Restricting choice of e-cigarette flavor and device type increases choices to use combusted cigarettes among adults who dual use both products: Results from a within-subjects randomized trial

IF 4.1 2区医学 Q1 PSYCHOLOGY, CLINICAL

Addictive behaviors Pub Date : 2026-03-01 Epub Date: 2025-12-01 DOI:10.1016/j.addbeh.2025.108578

Dana Rubenstein , Lauren R. Pacek , Michael J. Green , Maggie M. Sweitzer , Rachel Kozink , Alicia Holloway , Eric C. Donny , Tracy T. Smith , F. Joseph McClernon

{"title":"Restricting choice of e-cigarette flavor and device type increases choices to use combusted cigarettes among adults who dual use both products: Results from a within-subjects randomized trial","authors":"Dana Rubenstein , Lauren R. Pacek , Michael J. Green , Maggie M. Sweitzer , Rachel Kozink , Alicia Holloway , Eric C. Donny , Tracy T. Smith , F. Joseph McClernon","doi":"10.1016/j.addbeh.2025.108578","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Data from real-world e-cigarette (EC) flavor bans suggest that such bans may increase combusted cigarette (CC) use. However, experimental data are needed to better understand how EC characteristics affect EC appeal and CC use.</div></div><div><h3>Methods</h3><div>Participants were adults who used both CC and flavored EC. They made 10 choices per session between taking two puffs from an EC or CC (supplied by study) or abstaining. EC type was unblinded and varied across three counterbalanced sessions: 1) own device and flavor, 2) study device with a non-tobacco-flavored e-liquid, and 3) study device with a tobacco-flavored e-liquid. Analyses evaluated EC appeal and choices to use EC, CC, or abstain.</div></div><div><h3>Results</h3><div>Participants (n = 41) reported using CCs on 22.1 days/month and ECs on 26.9 days/month. Appeal of study EC was lower than participants’ own EC, and participants made fewer choices for EC during tobacco-flavor EC versus own device sessions (<em>p</em> = 0.006). Relative to own device sessions, participants made a greater number of choices for CC when study EC were available (<em>p</em>’s < 0.05), regardless of flavor.</div></div><div><h3>Discussion</h3><div>Regulators and public health officials should be aware that restricting EC characteristics such as device type and flavor may increase consumption of CC among people who use both products, especially people who find restricted EC less appealing than their own device. Findings are consistent with real-world sales data following EC flavor bans.</div></div>","PeriodicalId":7155,"journal":{"name":"Addictive behaviors","volume":"174 ","pages":"Article 108578"},"PeriodicalIF":4.1000,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Addictive behaviors","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0306460325003478","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/12/1 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PSYCHOLOGY, CLINICAL","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction

Data from real-world e-cigarette (EC) flavor bans suggest that such bans may increase combusted cigarette (CC) use. However, experimental data are needed to better understand how EC characteristics affect EC appeal and CC use.

Methods

Participants were adults who used both CC and flavored EC. They made 10 choices per session between taking two puffs from an EC or CC (supplied by study) or abstaining. EC type was unblinded and varied across three counterbalanced sessions: 1) own device and flavor, 2) study device with a non-tobacco-flavored e-liquid, and 3) study device with a tobacco-flavored e-liquid. Analyses evaluated EC appeal and choices to use EC, CC, or abstain.

Results

Participants (n = 41) reported using CCs on 22.1 days/month and ECs on 26.9 days/month. Appeal of study EC was lower than participants’ own EC, and participants made fewer choices for EC during tobacco-flavor EC versus own device sessions (p = 0.006). Relative to own device sessions, participants made a greater number of choices for CC when study EC were available (p’s < 0.05), regardless of flavor.

Discussion

Regulators and public health officials should be aware that restricting EC characteristics such as device type and flavor may increase consumption of CC among people who use both products, especially people who find restricted EC less appealing than their own device. Findings are consistent with real-world sales data following EC flavor bans.

查看原文本刊更多论文

限制电子烟口味和设备类型的选择增加了双重使用两种产品的成年人使用燃烧香烟的选择：一项受试者内随机试验的结果。

导读：来自现实世界电子烟（EC）风味禁令的数据表明，此类禁令可能会增加燃烧香烟（CC）的使用。然而，需要实验数据来更好地了解EC特性如何影响EC的吸引力和CC的使用。方法：参与者是同时使用CC和调味EC的成年人。每个疗程中，他们在抽两口EC或CC（由研究提供）或不抽之间做出10个选择。EC类型是无盲的，并且在三个平衡阶段有所不同：1)自己的设备和风味，2)使用非烟草味电子液体的研究设备，以及3)使用烟草味电子液体的研究设备。分析评估了EC的吸引力和使用EC、CC或弃权的选择。结果：参与者（n = 41）报告使用CCs的时间为22.1天/月，使用ec的时间为26.9天/月。研究EC的吸引力低于参与者自己的EC，参与者在烟草味EC期间对EC的选择少于自己的设备会话（p = 0.006）。相对于自己的设备，当研究EC可用时，参与者对CC的选择更多(p讨论：监管机构和公共卫生官员应该意识到，限制EC的特征，如设备类型和风味，可能会增加使用两种产品的人对CC的消费，特别是那些发现限制EC不如自己的设备有吸引力的人。研究结果与欧盟香料禁令后的实际销售数据一致。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Addictive behaviors 医学-药物滥用

CiteScore

8.40

自引率

4.50%

发文量

283

审稿时长

46 days

期刊介绍： Addictive Behaviors is an international peer-reviewed journal publishing high quality human research on addictive behaviors and disorders since 1975. The journal accepts submissions of full-length papers and short communications on substance-related addictions such as the abuse of alcohol, drugs and nicotine, and behavioral addictions involving gambling and technology. We primarily publish behavioral and psychosocial research but our articles span the fields of psychology, sociology, psychiatry, epidemiology, social policy, medicine, pharmacology and neuroscience. While theoretical orientations are diverse, the emphasis of the journal is primarily empirical. That is, sound experimental design combined with valid, reliable assessment and evaluation procedures are a requisite for acceptance. However, innovative and empirically oriented case studies that might encourage new lines of inquiry are accepted as well. Studies that clearly contribute to current knowledge of etiology, prevention, social policy or treatment are given priority. Scholarly commentaries on topical issues, systematic reviews, and mini reviews are encouraged. We especially welcome multimedia papers that incorporate video or audio components to better display methodology or findings. Studies can also be submitted to Addictive Behaviors? companion title, the open access journal Addictive Behaviors Reports, which has a particular interest in ''non-traditional'', innovative and empirically-oriented research such as negative/null data papers, replication studies, case reports on novel treatments, and cross-cultural research.