Trial Outcomes & Findings for Promotion and Mitigation Factors Leading to Illegal Tobacco Purchases (NCT NCT06001840)
NCT ID: NCT06001840
Last Updated: 2026-02-10
Results Overview
The study has 4 policy conditions with combinations of promotion strategy (VLNC standard) and mitigation strategy (penalties), and each combination: No Policy, Penalty only, VLNC only, and Penalty + VLNC. The average percentage of the budget spent on illegal cigarettes across all trials was calculated for each policy scenario.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
65 participants
Primary outcome timeframe
1 day
Results posted on
2026-02-10
Participant Flow
Participant milestones
| Measure |
Experimental: Exclusive Cigarette Smokers
Participants completed four within-subject ETM conditions (No Policy; Penalty Only; VLNC Only; Penalty + VLNC) in a randomized, counterbalanced order.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
Participants completed four within-subject ETM conditions (No Policy; Penalty Only; VLNC Only; Penalty + VLNC) in a randomized, counterbalanced order.
|
|---|---|---|
|
Overall Study
STARTED
|
33
|
32
|
|
Overall Study
No Policy
|
27
|
26
|
|
Overall Study
Penalty Only
|
31
|
29
|
|
Overall Study
VLNC Only
|
27
|
26
|
|
Overall Study
Penalty + VLNC
|
31
|
29
|
|
Overall Study
COMPLETED
|
27
|
26
|
|
Overall Study
NOT COMPLETED
|
6
|
6
|
Reasons for withdrawal
| Measure |
Experimental: Exclusive Cigarette Smokers
Participants completed four within-subject ETM conditions (No Policy; Penalty Only; VLNC Only; Penalty + VLNC) in a randomized, counterbalanced order.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
Participants completed four within-subject ETM conditions (No Policy; Penalty Only; VLNC Only; Penalty + VLNC) in a randomized, counterbalanced order.
|
|---|---|---|
|
Overall Study
Lost to Follow-up
|
4
|
4
|
|
Overall Study
Withdrawal by Subject
|
0
|
2
|
|
Overall Study
Screen fail
|
2
|
0
|
Baseline Characteristics
We did not collect this measure from exclusove cigarette users as they previously reported no e-cigarette use.
Baseline characteristics by cohort
| Measure |
Experimental: Exclusive Cigarette Smokers
n=27 Participants
Exclusive Cigarette Smokers completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
n=26 Participants
Duak completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
Total
n=53 Participants
Total of all reporting groups
|
|---|---|---|---|
|
Age, Continuous
|
44.74 years
STANDARD_DEVIATION 9.02 • n=27 Participants
|
43.15 years
STANDARD_DEVIATION 8.04 • n=26 Participants
|
43.94 years
STANDARD_DEVIATION 8.53 • n=53 Participants
|
|
Sex: Female, Male
Female
|
16 Participants
n=27 Participants
|
14 Participants
n=26 Participants
|
30 Participants
n=53 Participants
|
|
Sex: Female, Male
Male
|
11 Participants
n=27 Participants
|
12 Participants
n=26 Participants
|
23 Participants
n=53 Participants
|
|
Ethnicity (NIH/OMB)
Hispanic or Latino
|
0 Participants
n=27 Participants
|
1 Participants
n=26 Participants
|
1 Participants
n=53 Participants
|
|
Ethnicity (NIH/OMB)
Not Hispanic or Latino
|
27 Participants
n=27 Participants
|
25 Participants
n=26 Participants
|
52 Participants
n=53 Participants
|
|
Ethnicity (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
0 Participants
n=53 Participants
|
|
Race (NIH/OMB)
American Indian or Alaska Native
|
1 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
1 Participants
n=53 Participants
|
|
Race (NIH/OMB)
Asian
|
0 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
0 Participants
n=53 Participants
|
|
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
|
0 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
0 Participants
n=53 Participants
|
|
Race (NIH/OMB)
Black or African American
|
6 Participants
n=27 Participants
|
7 Participants
n=26 Participants
|
13 Participants
n=53 Participants
|
|
Race (NIH/OMB)
White
|
18 Participants
n=27 Participants
|
18 Participants
n=26 Participants
|
36 Participants
n=53 Participants
|
|
Race (NIH/OMB)
More than one race
|
2 Participants
n=27 Participants
|
1 Participants
n=26 Participants
|
3 Participants
n=53 Participants
|
|
Race (NIH/OMB)
Unknown or Not Reported
|
0 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
0 Participants
