Differing Predictors of Snus, Electronic Cigarette, and Dissolvable Tobacco Use and Implications for Communication Intervention

Theoretical Background and research questions/hypothesis:  Smokeless nicotine product use has risen recently, e.g., Kuehn (2009), Henningfield & Zaatari (2010), Ayers et al. (in press).  Some have argued that these new products reduce harm (Gilljam & Galanti, 2003; Siegel et al., in press) and others have attempted to show an association between adoption of such products and tobacco smoking cessation (Biener & Bogen, 2009; Siegel et al., in press).  Whether we can treat all smokeless nicotine product use as equivalent, however, is an open question.  New nicotine product use might represent an array of different behaviors.  Snus use, for example, appears to be a function of different predictors than is cigarette use (Southwell et al., 2011).  Electronic cigarette (e-cigarette) use, in turn, might be functionally different than dissolvable tobacco use or snus use.  We addressed two research questions using data from a recent survey of smokers in Florida.  Which demographic characteristics predict snus, electronic cigarette, and dissolvables use?  Do new product users vary with respect to desire to quit smoking? 

Methods:    To discern potential target audiences for future communication intervention, we compared different categories of smokeless nicotine product use through analysis of data (N = 522) from the 2010 Online Smokers’ Survey (OSS), the latest wave of a cross-sectional survey of Florida smokers conducted for the Florida Bureau of Tobacco Prevention Program.  These data are innovative; many recent surveys ask about all new products as an aggregate group whereas we were able to analyze each behavior separately.  We used logistic regression to predict any trial of e-cigarettes, snus, or dissolvable tobacco in the past year, modeling each as a function of no reported desire to quit smoking (measured dichotomously) as well as age, sex, and race.   

Results:    Results suggest differences between products.  There are sex differences for snus use; men were more than twice as likely as women to report snus trial, OR = 2.5, p < .05.  Dissolvable tobacco seems to be more in favor among younger smokers than among their older peers; both adults age 35 to 49, OR = 0.21, p < .05, and adults age 50 or older, OR = 0.06, p < .05, were less likely to have tried dissolvable tobacco than their 18 to 34 peers.  Having no desire to quit smoking was not predictive in the final model for any behavior despite our anticipation of a potential inverse relationship.  There were important bivariate differences between behaviors in terms of desire to quit smoking, however.  Whereas almost 10 percent of snus users expressed no desire to quit in weighted results, for example, literally everyone who had tried an e-cigarette expressed at least some desire to quit smoking.   

Conclusions:  Among Florida smokers, snus users tend to be male and more likely to have absolutely no desire to quit smoking than e-cigarette users.  Dissolvable tobacco use appears to be exploratory behavior for younger audiences.  The various new nicotine products harbor somewhat different user profiles. 

Implications for research and/or practice:    Communication programs to curb nicotine use should acknowledge differences between new nicotine products rather than simply extending current tobacco control efforts.