In a within-subject design, cigarette smokers, stratified by age, will purchase tobacco products under three tax rate conditions based on abuse liability, that is taxes based on: (1) product category score (i.e. score ranging from 0-1 based on abuse liability effect sizes); (2) product category rank (i.e. position of a product relative to all others; e.g. 1st, 5th); and (3) product tiers (i.e. low-, medium-, high abuse liability), as well as a control. In the ETM, the effects of these interventions will be examined on cigarette demand and other products substitution.
The investigators will use a repeated-measures (within subject) analysis of variance (ANOVA) to test if there are differences between conditions (i.e., tax proposals) independently for each product. The models will include study design parameters for order effects to account for counterbalancing the tax conditions in the ETM. Each tax condition will be compared to the control. All distributional assumptions will be checked prior to analyses and the appropriate transformations will be employed, if needed. For each significant result from the omnibus test, the investigators will perform planned contrasts to test the proposed hypotheses previously described. Note that the omnibus test can result in a significant finding while the contrasts of interest may be non-significant. In this case, the investigators will only report the results from the planned contrasts.
Additional analyses might be conducted.
Provide informed consent
Be at least 21 years of age or older
Provide a breath sample for measuring carbon monoxide (CO ≥ 8 ppm)
Smoke at least 10 cigarettes daily
Have uncontrolled physical or mental health conditions
Use of smoking cessation medications (e.g., nicotine replacement, bupropion, varenicline) in the past 30 days
Report concrete, immediate plans to alter/quit using their usual tobacco products in the next 30 days
If they are pregnant or lactating
Single group
Control
BehavioralIn the control condition, participants will purchase tobacco/nicotine products in the ETM. Cigarettes will increase in price across trials.
Product Category Score
BehavioralIn the product category score condition, participants will purchase tobacco/nicotine products in the ETM where the percentage of taxes applied to each product category will be distributed between 0% and 100% proportional to their abuse liability score. Abuse liability scores will be scaled such that the product category with the highest abuse liability will be taxed at 100%.
Product Category Rank
BehavioralIn the product category rank condition, participants will purchase tobacco/nicotine products in the ETM where the tax percentage applied to each product category will be determined by the number of categories and their position in the ranking. The product category with the highest abuse liability will be taxed at 100%; the product with the lowest abuse liability will be taxed at 0%. All other tax rates will be equally spaced across other products based on ranking.
Product Tiers
BehavioralIn the product tiers condition, participants will purchase tobacco/nicotine products in the ETM where tobacco products will be placed in tax tiers to simplify the existing complex tobacco tax system. The investigators will use three tax tiers (i.e., high tax, medium tax, and no tax), as adopted by four states. Products will be placed into tiers depending on their average score (i.e. no tax: \< 0.33, medium tax: 0.33-0.66, and high tax: \>0.66). Products in the high tax tier will be taxed at 100% and products in the medium tax tier will be taxed at 50%.
Cigarette Demand Intensity
Participants will complete purchasing trials in an Experimental Tobacco Marketplace (ETM), where nicotine/tobacco prices will increase accordingly with the condition. The quantity of products purchased in the ETM will be converted to milligrams (mg) of nicotine to standardize the unit of measurement across products. The data will reflect the relationship between nicotine purchased (mg; y-axis) and cigarette price (x-axis). Demand will be estimated using the exponential equation: Q = Q0 \* 10\^k(exp(-αQ0C) - 1), where Q is nicotine purchased (mg), C is price, Q0 is demand intensity (purchases at no cost), k is the function's logarithmic span, and α is demand elasticity. Intensity will be reported, which represents the estimated mg of nicotine purchased when cigarettes are free (price = 0).
Cigarette Demand Elasticity
Participants will complete purchasing trials in an Experimental Tobacco Marketplace (ETM), where nicotine/tobacco prices will increase accordingly with the condition. The quantity of products purchased in the ETM will be converted to milligrams (mg) of nicotine to standardize the unit of measurement across products. The data will reflect the relationship between nicotine purchased (mg; y-axis) and cigarette price (x-axis). Demand will be estimated using the exponential equation: Q = Q0 \* 10\^k(exp(-αQ0C) - 1), where Q is nicotine purchased (mg), C is price, Q0 is demand intensity (purchases at no cost), k is the function's logarithmic span, and α is demand elasticity. Elasticity will be reported, which represents the sensitivity of purchasing to changes in cigarette price.
Nicotine/Tobacco Products Substitution Slope
Participants will complete purchasing trials in an Experimental Tobacco Marketplace (ETM), where nicotine/tobacco prices will increase accordingly with the condition. The quantity of products purchased in the ETM will be converted to milligrams (mg) of nicotine to standardize the unit of measurement across products. The data will reflect the relationship between nicotine purchased (mg; y-axis) and cigarette price (x-axis). To obtain estimates of substitution of price-constant products in the different ETM conditions, the investigators will use ordinary least squares regression to predict total mg of nicotine purchased of the price-constant product. Slope of price-constant products will be reported, which represents the change in mg of nicotine purchased of price-constant products divided by the change in cigarette price.
Nicotine/Tobacco Products Substitution Intercept
Participants will complete purchasing trials in an Experimental Tobacco Marketplace (ETM), where nicotine/tobacco prices will increase accordingly with the condition. The quantity of products purchased in the ETM will be converted to milligrams (mg) of nicotine to standardize the unit of measurement across products. The data will reflect the relationship between nicotine purchased (mg; y-axis) and cigarette price (x-axis). To obtain estimates of substitution of price-constant products in the different ETM conditions, the investigators will use ordinary least squares regression to predict total mg of nicotine purchased of the price-constant product. Y-intercept of price-constant products will be reported.
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Virginia Polytechnic Institute and State University
Lead sponsor
National Cancer Institute (NCI)
Collaborator
National Institutes of Health (NIH)
Collaborator
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