Cigar Smoking, Tobacco Use
Conditions
Brief summary
This within-subjects study aims to evaluate the subjective rewarding value, the relative reinforcing value, and the absolute reinforcing value of sweet flavored cigarillos across three separate laboratory visits among 86 young adults (ages 18-24 years old) who have previously smoked \> 10 or more cigarillos in their lifetime.
Interventions
OTHERFlavor
Sweet flavored vs. non-flavored cigarillos.
Sponsors
University of Pennsylvania
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 24 Years
Healthy volunteers
Yes
Inclusion criteria
1. Able to communicate fluently in English (i.e. speaking, writing, and reading). 2. Male and female young adults who are between 18 and 24 years of age who have used \> 10 cigarillos in their lifetime. 3. Not currently undergoing smoking cessation treatment or planning to quit smoking cigarettes within the next 30 days. 4. Plan to live in the area for the duration of the study. 5. Willing to use study-provided cigarillos during three laboratory visits. 6. Capable of giving written informed consent, which includes compliance with the requirements and restrictions listed in the combined consent and HIPAA form.
Exclusion criteria
Smoking Behavior 1. Use of less than 10 cigarillos in lifetime 2. Current enrollment or plans to enroll in a tobacco cessation program over the duration of the study. 3. Current use of nicotine replacement therapy or other smoking cessation medication. Alcohol and Drug 1. History of substance abuse (other than nicotine dependence) in the past 12 months and/or currently receiving medical treatment for substance abuse. Counseling and support groups (e.g. Alcoholics Anonymous and Narcotics Anonymous) will not be considered medical treatment for the purposes of this protocol. 2. Current alcohol consumption that exceeds 25 standard drinks/week. 3. Breath alcohol reading (BrAC) greater than .000 at Laboratory Visit 1. 4. Use of e-cigarettes on \>5 days in the past 30 days. Medical 1. Women, including all individuals assigned as female at birth, who are pregnant, breast feeding, or planning a pregnancy over the duration of the study period. 2. Serious or unstable disease within the past year (e.g. cancer, heart disease). Applicable conditions will be evaluated on a case-by-case basis by the Principal Investigator. Psychiatric 1. Lifetime history of schizophrenia or psychosis 2. Lifetime history of a suicide attempt. 3. Current use of medications used to treat mood, such as depression or anxiety. 1. Individuals will be excluded if they take psychotropic medications that may impact laboratory assessments of nicotine/flavoring reward and reinforcement. 2. Participants with a history of depression or anxiety will not be excluded- however, participants who are currently taking any medications used to treat these will be ineligible to participate. 3. Participants who are not currently taking these medications but are receiving treatment such as therapy or counseling will be eligible to participate. 4. Current or recent use of anti-psychotic medications. General Exclusion 1. Past, current, anticipated, or pending enrollment in another research program over the study period that could potentially impact subject safety, study data, and/or the study design as determined by the Principal Investigator. 2. Any medical condition, illness, disorder, adverse event (AE), or concomitant medication that could compromise participant safety or significantly impact study performance as determined by the Principal Investigator. Subjects may be deemed ineligible for any of the aforementioned reasons at any point throughout the study, as well as during the initial telephone screen. 3. Significant non-compliance with protocol and/or study design as determined by the Principal Investigator. Subjects may be deemed ineligible at any point throughout the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Subjective Rewarding Value of Cigarillo Flavoring | Laboratory visit 1 (Day 1, 1.5 hours) | Subjective rewarding value of cigarillo flavoring will be measured with the Cigarette Evaluation Scale (CES) adapted for cigarillo use. The CES is an 11 item Likert-format (1=not at all to 7=extremely) self-report instrument with established validity and reliability (α \> .80). The investigators will focus on the sum of the two-item satisfaction subscale (Was it satisfying? and Did it taste good?) to calculate the subjective rewarding value. The minimum possible score is 2 and the maximum is 14. Higher scores denote greater subjective rewarding value. Primary Outcome measured at visit 1. |
| Relative Reinforcing Value of Cigarillo Flavoring | Laboratory visit 2 (Day 2, 2 hours) | Relative reinforcing value of cigarillo flavoring will be measured with a validated choice paradigm, evaluating the preference for sweet flavored (the cigarillo with the highest rewarding value measured in visit 1) relative to non-flavored cigarillos. The reinforcement schedule in the non-flavored cigarillo remained constant at a fixed ratio FR-25, while the reinforcement schedule for the sweet-flavored cigarillo increased with a progressive ratio schedule of PR-25x over 10 trials. RRVF will be defined by the breakpoint (highest trial completed across 10 trials to earn puffs for sweet flavored versus non-flavored cigarillos). Higher breakpoints indicate a greater relative reinforcing value. Primary Outcome measured at visit 2. |
