Effects of Tax Proposals and Cigarette Availability on Tobacco Purchasing

Virginia Polytechnic Institute and State University

Status: Enrolling

Conditions: Cigarette Smoking

Treatments: Behavioral: Nicotine Content Tax - Normal Nicotine Cigarettes Not Available; Behavioral: Modified Risk Tobacco Product Tax - Normal Nicotine Cigarettes Not Available; Behavioral: Nicotine Content Tax - Normal Nicotine Cigarettes Available; Behavioral: Harm Reduction Tax - Normal Nicotine Cigarettes Not Available; Behavioral: Harm Reduction Tax - Normal Nicotine Cigarettes Available; Behavioral: Modified Risk Tobacco Product Tax - Normal Nicotine Cigarettes Available; Behavioral: Tobacco Parity Tax - Normal Nicotine Cigarettes Not Available; Behavioral: Tobacco Parity Tax - Normal Nicotine Cigarettes Available

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT07142668

VT IRB 25-612

R01CA266966 (U.S. NIH Grant/Contract)

Details and patient eligibility

About

This study will investigate the effects of normal-nicotine versus low-nicotine cigarette availability in the context of four tax proposals (Tobacco Parity, Nicotine-Content, Harm-Reduction, and Modified Risk Tobacco Product-based taxes) on tobacco product purchasing patterns in a virtual marketplace.

Full description

In a within/between subjects design, the investigators will use an Experimental Tobacco Marketplace (ETM) to systematically impose four innovative tobacco/nicotine tax proposals (Tobacco Parity, Nicotine-Content, Harm-Reduction, and Modified Risk Tobacco Product-related taxes) covering a broad range of tax magnitudes. Participants will complete two control trials and one tax proposal condition, with and without the conventional cigarettes available in the marketplace. Each condition (with and without conventional cigarettes) will include five price scenarios, with tax rates increasing across scenarios by a multiplicative factor. Tobacco products are placed into three tax tiers: high-, medium-, and no-tax, according to the goals of each proposal.

Enrollment: 316 estimated patients

Sex: All

Ages: 21+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• provide informed consent
• provide a breath carbon monoxide sample ≥ 8 ppm,
• be at least 21 years of age (the legal age to purchase tobacco),
• smoke at least 10 cigarettes daily, and
• use other tobacco products less than weekly.

Exclusion criteria

• report uncontrolled physical or mental health conditions (e.g., uncontrolled diabetes, high blood pressure, major depressive disorder, etc.),
• 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,
• be pregnant or lactating, or
• have plans to move out of the area during the experiment.

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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316 participants in 4 patient groups

Tobacco Parity

Experimental group

Description:

Exclusive cigarette smokers will be recruited and will be exposed to two control trials and the Tobacco Parity Tax condition. Tobacco products in the Experimental Tobacco Marketplace are placed into three tax tiers: high-, medium-, and no-tax. In this condition, all tobacco products are placed in the high-tax tier while products that do not contain tobacco (e.g., herbal cigarettes and nicotine-free ENDS) are placed in the medium-tax tier. Nicotine Replacement Therapy products are placed in the no-tax tier.

Treatment:

Behavioral: Tobacco Parity Tax - Normal Nicotine Cigarettes Not Available

Behavioral: Tobacco Parity Tax - Normal Nicotine Cigarettes Available

Nicotine Content

Experimental group

Description:

Exclusive cigarette smokers will be recruited and will be exposed to two control trials and the Nicotine-Content Tax Condition. Products in the Experimental Tobacco Marketplace are placed into three tax tiers: high-, medium-, and no-tax. In this condition, products with greater than 3 mg nicotine per single unit are placed in the high-tax tier, products with 0.6-3.0 mg/unit in the medium-tax tier, and those with 0.5 mg/unit or less in the no-tax tier.

Treatment:

Behavioral: Nicotine Content Tax - Normal Nicotine Cigarettes Available

Behavioral: Nicotine Content Tax - Normal Nicotine Cigarettes Not Available

Harm Reduction

Experimental group

Description:

Exclusive cigarette smokers will be recruited and will be exposed to two control trials and the Harm Reduction Tax Condition. Tobacco products in the Experimental Tobacco Marketplace are placed into three tax tiers: high-, medium-, and no-tax. In this condition, all combustible products with high abuse liability are placed in the high-tax tier. All non-combustible products or combustible products with low abuse liability are placed in the medium-tax tier. Nicotine Replacement Therapy products are placed in the no-tax tier.

Treatment:

Behavioral: Harm Reduction Tax - Normal Nicotine Cigarettes Not Available

Behavioral: Harm Reduction Tax - Normal Nicotine Cigarettes Available

Modified Risk Tobacco Products (MRTP)

Experimental group

Description:

Exclusive cigarette smokers will be recruited and will be exposed to two control trials and the Modified Risk Tobacco Products tax condition. Tobacco products in the Experimental Tobacco Marketplace are placed into three tax tiers: high-, medium-, and no-tax. In this condition, all non-MRTP tobacco products are placed in the high-tax tier, MRTPs are placed in the medium-tax tier, and Nicotine Replacement Therapy products are placed in the no-tax tier.

Treatment:

Behavioral: Modified Risk Tobacco Product Tax - Normal Nicotine Cigarettes Available

Behavioral: Modified Risk Tobacco Product Tax - Normal Nicotine Cigarettes Not Available