The Effects of Oral Nicotine Pouch Packaging Features on Adult Tobacco Users’ and Non-Users’ Product Perceptions

Author:

Mays Darren1ORCID,Long Lauren1,Alalwan Mahmood A.12,Wagener Theodore L.1,Shang Ce1ORCID,Roberts Megan E.3,Patterson Joanne G.3ORCID,Keller-Hamilton Brittney1ORCID

Affiliation:

1. Department of Internal Medicine, The Ohio State University College of Medicine, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, USA

2. Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, OH 43210, USA

3. Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, OH 43210, USA

Abstract

Background: Oral nicotine pouches (ONPs) are novel products that are marketed as “tobacco-free” alternatives to cigarettes and smokeless tobacco (ST). This study examined the effects of ONP packaging features on adult tobacco users’ and non-users’ product perceptions. Materials and Methods: Adult tobacco users (cigarettes, ST, and dual cigarette/ST) and non-users (total N = 301) viewed ONP pack images in a 4 × 3 × 2 between-subject experiment testing the effects of the displayed flavor (cool mint, coffee, dark frost, and smooth), nicotine concentration (none displayed on the package, 3 mg, and 6 mg), and addiction warning label (yes or no). The outcomes were perceived substitutability of ONPs for cigarettes and ST and perceived risks. We modeled the effects of tobacco user status and the experimental factors on these outcomes. Results: All tobacco user groups perceived ONPs to be significantly less harmful and less addictive than non-users. There were significant effects of nicotine concentration on perceived risks. Compared to packages that did not display nicotine concentration, packages displaying 6 mg nicotine concentration produced significantly lower perceived harm (β = −0.23, 95% CI −0.44, −0.02), perceived addictiveness (β = −0.28, 95% CI −0.51, −0.05), risk appraisals of harm (β = −0.50, 95% CI −0.88, −0.12) and risk appraisals of addictiveness (β = −0.53, 95% CI −0.95, −0.11). Conclusions: The study findings demonstrate that the nicotine concentration displayed on ONP packaging can affect adults’ perceptions of ONPs. Further research on the effects of ONP packaging features emphasizing nicotine (e.g., “tobacco free” nicotine claims) on tobacco users and non-users is needed to assess their potential public health impact.

Funder

The Ohio State University Comprehensive Cancer Center—the James

National Cancer Institute of the National Institutes of Health

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

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