco product use with cigarette was more common. The most used tobacco product with cigarette was cigar. Being male, younger and less ready to quit were associated with current PTU.

Patterns of non-cigarette tobacco and nicotine use among current cigarette smokers and recent quitters: Findings from the 2020 ITC Four Country Smoking and Vaping Survey

2021 ◽  
Author(s):  
Lin Li ◽  
Ron Borland ◽  
K Michael Cummings ◽  
Shannon Gravely ◽  
Anne C K Quah ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Cigarette Smoking ◽  
Smoking Status ◽  
Tobacco Product ◽  
Cigarette Tobacco ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Patterns Of Use ◽  
Levels Of Use ◽  
Current Cigarette

Abstract Introduction This study explores patterns of use of non-cigarette tobacco and nicotine products among adult cigarette smokers and recent ex-smokers. Along with cigarette smoking status we explore differences as a function of countries with different product regulations, gender and age. Methods Data came from the ITC Four Country Smoking and Vaping Wave 3 Survey conducted between February-June 2020. The analytic sample consisted of 9112 current cigarette smokers (at least monthly) and 1184 recent ex-smokers (quit cigarettes ≤ 2 years) from Australia, Canada, England, and the US. Respondents were asked about their cigarette smoking and current use of the following non-cigarette products: combustible tobacco (cigars, cigarillos, pipe, waterpipe); non-combustible tobacco (smokeless tobacco, and heated tobacco products (HTPs)); and non-tobacco nicotine products (nicotine vaping products (NVPs), nicotine replacement therapy (NRT), and nicotine pouches)). Results Overall, NVPs (13.7%) and NRT (10.9%) were the most reported nicotine products used, followed by cigars (5.3%), cigarillos (4.2%), and HTPs (3.5%). More than 21% current and recent ex-smokers of cigarettes reported using a non-tobacco nicotine product and non-combustible product, with respondents in England reporting the highest levels of use (&gt;26%). Males, younger respondents, and current non-daily cigarette smokers were more likely to use non-cigarette nicotine products. Notably, 11.6% of ex-cigarette smokers were using other combustible tobacco. Conclusion Considerable percentages of current cigarette smokers and ex-smokers use non-cigarette nicotine products, and there are unexpectedly high levels of use of other combustible products by those recent ex-smokers of cigarettes which is concerning and has important implications for definitions of smoking cessation. Implications The tobacco product market has evolved to include new products which add to existing non-cigarette tobacco products creating a much more diverse nicotine market. This brief report provides a snapshot of use of various combustible and non-combustible nicotine containing products among current cigarette smokers and recent ex-smokers in four western countries. Our results indicate that use of non-cigarette tobacco and nicotine products among these cigarette smokers and recent ex-smokers is not low, particularly among males, younger and non-daily cigarette smokers. Use of other combustible tobacco among respondents that recently quit cigarette smoking is concerning and has important implications for definitions of smoking cessation. Increased emphasis on researching non-cigarette nicotine product use is warranted in tobacco control generally and smoking cessation in particular.

Workplace smoke-free policies that allow heated tobacco products and electronic cigarettes use are associated with use of both these products and conventional tobacco smoking: the 2018 JASTIS study

2020 ◽  
pp. tobaccocontrol-2019-055465
Author(s):  
Yanakawee Siripongvutikorn ◽  
Takahiro Tabuchi ◽  
Sumiyo Okawa
Keyword(s):  
Regression Models ◽  
Electronic Cigarettes ◽  
Internet Survey ◽  
Survey Study ◽  
Cigarette Use ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
National Legislation ◽  
Adjusted Rate ◽  
Rate Ratios

