U54 Pilot: A Behavioral Economic Assessment of Nicotine Pouch Valuation and Product Switching

We propose a study to assess the effects of nicotine concentration on demand for and substitution from nicotine pouches (NP) among a sample of 400 crowdsourced NP users, and to assess the effects of relative rurality on these indices. Nicotine pouches are a novel tobacco product of great regulatory interest, as use rates have steadily increased since their inception in US markets in 2008. Nicotine concentration for NP''s has also increased at a worrying rate. Food and Drug Administration Center for Tobacco Products (FDA CTP) Priority Research Areas have changed to address this new public health challenge, and include assessing the impact of nicotine concentration on tobacco use preferences and behaviors, including poly use and switching. Behavioral economic methods are a prime method to explore these priorities. The Experimental Tobacco Marketplace (ETM) is one such behavioral economic tool that can assess the degree to which individuals value NP''s (demand characteristics), and how likely they are to switch from NP''s to other products (substitution). Demand characteristics of NP''s and substitution from NP''s is currently poorly understood, and no study has assessed how these behavioral economic indices are affected by nicotine concentration, which is known to affect addictive potential and severity of other products. Rural individuals are especially vulnerable to novel tobacco product marketing and have fewer resources to combat tobacco use. As such, NP''s represent a potential health disparity for rural individuals which should be assessed. Our proposed study seeks to assess whether demand characteristics and substitution patterns differ based on degree of rurality, and whether this moderates indices relationships with nicotine concentration. This research supports both FDA CTP priority areas and AppalTRUST''s mission of identifying tobacco related health disparities among rural individuals and would provide valuable information on a product that has yet to be studied in-depth.