| Absolute Reinforcing Value of Cigarillo Flavoring | Laboratory visit 3 (Day 3, 2.5 hours) | Absolute reinforcing value of cigarillo flavoring is operationalized as the number of sweet flavored versus non-flavored cigarillo puffs consumed during the ad libitum smoking session. A research assistant will videotape, monitor, and count the number of cigarillo puffs taken during the 90-minute period. The primary comparison is the amount of consumption (puffs) of the sweet flavored (determined at visit 1) versus non-flavored cigarillo. A greater number of puffs indicates a higher absolute reinforcing value. Primary Outcome measured at visit 3. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Flavor Either a sweet-flavored or a non-flavored cigarillo
Flavor: Sweet flavored vs. non-flavored cigarillos. | 86 |
| Total | 86 |
Withdrawals & dropouts
| Period | Reason | FG000 |
|---|---|---|
| Overall Study | Lost to Follow-up | 7 |
| Overall Study | Withdrawal by Subject | 2 |
Baseline characteristics
| Characteristic | Flavor |
|---|---|
| Advertising Exposure | 3.24 units on a scale STANDARD_DEVIATION 1.21 |
| Age, Continuous | 22.23 years STANDARD_DEVIATION 1.57 |
| Blunt Use Frequent | 36 Participants |
| Blunt Use Infrequent | 41 Participants |
| Blunt Use Never | 9 Participants |
| Cigarette Use Frequent | 22 Participants |
| Cigarette Use Infrequent | 43 Participants |
| Cigarette Use Never | 21 Participants |
| Cigarillo Dependence | 1.71 units on a scale STANDARD_DEVIATION 2.26 |
| Cigarillo Flavor Preference Flavored | 63 Participants |
| Cigarillo Flavor Preference Non-flavored | 23 Participants |
| Cigarillo Use Frequent | 28 Participants |
| Cigarillo Use Infrequent | 58 Participants |
| E-cigarette Use Frequent | 16 Participants |
| E-cigarette Use Infrequent | 51 Participants |
| E-cigarette Use Never | 19 Participants |
| Flavored Risk Perceptions | 1.41 units on a scale STANDARD_DEVIATION 0.61 |
| Race/Ethnicity, Customized Black/African American | 29 Participants |
| Race/Ethnicity, Customized Other | 24 Participants |
| Race/Ethnicity, Customized White/Caucasian | 33 Participants |
| Receives Marketing Promotions | 12 Participants |
| Sex: Female, Male Female | 23 Participants |
| Sex: Female, Male Male | 63 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 86 |
| other Total, other adverse events | 1 / 86 |
| serious Total, serious adverse events | 0 / 86 |
Outcome results
Primary
Absolute Reinforcing Value of Cigarillo Flavoring
Absolute reinforcing value of cigarillo flavoring is operationalized as the number of sweet flavored versus non-flavored cigarillo puffs consumed during the ad libitum smoking session. A research assistant will videotape, monitor, and count the number of cigarillo puffs taken during the 90-minute period. The primary comparison is the amount of consumption (puffs) of the sweet flavored (determined at visit 1) versus non-flavored cigarillo. A greater number of puffs indicates a higher absolute reinforcing value. Primary Outcome measured at visit 3.
Time frame: Laboratory visit 3 (Day 3, 2.5 hours)
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Flavor | Absolute Reinforcing Value of Cigarillo Flavoring | Sweet flavored | 40.88 puffs |
| Flavor | Absolute Reinforcing Value of Cigarillo Flavoring | Non-flavored | 23.12 puffs |
Primary
Relative Reinforcing Value of Cigarillo Flavoring
Relative reinforcing value of cigarillo flavoring will be measured with a validated choice paradigm, evaluating the preference for sweet flavored (the cigarillo with the highest rewarding value measured in visit 1) relative to non-flavored cigarillos. The reinforcement schedule in the non-flavored cigarillo remained constant at a fixed ratio FR-25, while the reinforcement schedule for the sweet-flavored cigarillo increased with a progressive ratio schedule of PR-25x over 10 trials. RRVF will be defined by the breakpoint (highest trial completed across 10 trials to earn puffs for sweet flavored versus non-flavored cigarillos). Higher breakpoints indicate a greater relative reinforcing value. Primary Outcome measured at visit 2.
Time frame: Laboratory visit 2 (Day 2, 2 hours)
| Arm | Measure | Group | Value (MEAN) |
|---|---|---|---|
| Flavor | Relative Reinforcing Value of Cigarillo Flavoring | Non-flavored | 3.66 trials |
| Flavor | Relative Reinforcing Value of Cigarillo Flavoring | Sweet flavored | 6.34 trials |
Primary
Subjective Rewarding Value of Cigarillo Flavoring
Subjective rewarding value of cigarillo flavoring will be measured with the Cigarette Evaluation Scale (CES) adapted for cigarillo use. The CES is an 11 item Likert-format (1=not at all to 7=extremely) self-report instrument with established validity and reliability (α \> .80). The investigators will focus on the sum of the two-item satisfaction subscale (Was it satisfying? and Did it taste good?) to calculate the subjective rewarding value. The minimum possible score is 2 and the maximum is 14. Higher scores denote greater subjective rewarding value. Primary Outcome measured at visit 1.
Time frame: Laboratory visit 1 (Day 1, 1.5 hours)
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Flavor | Subjective Rewarding Value of Cigarillo Flavoring | Citrus Jazz | 4.03 score on a scale | Standard Deviation 1.47 |
| Flavor | Subjective Rewarding Value of Cigarillo Flavoring | Cream | 3.63 score on a scale | Standard Deviation 1.42 |
| Flavor | Subjective Rewarding Value of Cigarillo Flavoring | Non-flavored | 3.30 score on a scale | Standard Deviation 1.61 |