Exposure to IQOS ads and reduced exposure claims, and association with perceived risk from COVID-19 on IQOS purchase and use intentions: results from a web-based survey

Introduction

IQOS was authorized to be marketed as a reduced exposure product by the Food and Drug Administration in October 2020 during the global COVID-19 pandemic. Those who smoke may be more sensitive to reduced exposure marketing claims and may have an increased inclination toward IQOS use. We evaluated the likelihood of trying and purchasing IQOS as a function of exposure to ads, product appeal, and COVID-19 risk perceptions using the original IQOS ads with reduced exposure marketing.

Method

An online cross-sectional survey recruited 604 US adults (18-45 years), both who smoke and do not smoke. Participants saw one of the six randomly assigned IQOS ads with or without reduced exposure claims, and they answered questions about product appeal and likelihood to try and purchase IQOS. Generalized linear models were used to examine associations.

Results

A per unit increase in product appeal was associated with a greater likelihood of purchasing (B = 0.17, 95% CI: 0.15-0.18) and trying IQOS (B = 0.16, 95% CI = 0.14-0.18). Current smokers and former e-cigarette users reported greater intentions to try IQOS than never-smokers and never e-cigarette users, respectively. Likelihood to purchase IQOS was associated with greater confidence in not contracting COVID-19 (B = 0.11, 95% CI: 0.01-0.21). No significant differences were observed between different ad conditions. Current (B = -0.34, 95% CI = -0.50-(-0.19)) and former (B = -0.92, 95% CI = -0.15-(-0.68)) cigarette smokers who were someday e-cigarette users reported less intentions to purchase IQOS than never e-cigarette users. However, never smokers who were someday (B = 0.58, 95% CI = 0.27-0.89; B = 0.68, 95% CI = 0.39-0.98) and former e-cigarette (B = 0.38, 95% CI = 0.15-0.61) users reported greater intentions to purchase and try IQOS, respectively.

Discussion

IQOS may have a higher product appeal, especially for those who currently smoke and those who have lower risk perceptions from COVID-19. Among never smokers, those who currently use or have used e-cigarettes in the past may be more receptive to IQOS marketing. The data are informative for potential trends in the use of IQOS in the future and may have implications for marketing regulations of heated tobacco products (HTPs).

Intention to purchase alternative tobacco products as a function of smoking status and responses to advertising, packaging, and sensory experiences

INTRODUCTION

Tobacco manufacturers design and marketed products with appealing sensory characteristics to drive product uptake and continued use. We assessed smokers' and non-smokers' cognitive, affective, and sensory responses to Camel Snus (CS) and Nicotine gum (NG) to gauge future intentions to use.

METHOD

In a single laboratory session, 348 participants (including current smokers and nonsmokers in Buffalo, NY and Boston, MA) were exposed to CS and NG products in counterbalanced order. Exposure involved a cumulative set of 3 steps in which participants i) viewed an advertisement; ii) viewed the packaging, and iii) touched and smelled the product, without actual use. Current daily and non-daily smokers were invited to undertake a fourth exposure step by sampling the product. Following product exposure, participants completed perception measures and reported future intentions to use either product at the end of the survey. After each exposure, participants' reported feelings of valence and arousal.

RESULTS

Smokers reported greater preference to try NG (63.8%) compared with CS (17.4%) or neither (18.8%), whereas majority of nonsmokers preferred neither product (64.3%) (p < 0.01). Of those offered to sample the products, 78.3% daily smokers and 68.4% non-daily smokers opted to sample. When asked about intentions to try, a greater proportion of smokers stated a preference to try NG over CS, as did the small number of nonsmokers who expressed a preference.

CONCLUSION

Intentions to try CS were low despite different levels of exposure to product, and this low product appeal and interest in use may translate to limited potential of CS to serve as a reduced harm product for smokers.

Rapid prototyping of flexible terahertz metasurfaces using a microplotter

Additive manufacturing is a promising tool for the rapid prototyping of terahertz metamaterials at low-cost. In this letter, a terahertz metamaterial is fabricated using a microplotter system on a flexible polyimide film. The limits of the rapid prototyping technique is investigated both experimentally and numerically in order to determine the spectral range accessible by the fabricated metamaterials. Here, the metamaterial is composed of four arrays of metal-insulator-metal (MIM) antennas exhibiting a Fabry Perot resonance at frequencies from 0.25 to 0.8 THz. From a structural analysis of the printed antennas, we determined that the printing resolution is limited to about 5 μm. The arrays are analyzed by terahertz time-domain spectroscopy (THz-TDS). The good agreement between THz-TDS measurements and numerical simulations showed that the microplotter system can be used for rapid prototyping by adjusting a limited number of fabrication parameters.

Worry about lung cancer is related to numeracy and risk perception of diseases associated with smoking

Background

Numeracy is one's ability to use numbers in context and influence's decision making and perceptions of health risk. Worry about lung cancer¹ is an indicator of perceived risk² and is related to interest in cessation and cancer screening.

Purpose

The analysis sought to explore underlying relationships among worry about lung cancer, smoking-related disease risk perceptions, and numeracy in a web-based panel.