n=53 Participants
|
|
Household Income
Less than $19,000
|
18 Participants
n=27 Participants
|
18 Participants
n=26 Participants
|
36 Participants
n=53 Participants
|
|
Household Income
$20,000-$39,999
|
4 Participants
n=27 Participants
|
5 Participants
n=26 Participants
|
9 Participants
n=53 Participants
|
|
Household Income
$40,000-$64,999
|
1 Participants
n=27 Participants
|
3 Participants
n=26 Participants
|
4 Participants
n=53 Participants
|
|
Household Income
$65,000-$99,999
|
2 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
2 Participants
n=53 Participants
|
|
Household Income
$100,000-$154,999
|
2 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
2 Participants
n=53 Participants
|
|
Household Income
Greater than $155,000
|
0 Participants
n=27 Participants
|
0 Participants
n=26 Participants
|
0 Participants
n=53 Participants
|
|
Education
< 12 years
|
4 Participants
n=27 Participants
|
2 Participants
n=26 Participants
|
6 Participants
n=53 Participants
|
|
Education
12 years
|
8 Participants
n=27 Participants
|
8 Participants
n=26 Participants
|
16 Participants
n=53 Participants
|
|
Education
13-15 years
|
12 Participants
n=27 Participants
|
13 Participants
n=26 Participants
|
25 Participants
n=53 Participants
|
|
Education
16+ years
|
3 Participants
n=27 Participants
|
3 Participants
n=26 Participants
|
6 Participants
n=53 Participants
|
|
Timeline Follow Back (TLFB)- Cigarettes
|
19.95 cigarettes per day
STANDARD_DEVIATION 7.77 • n=27 Participants
|
17.71 cigarettes per day
STANDARD_DEVIATION 0.76 • n=26 Participants
|
18.83 cigarettes per day
STANDARD_DEVIATION 4.26 • n=53 Participants
|
|
ETM Budget
|
53.10 dollars per week
STANDARD_DEVIATION 25.0 • n=27 Participants
|
71.5 dollars per week
STANDARD_DEVIATION 28.2 • n=26 Participants
|
62.3 dollars per week
STANDARD_DEVIATION 26.6 • n=53 Participants
|
|
Heaviness of Smoking Index (HSI)
|
4.04 units on a scale
STANDARD_DEVIATION 1.09 • n=27 Participants
|
3.81 units on a scale
STANDARD_DEVIATION 2.56 • n=26 Participants
|
3.93 units on a scale
STANDARD_DEVIATION 1.83 • n=53 Participants
|
|
Questionairre on Smoking Urges (QSU)- brief
Cigarettes
|
47.93 units on a scale
STANDARD_DEVIATION 15.77 • n=27 Participants
|
50.42 units on a scale
STANDARD_DEVIATION 13.96 • n=26 Participants
|
49.18 units on a scale
STANDARD_DEVIATION 14.87 • n=53 Participants
|
|
Questionairre on Smoking Urges (QSU)- brief
E-cigarettes
|
17.22 units on a scale
STANDARD_DEVIATION 12.58 • n=27 Participants
|
41.81 units on a scale
STANDARD_DEVIATION 15.19 • n=26 Participants
|
29.52 units on a scale
STANDARD_DEVIATION 13.89 • n=53 Participants
|
|
Intention to quit cigarettes
|
6.50 units on a scale
STANDARD_DEVIATION 2.43 • n=27 Participants
|
6.00 units on a scale
STANDARD_DEVIATION 1.41 • n=26 Participants
|
6.25 units on a scale
STANDARD_DEVIATION 1.92 • n=53 Participants
|
|
Timeline Follow Back (TLFB)- E-cigarettes
|
0.00 mL per day
STANDARD_DEVIATION 0.01 • n=27 Participants
|
0.98 mL per day
STANDARD_DEVIATION 1.42 • n=26 Participants
|
0.49 mL per day
STANDARD_DEVIATION 0.72 • n=53 Participants
|
|
Heavines of Vaping Index (HVI)
|
—
|
2.56 units on a scale
STANDARD_DEVIATION 2.29 • n=26 Participants • We did not collect this measure from exclusove cigarette users as they previously reported no e-cigarette use.
|
2.56 units on a scale
STANDARD_DEVIATION 2.29 • n=26 Participants • We did not collect this measure from exclusove cigarette users as they previously reported no e-cigarette use.
|
|
Intention to quit e-cigarettes
|
—
|
2.24 units on a scale
STANDARD_DEVIATION 2.54 • n=26 Participants • We did not collect this measure for exclusive cigarette users as they preveiously reported no e-cigarette use.
|
2.24 units on a scale
STANDARD_DEVIATION 2.54 • n=26 Participants • We did not collect this measure for exclusive cigarette users as they preveiously reported no e-cigarette use.
|
PRIMARY outcome
Timeframe: 1 dayThe study has 4 policy conditions with combinations of promotion strategy (VLNC standard) and mitigation strategy (penalties), and each combination: No Policy, Penalty only, VLNC only, and Penalty + VLNC. The average percentage of the budget spent on illegal cigarettes across all trials was calculated for each policy scenario.