ObjectivesHeated tobacco products (HTPs) and electronic cigarettes (e-cigarettes) are rapidly gaining popularity, especially in Japan. However, at the time of the survey (2018), there was no national legislation banning HTPs or e-cigarette use in the workplace. The objective is to examine the current situation for workplace smoke-free policies which ban the use of HTPs/e-cigarettes and the associations of such rules with the use of HTP and e-cigarette as well as conventional cigarette smoking.MethodsAn internet-based self-reported questionnaire survey was conducted in 2018 as a part of the Japan Society and New Tobacco Internet Survey study. 5646 eligible employees aged 15–72 years were analysed. Proportions and adjusted rate ratios for HTP and e-cigarette use were calculated according to covariates, using Poisson regression models. Those who reported HTP or e-cigarette use within 30 days were defined as current user of the products.ResultsIn workplaces which prohibited smoking indoors but permitted the use of HTPs/e-cigarettes, the rate ratios of HTP use was 2.19 (95% CI 1.57 to 3.06), e-cigarette use was 3.86 (95% CI 1.97 to 7.57) and combustible cigarette use was 1.67 (95% CI 1.19 to 2.34) when using workplaces which also prohibited HTPs/e-cigarettes as a reference category.ConclusionsWorkplaces that allow HTP/e-cigarette use indoors were associated with higher rate for HTP and e-cigarette users, and for combustible cigarette smokers. National legislation banning tobacco should be enforced and also cover HTPs and e-cigarettes in order to avoid renormalisation of smoking and nicotine addiction.

scholarly journals Visual Attention to Tobacco-Related Stimuli in a 3D Virtual Store

2020 ◽  
Author(s):  
Lauren M. Dutra ◽  
James Nonnemaker ◽  
Nathaniel Taylor ◽  
Ashley Feld ◽  
Brian Bradfield ◽  
...  
Keyword(s):  
Visual Attention ◽  
Eye Tracking ◽  
Dwell Time ◽  
Three Dimensional ◽  
Tobacco Product ◽  
Convenience Store ◽  
Tobacco Products ◽  
Point Of Sale ◽  
Current Cigarette ◽  
Store Environment

We used eye tracking to measure visual attention to tobacco products and pro- and anti-tobacco advertisements (pro-ads and anti-ads) during a shopping task in a three-dimensional virtual convenience store. We used eye-tracking hardware to track the percentage of fixations (number of times the eye was essentially stationary; F) and dwell time (time spent looking at an object; DT) for several categories of objects and ads for 30 adult current cigarette smokers. We used Wald F-tests to compare fixations and dwell time across categories, adjusting comparisons of ads by the number of each type of ad. Overall, unadjusted for the number of each object, participants focused significantly greater attention on snacks and drinks and tobacco products than ads (all P<0.005). Adjusting for the number of each type of ad viewed, participants devoted significantly greater visual attention to pro-ads than anti-ads or ads unrelated to tobacco (P<0.001). Visual attention for anti-ads was significantly greater when the ads were placed on the store’s external walls or hung from the ceiling than when placed on the gas pump or floor (P<0.005). In a cluttered convenience store environment, anti-ads at the point of sale have to compete with many other stimuli. Restrictions on tobacco product displays and advertisements at the point of sale could reduce the stimuli that attract smokers’ attention away from anti-ads.

scholarly journals Cannabis use among a nationally representative cross-sectional sample of smokers and non-smokers in the Netherlands: results from the 2015 ITC Netherlands Gold Magic Survey

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. E024497 ◽  
Author(s):  
Brian Vincent Fix ◽  
Danielle Smith ◽  
Richard O’Connor ◽  
Bryan W Heckman ◽  
Marc C Willemsen ◽  
...  
Keyword(s):  
Cigarette Smoking ◽  
Cannabis Use ◽  
Nicotine Exposure ◽  
Cross Sectional ◽  
Cigarette Smokers ◽  
Current Cigarette ◽  
Former Smokers ◽  
Nationally Representative ◽  
Never Smokers ◽  
Current Tobacco