Methods

A Web-based survey, including a numeracy measure, was completed by 1,682 participants aged 18-65 recruited in 2014. Former and current smokers were asked about LC worry and current smokers were asked their PR of diseases associated with smoking.

Results

Females (m=25.64, 95% CI [24.67, 26.61]), respondents aged 45-65 (m=26.15, 95% CI [24.89, 27.41]), those who worry "all the time" about LC (m=27.62, 95% CI [25.66, 29.58]), and respondents perceiving a higher risk of LC compared to other smokers (m=28.84, 95% CI [27.66, 30.01]) expressed significantly higher PR means. Higher household income (OR=1.20, 95% CI [1.08, 1.34]), age (OR=0.86, 95% CI [0.77, 0.98]), and comparative LC risk (OR=2.52, 95% CI [2.01, 3.17]) were significantly associated with greater worry about LC. As PR increases by one unit, the probability of worrying increases by 4.6%. For numeracy scores, odds ratio showed that as scores increased by one unit, the probability of worrying decreased by 11.9%.

Discussion

In this study, we have shown that PR has a positive association with LC worry and that numeracy has a negative association with LC worry.

Translation to health education practice

This information can be used to target subpopulations with low PR and numeracy about their risks for lung cancer and to develop tailored messages to educate these people.

Free nicotine patch giveaway program 12-month follow-up of participants

OBJECTIVE

To estimate the effectiveness of a free nicotine patch giveaway program offered to New York City (NYC) smokers conducted in 2003.

METHODOLOGY

The effectiveness of the program was assessed by contrasting the 12-month quit rate of program participants with the quit rate from a group of Quitline callers who were not offered free nicotine patches. The follow-up surveys were conducted in 2004 and the analysis in 2005.

RESULTS

The 7-day nonsmoking prevalence rate measured at 12 months among callers who received the nicotine patches was 1.78 times higher (95% confidence interval [CI] = 1.19-2.66) than the quit rate among a comparable group of callers to the Quitline from NYC a year earlier who did not receive nicotine patches.

CONCLUSIONS

The provision of free nicotine patches through a telephone quitline was effective in inducing a large number of smokers to make a quit attempt and stop smoking, above and beyond the efficacy of the quitline support alone.

Reach, efficacy, and cost-effectiveness of free nicotine medication giveaway programs

In an effort to increase access to evidence-based smoking cessation therapies, regional tobacco control programs in New York State implemented different interventions to make free nicotine patches and gum available to smokers wishing to quit. In one region, eligible smokers were sent a voucher redeemable at a local pharmacy for a 2-week supply of either nicotine patches or gum. In other regions, smokers received either a 1-week supply or a 2-week supply of nicotine patches sent to their home. In New York City, eligible smokers received a 6-week supply of nicotine patches and a follow-up phone call. All of the programs utilized the state's Smokers' Quitline to screen and register eligible smokers for the free medication. The reach of the different programs was evaluated by computing the proportion of eligible smokers within a given area enrolled in the program and tracking call volume to the Quitline before, during, and after the free giveaway promotions. Efficacy was evaluated by a telephone follow-up survey of program participants conducted 4 months after enrollment to measure use of the medications and smoking behavior. The quit rate of program participants was contrasted with the quit rate computed from an earlier follow-up survey of Quitline callers who were not provided nicotine replacement therapy (NRT). Free nicotine patches or gum was sent to 40,090 smokers representing about 2.9 percent of eligible heavy smokers (10+ cigarettes per day) in the state. In each time period and location where free NRT was offered, call volume to the Quitline increased dramatically. Quit rates varied in relationship to the supply of NRT sent to participants, but in all cases was higher than the quit rate observed among smokers not sent NRT (21%-35% vs 12%). The offer of free NRT appears to be a cost-effective method to induce large numbers of smokers to make a quit attempt.

Financial Incentives to Promote Smoking Cessation

In an effort footline to motivate smokers across New York State to stop smoking, tobacco control programs across the state held 'Quit and Win' incentive-based stop-smoking contests. These contests encouraged smokers to make a quit attempt by offering a chance to win cash prize (usually 1,000 dollars) for successfully stopping smoking for at least 1 month. Between 2001 and 2004, 11 different Quit and Win Contests involving 5,504 adult smokers were sponsored in different communities across New York State. Follow-up surveys were conducted 4 to 6 months after each contest ended to evaluate participants' success in quitting smoking. Expenditures for promoting contests varied from a high of 91,441 dollars to a low of 4,345 dollars, with a median of 25,928 dollars. An average of 0.55 percent of smokers was recruited to join contests across the 11 communities. Among smokers who enrolled in a contest, 9 out of 10 reported making a quit attempt, and between 53 percent and 72 percent reported quitting for the full month of the contest. At 4 to 6 months follow-up, self-reported quit rates (7-day point prevalence) among contestants ranged from 22 percent to 49 percent, with an average of 31 percent. Based on a statewide population survey, 8 of the 11 programs showed quit rates that were significantly higher (P < .001 by Wilcoxon rank-sum test) than the estimated quit rate of 21 percent seen among smokers making a quit attempt in the past year. This study shows that for a relatively modest investment of resources, thousands of smokers can be recruited to make a serious quit attempt, with many remaining smoke-free months later.