Outcome measures
| Measure |
Experimental: Exclusive Cigarette Smokers
n=27 Participants
Exclusive Cigarette Smokers completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
n=26 Participants
Dual users completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
|---|---|---|
|
Percent Budget Spent on Illegal Cigarettes Across Policy Conditions
Penalty + VLNC
|
26.31 percentage of budget spent
Standard Error 3.47
|
20.94 percentage of budget spent
Standard Error 3.09
|
|
Percent Budget Spent on Illegal Cigarettes Across Policy Conditions
No Policy
|
40.78 percentage of budget spent
Standard Error 4.04
|
38.41 percentage of budget spent
Standard Error 3.63
|
|
Percent Budget Spent on Illegal Cigarettes Across Policy Conditions
Penalty only
|
12.14 percentage of budget spent
Standard Error 2.66
|
9.64 percentage of budget spent
Standard Error 2.32
|
|
Percent Budget Spent on Illegal Cigarettes Across Policy Conditions
VLNC only
|
71.20 percentage of budget spent
Standard Error 3.42
|
65.18 percentage of budget spent
Standard Error 2.84
|
PRIMARY outcome
Timeframe: 1 dayThe study has 4 policy conditions with combinations of promotion strategy (VLNC standard) and mitigation strategy (penalties), and each combination: No Policy, Penalty only, VLNC only, and Penalty + VLNC. The average percentage of the budget spent on legal cigarettes across all trials was calculated for each policy scenario.
Outcome measures
| Measure |
Experimental: Exclusive Cigarette Smokers
n=27 Participants
Exclusive Cigarette Smokers completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
n=26 Participants
Dual users completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
|---|---|---|
|
Percent Budget Spent on Legal Cigarettes Across Policy Conditions
No Policy
|
37.97 percentage of budget spent
Standard Error 3.73
|
29.72 percentage of budget spent
Standard Error 3.28
|
|
Percent Budget Spent on Legal Cigarettes Across Policy Conditions
Penalty only
|
57.30 percentage of budget spent
Standard Error 3.59
|
47.73 percentage of budget spent
Standard Error 3.30
|
|
Percent Budget Spent on Legal Cigarettes Across Policy Conditions
VLNC only
|
4.32 percentage of budget spent
Standard Error 1.31
|
0.89 percentage of budget spent
Standard Error 0.37
|
|
Percent Budget Spent on Legal Cigarettes Across Policy Conditions
Penalty + VLNC
|
19.71 percentage of budget spent
Standard Error 2.84
|
9.69 percentage of budget spent
Standard Error 2.06
|
PRIMARY outcome
Timeframe: 1 dayThe study has 4 policy conditions with combinations of promotion strategy (VLNC standard) and mitigation strategy (penalties), and each combination: No Policy, Penalty only, VLNC only, and Penalty + VLNC. The average percentage of the budget spent on e-cigarettes across all trials was calculated for each policy scenario.
Outcome measures
| Measure |
Experimental: Exclusive Cigarette Smokers
n=27 Participants
Exclusive Cigarette Smokers completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
n=26 Participants
Dual users completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
|---|---|---|
|
Percent Budget Spent on E-cigarettes Across Policy Conditions
No Policy
|
10.01 percentage of budget spent
Standard Error 1.48
|
23.06 percentage of budget spent
Standard Error 2.27
|
|
Percent Budget Spent on E-cigarettes Across Policy Conditions
Penalty only
|
20.16 percentage of budget spent
Standard Error 2.56
|
27.15 percentage of budget spent
Standard Error 2.41
|
|
Percent Budget Spent on E-cigarettes Across Policy Conditions
VLNC only
|
11.49 percentage of budget spent
Standard Error 1.71
|
24.06 percentage of budget spent
Standard Error 2.39
|
|
Percent Budget Spent on E-cigarettes Across Policy Conditions
Penalty + VLNC
|
37.63 percentage of budget spent
Standard Error 3.12
|
46.51 percentage of budget spent
Standard Error 3.16
|
PRIMARY outcome
Timeframe: 1 dayThe study has 4 policy conditions with combinations of promotion strategy (VLNC standard) and mitigation strategy (penalties), and each combination: No Policy, Penalty only, VLNC only, and Penalty + VLNC. The average percentage of the budget spent on nicotine replacement theray across all trials was calculated for each policy scenario.