ObjectivesExisting evidence shows that co-occurring use of tobacco and cannabis is widespread. Patterns of co-use of tobacco and cannabis may change as more jurisdictions legalise medicinal and/or recreational cannabis sales. This analysis examined predictors of current cannabis use and characterised methods of consumption among smokers and non-smokers in a context where cannabis use is legal.SettingThe 2015 International Tobacco Control Netherlands—Gold Magic Survey conducted between July and August 2015.ParticipantsParticipants (n=1599; 1003 current smokers, 283 former smokers and 390 non-smokers) were asked to report their current (past 30-day) use of cigarettes and cannabis. Cigarette smokers reported whether they primarily used factory made of roll-your-own cigarettes. Those who reported any cannabis use in the last 30 days were asked about forms of cannabis used. X2and logistic regression analyses were used to assess relationships among combustible tobacco and cannabis use.ResultsPast 30-day cannabis use was somewhat higher among current tobacco (or cigarette) smokers (n=57/987=5.8%) than among former or never smokers (n=10/288=3.5% and n=6/316=1.9%, respectively). Joints were the most commonly used form of cannabis use for both current cigarette smokers (96.9%) and non-smokers (76.5%). Among those who smoked cannabis joints, 95% current smokers and 67% of non-smokers reported that they ‘always’ roll cannabis with tobacco.ConclusionsIn this Netherlands-based sample, most cannabis was reported to be consumed via smoking joints, most often mixed with tobacco. This behaviour may present unique health concerns for non-cigarette smoking cannabis users, since tobacco use could lead to nicotine dependence. Moreover, many non-cigarette smoking cannabis users appear to be misclassified as to their actual tobacco/nicotine exposure.

scholarly journals Awareness, trial and use of heated tobacco products among adult cigarette smokers and e-cigarette users: findings from the 2018 ITC Four Country Smoking and Vaping Survey

2020 ◽  
pp. tobaccocontrol-2020-055985
Author(s):  
Connor R Miller ◽  
Edward Sutanto ◽  
Danielle M Smith ◽  
Sara C Hitchman ◽  
Shannon Gravely ◽  
...  
Keyword(s):  
Tobacco Product ◽  
Regulatory Environment ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
The Usa ◽  
Multivariable Analyses ◽  
Former Smokers ◽  
Use Categories

ObjectiveTo evaluate heated tobacco product (HTP) awareness, trial and current use among adult cigarette smokers and vaping product users in four countries with varying regulations governing HTP sales.DesignData came from Wave 2 of the ITC Four Country Smoking and Vaping Survey, collected from February to July 2018. Respondents were current and former smokers and/or users of vaping products (18 years or older) from Canada (CA; n=3778), England (EN; n=4848), the USA (US; n=2846) and Australia (AU; n=1515). At the time of the survey, only Canada and England permitted the sale of contemporary HTPs (eg, IQOS).ResultsOverall, 30.2% of respondents reported being aware of HTPs (CA=30.4%; EN=31.0%; US=30.2%; AU=27.4%; p=0.346), 2.4% had ever tried HTPs (CA=3.3%; EN=2.4%; US=2.0%; AU=0.9%; p=0.001) and 0.9% currently used HTPs at least monthly (CA=0.8%; EN=1.2%; US=0.7%; AU=0.2%; p<0.001). Trial and current use were higher among those who concurrently smoked and vaped (at least monthly) versus other nicotine use categories (trial: 10.9% v. 1.2%–2.0%, p<0.001; current use: 8.4% v. 0.1%–1.0%, p<0.001). In multivariable analyses, HTP awareness did not differ across countries, whereas odds of trial and current use were lower where HTPs were unavailable. Odds of HTP trial did not differ by regulatory environment when restricting analysis to HTP-aware concurrent smokers–vapers.ConclusionApproximately one third of respondents were aware of HTPs, even in the USA and Australia, where contemporary HTPs were not yet on the market. Trial and use were uncommon, except among concurrent smokers–vapers. Restrictions on availability may have limited HTP use generally, but less so for concurrent smokers–vapers.

