Tobacco & Nicotine Products
Acute Subjective Responses to Smokeless Tobacco Products: Results from Trial 2
(UMD SPH Epidemiology and Biostatistics Faculty )
Das, Babita (UMD SPH Behavioral and Community Health), Cruz-Cano, Raul (UMD SPH Epidemiology and Biostatistics), Kidanu, Azieb W. (UMD SPH Behavioral and Community Health), Nkongho, Lizette E. (UMD SPH Behavioral and Community Health), Havis, Nicole C. (UMD SPH Behavioral and Community Health), Kim, Hyoshin (Battelle Memorial Institute), Buzzell/McDonald, George/Craig (George Mason University), Brinkman, Marielle C. (Battelle Memorial Institute), Gordon, Sydney (Battelle Memorial Institute), Clark, Pamel
The last few decades have witnessed a substantial increase in the use of smokeless tobacco (ST) products. The characterization of new ST products is vital to understanding their rise in popularity and the consequences of their use. The current study administered a series of cross-over trials to rapidly characterize the abuse liability and likelihood of adoption of a variety of ST products. Trial 1 compared subjective responses to a diverse range of ST such as snuff, snus, dissolvable, chewable, and medicinal products. In Trial 2, reported here, 30 ST users used General Classic Blend Swedish snus, Copenhagen moist snuff, Hawken Rough moist snuff wintergreen, Red Man moist snuff wintergreen, or Nicorette lozenges (control product) on each of five separate laboratory visits. Differences between products in self-reported liking, change in craving, and change in withdrawal were measured. Repeated measures mixed model analysis revealed significant differences between products in overall reinforcement (p<.0001), and in the aversion (p<.0001), reduced craving (p<.0001), enjoy sensations (p<.0001), psychological reward (p<.0001), and satisfaction (p<.0001) factors of the Cigarette Evaluation Scale modified for Smokeless Tobacco. Significant differences were also found between products in ratings of liking (p<.0001), satisfaction (p<.0001), nicotine content (p<.0001), and strength of the tobacco (p<.0001) as measured by the Duke Sensory Questionnaire modified for Smokeless Tobacco. Reduction in overall craving as measured by the Questionnaire for Smoking Urges (p<.0001) and Schuh Stitzer Scale of Tobacco Use Urges (p<.0001), as well as reduction in overall withdrawal as measured by the Minnesota Nicotine Withdrawal Scale (p<.0001) (all modified to measure ST use), also revealed significant differences across products. Red Man and Copenhagen snuff, which consistently produced the highest ratings of liking and reduction in craving across measures, also contained the greatest amount of total nicotine. While Trial 1 revealed diversity across different ST types, Trial 2 exposed diversity in abuse liability and likelihood of adoption across similar ST types.