Author ORCID Identifier
https://orcid.org/0000-0002-5129-0752
Defense Date
2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy
Department
Health Psychology
First Advisor
Thomas Eissenberg
Second Advisor
Alison Breland
Third Advisor
Caroline Cobb
Fourth Advisor
Andrew Barnes
Fifth Advisor
Matthew Halquist
Sixth Advisor
Rashelle Hayes
Abstract
People who use smokeless tobacco (SLT) are exposed to a variety of carcinogenic toxicants, yet, despite health risks, nearly 6 million people in the US use SLT. SLT contains and delivers nicotine, a psychostimulant that causes dependence and hinders cessation efforts. An orally-administered nicotine pouch marketed as “tobacco-free” recently has become available for purchase in the US. However, there are very few non-industry-sponsored studies regarding the effects of these oral nicotine pouches.
The current study used clinical laboratory methods to determine the acute effects of an oral nicotine pouch in people who use SLT. Participants completed four sessions (within subjects, Latin-square ordered) that included an own brand (OB) SLT positive control and three oral nicotine pouch conditions (ONP; 2, 4, and 8 mg total nicotine content; “ON!”, Altria, Richmond VA). Outcomes included plasma nicotine concentration and subjective measures. The primary hypotheses are that plasma nicotine concentration will increase significantly as ONP total nicotine content increases, such that the 2 and 4 mg ONP condition will differ but the 8 mg ONP condition will not differ from OB SLT, and abstinence symptoms will be lowest in the OB and 8 mg ONP condition and will differ significantly from the 2 and 4 mg ONP conditions. Results indicate the 8 mg ONP did not differ significantly from OB across physiological and subjective measures; the 4 mg ONP differed from OB and 8 mg on some measures, and the 2 mg reliably delivered less nicotine and reduced abstinence symptoms less effectively when compared to OB and the 8 mg ONP. Study results offer preliminary support for the notion that ONPs may substitute for SLT in people who use SLT regularly. Results also are consistent with the idea that lower nicotine content ONPs may mimic “starter” SLT products of the past by being more palatable to nicotine-naïve users; historically, starter products were designed to facilitate nicotine use and initiate a “graduation” to higher nicotine content ONPs or other products that deliver nicotine more effectively. One policy-related implication of these results is that regulating ONP pH (and SLT pH) such that there is an upper limit on the pH of these products may help reduce the likelihood that nicotine-naive individuals who begin using these products will continue that use over the long-term.
Rights
© The Author
Is Part Of
VCU University Archives
Is Part Of
VCU Theses and Dissertations
Date of Submission
6-25-2024