A Mixed-Methods Study on Use of Different Tobacco Products among Younger and Older Adults with Lower and Higher Levels of Nicotine Exposure in California in 2019–2020

Arit Harvanko, Kimberly A. Koester, Gideon St. Helen, Sarah Olson, Hyunjin Cindy Kim and Pamela M. Ling
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Arit Harvanko: Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA
Kimberly A. Koester: Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA
Gideon St. Helen: Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA
Sarah Olson: Divison of General Internal Medicine, Department of Medicine, University of California, San Francisco, CA 94143-1390, USA
Hyunjin Cindy Kim: Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA
Pamela M. Ling: Center for Tobacco Control Research and Education, University of California, San Francisco, CA 94143-1390, USA

IJERPH, 2022, vol. 19, issue 9, 1-14

Abstract: An increasing number of tobacco products are entering the market, offering a variety of options to attain desired nicotine intake. However, little is known about the effect of this diverse marketplace on the experiences and nicotine exposure among tobacco users. A mixed-methods study examined experiences with tobacco products among individuals with relatively lower or higher levels of biomarkers of nicotine exposure. Semi-structured interviews were conducted with younger and older adults to examine tobacco use behaviors, addiction to tobacco products, and nicotine effects. Younger and older adults provided similar narratives about addiction and nicotine effects, which were similar across age groups, product types (i.e., ENDS, combustible cigarettes, or oral tobacco products), and having lower or higher nicotine exposure. Some individuals with higher nicotine exposure who switched from combustible cigarettes to another product (e.g., ENDS) found similar or greater access and perceived addiction to nicotine. Adults with higher and lower levels of nicotine exposure provided narratives consistent with features of nicotine addiction, regardless of age and products used. Availability of multiple tobacco products may be associated with greater access and exposure to nicotine. Addiction may occur at low levels of use and with non-cigarette products.

Keywords: ENDS; e-cigarettes; cigarettes; nicotine gum; TNE; mixed methods; pod (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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