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Cigarette smokers’ concurrent use of smokeless tobacco: dual use patterns and nicotine exposure

Felicione, NJ, Ozga-Hess, JE, Ferguson, SG ORCID: 0000-0001-7378-3497, Dino, G, Kuhn, S, Haliwa, L and Blank, MD 2020 , 'Cigarette smokers’ concurrent use of smokeless tobacco: dual use patterns and nicotine exposure' , Tobacco Control , doi: 10.1136/tobaccocontrol-2019-055345.

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Background: The concurrent use of cigarettes withother tobacco products, such as smokeless tobacco(SLT), is increasingly common. Extant work withcigarette smokers who also use SLT is based heavily onretrospective reports and between-group comparisons.The purpose of this study was to assess prospectively thepatterns of dual users’ product use and nicotine exposureon days when cigarettes were smoked exclusively (singleuse) versus concurrently with SLT (dual use).Design: Forty-six dual cigarette-SLT users recordedtheir product use in real time via ecological momentaryassessment for a 2-week longitudinal design. Theyresponded to questions about situational factors (eg,location, mood) using this same diary, and collectedsaliva samples each night for later cotinine measurement.At the end of this 2-week period, users reported on theirreasons for and beliefs about SLT use.Results: Cotinine levels were significantly higher on dualversus single use days (mean±SEM=374.48±41.08 ng/mL vs 300.17±28.13 ng/mL, respectively; pConclusions: Results support the idea of productsupplementation rather than replacement among thisconvenience sample of dual users. For smokers whoseprimary motivation for SLT use involves situations wherethey would otherwise be tobacco free, the potentialbenefits of clean indoor air laws may be diminished.

Item Type: Article
Authors/Creators:Felicione, NJ and Ozga-Hess, JE and Ferguson, SG and Dino, G and Kuhn, S and Haliwa, L and Blank, MD
Keywords: nicotine, tobacco control, dual use
Journal or Publication Title: Tobacco Control
Publisher: B M J Publishing Group
ISSN: 0964-4563
DOI / ID Number: 10.1136/tobaccocontrol-2019-055345
Copyright Information:

© Author(s) (or their employer(s)) 2020.

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