The Experimental Tobacco Marketplace II: Substitutability and sex effects in dual electronic cigarette and conventional cigarette users

Aim The aim of the current study was to evaluate tobacco product purchasing in the Experimental: Tobacco Marketplace (ETM) among male and female smokers who also use e-cigarettes. We hypothesized a high substitution profile for e-cigarettes and that males would purchase more Snus than females. Methods The ETM is an online market used in clinical abuse liability research to mimic real-world purchasing patterns. Tobacco products, including each participant's usual choice of conventional and e-cigarettes, were presented along with a price and description of nicotine content. Participants were endowed with an account balance based on the number of cigarettes and e-cigarettes consumed per week. Each participant was exposed to four ETM sessions in random order during which the price of conventional cigarettes was manipulated. Results Cigarette consumption decreased as price increased. A mixed factor three-way ANOVA revealed a significant main effect of price (i.e., more alternative products were purchased at higher cigarette prices), product (i.e., more e-cigarettes were purchased than gum, lozenges, and Snus), and sex (i.e., males purchased more than females). A significant three-way interaction indicated that males purchased more e-cigarettes, Snus, and dip than females at higher cigarette prices. Conclusion This study suggests that the user profile of cigarette smokers is associated with behavioral economic measures of alternative product substitution and indicates that the evaluation of nicotine replacement products should be considered for both males and females separately.