scholarly journals Effectiveness of Text-Only Cigarette Health Warnings in Japan: Findings from the 2018 International Tobacco Control (ITC) Japan Survey

2020 ◽  
Vol 17 (3) ◽  
pp. 952 ◽  
Author(s):  
Janet Chung-Hall ◽  
Geoffrey T. Fong ◽  
Gang Meng ◽  
Mi Yan ◽  
Takahiro Tabuchi ◽  
...  
Keyword(s):  
Tobacco Control ◽  
Health Risks ◽  
Regression Models ◽  
Smoking Initiation ◽  
Effective Strategy ◽  
Health Warnings ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
Logistic Regression Models ◽  
Pictorial Warnings

Health warnings are an effective strategy for communicating the health harms of smoking, encouraging quitting, and preventing smoking initiation. This study examines the effectiveness of existing text-only health warnings, identifies key predictors of warning effectiveness, and assesses support for pictorial warnings in Japan. Data are from the 2018 International Tobacco Control (ITC) Japan Survey, a cohort survey of adult cigarette smokers (n = 3306), dual users of cigarettes and heated tobacco products (n = 555), and non-cigarette smokers (n = 823). Weighted multivariable logistic regression models were used to assess predictors of warning effectiveness and support for pictorial warnings. Overall, 15.6% of respondents noticed warnings, and 7.9% read or looked closely at warnings. Overall, 10.3% of smokers and dual users said the warnings stopped them from having a cigarette, and 7.2% avoided warnings. Overall, 27.5% of respondents said the warnings made them think about health risks of smoking, but only 2.7% of smokers and dual users said the warnings made them more likely to quit. Overall, 57.6% of respondents supported pictorial warnings. The weak effectiveness of Japan’s text-only warnings is consistent with that in other countries with similar warnings. There is majority support for pictorial warnings in Japan, although the level of support is lower than in other countries.

JUUL use and reasons for initiation among adult tobacco users

2019 ◽  
Vol 28 (6) ◽  
pp. 681-684 ◽  
Author(s):  
Minal Patel ◽  
Alison Cuccia ◽  
Jeffrey Willett ◽  
Yitong Zhou ◽  
Elexis C Kierstead ◽  
...  
Keyword(s):  
Policy Development ◽  
Dual Use ◽  
Cigarette Smokers ◽  
Tobacco Products ◽  
The Past ◽  
Quit Smoking ◽  
Cessation Intervention ◽  
Current Cigarette ◽  
Current Tobacco ◽  
Total Dollar

BackgroundThe electronic nicotine delivery system (ENDS) JUUL has quickly captured the ENDS market, representing 74.6% of the total dollar share for this category as of November 2018. Although JUUL is marketed as an alternative to cigarettes intended for current adult smokers, evidence suggests that a majority of ENDS users are concurrently current cigarette smokers. Little is known about the dual use of JUUL and cigarettes, as well as the reasons for trying JUUL among adult tobacco users.MethodsA survey fielded via web and phone of 1332 current cigarette, cigar, little cigar or cigarillo (CLCC), and ENDS users aged 18–54 years was conducted from March to May 2018. Weighted descriptive and bivariate analyses examined JUUL use and reasons for trying JUUL by demographics, combustible tobacco use, ENDS use and intention to quit.ResultsApproximately 81% of our sample reported current use of two or more tobacco products, including cigarettes, CLCCs or ENDS. Among current tobacco users, 15% ever used JUUL and 12% used JUUL in the past 30 days. Most individuals (74%) reporting ever JUUL use indicated using it for 5 days or fewer in the past 30 days. The most common reason for trying JUUL was trying to quit smoking cigarettes (37%), followed by family, friends or colleagues using the product (32%).ConclusionAlthough some tobacco users may be initiating JUUL to decrease combustible use, most were using the product infrequently and concurrently with other products. Findings have significant implications for cessation intervention efforts and policy development to help smokers quit.

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