Outcome measures
| Measure |
Experimental: Exclusive Cigarette Smokers
n=27 Participants
Exclusive Cigarette Smokers completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
n=26 Participants
Dual users completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
|---|---|---|
|
Percent Budget Spent on Nicotine Replacement Therapy Across Policy Conditions
No Policy
|
2.00 percentage of budget spent
Standard Error 0.44
|
3.67 percentage of budget spent
Standard Error 0.86
|
|
Percent Budget Spent on Nicotine Replacement Therapy Across Policy Conditions
Penalty only
|
3.11 percentage of budget spent
Standard Error 0.70
|
4.56 percentage of budget spent
Standard Error 0.91
|
|
Percent Budget Spent on Nicotine Replacement Therapy Across Policy Conditions
VLNC only
|
3.46 percentage of budget spent
Standard Error 0.94
|
4.38 percentage of budget spent
Standard Error 1.10
|
|
Percent Budget Spent on Nicotine Replacement Therapy Across Policy Conditions
Penalty + VLNC
|
8.71 percentage of budget spent
Standard Error 1.41
|
6.89 percentage of budget spent
Standard Error 1.08
|
PRIMARY outcome
Timeframe: 1 dayThe study has 4 policy conditions with combinations of promotion strategy (VLNC standard) and mitigation strategy (penalties), and each combination: No Policy, Penalty only, VLNC only, and Penalty + VLNC. The average percentage of the budget spent on oral nicotine/tobacco across all trials was calculated for each policy scenario.
Outcome measures
| Measure |
Experimental: Exclusive Cigarette Smokers
n=27 Participants
Exclusive Cigarette Smokers completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
|
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
n=26 Participants
Dual users completed all four within-subject experimental conditions described in the intervention section, presented in a randomized, counterbalanced order. Within each condition, participants completed five trials in which the market price of legal cigarettes systematically increased from ½×, 1×, 2×, 4×, to 8× , allowing evaluation of purchasing behavior under escalating prices. Sequences of conditions were not tracked. Milestones (conditions) are used to indicate exposure without double-counting participants.
Promotion Factors:
In full nicotine conditions, participants' preferred cigarettes were available in the Legal Experimental Tobacco Marketplace (LETM), while preferred cigarettes were also available in the Illegal Experimental Tobacco Marketplace (iETM).
In low nicotine conditions, very low nicotine content (VLNC) cigarettes were available in the LETM, while preferred cigarettes remained available in the iETM.
Mitigation Strategy:
Penalties simulated enforcement with a 60% likelihood of being "caught" making an illegal purchase. If caught, participants left the session without products.
No Policy: Full nicotine cigarettes available in LETM; no penalty.
Penalty Only: Full nicotine cigarettes available in LETM; 60% chance of being caught.
VLNC Only: Only VLNC cigarettes available in LETM; no penalty.
Penalty + VLNC: VLNC cigarettes only in LETM; 60% chance of being caught.
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|---|---|---|
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Percent Budget Spent on Oral Nicotine/Tobacco Across Policy Conditions
No Policy
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0.85 percentage of budget spent
Standard Error 0.40
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0.12 percentage of budget spent
Standard Error 0.05
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Percent Budget Spent on Oral Nicotine/Tobacco Across Policy Conditions
Penalty only
|
0.69 percentage of budget spent
Standard Error 0.32
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0.89 percentage of budget spent
Standard Error 0.63
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Percent Budget Spent on Oral Nicotine/Tobacco Across Policy Conditions
VLNC only
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1.08 percentage of budget spent
Standard Error 0.50
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0.21 percentage of budget spent
Standard Error 0.09
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Percent Budget Spent on Oral Nicotine/Tobacco Across Policy Conditions
Penalty + VLNC
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0.71 percentage of budget spent
Standard Error 0.31
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0.37 percentage of budget spent
Standard Error 0.11
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Adverse Events
Experimental: Exclusive Cigarette Smokers
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Experimental: Dual Cigarette/ Nicotine Vaping Product Users
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Dr. Roberta Freitas-Lemos
Fralin Biomedical Research Institute at VTC
Phone: 540 526 2106
Email: [email protected]
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place