Subjective experiences, contexts, and risk perceptions of very low nicotine content cigarettes and electronic cigarettes among people with depression and anxiety disorders who smoke.

Introduction:
This text provides an analysis of a qualitative study examining the experiences and perceptions of people with depression and anxiety disorders who used very low nicotine content (VLNC) cigarettes with or without electronic cigarettes during a randomized controlled trial. The study aimed to understand the subjective experiences, contexts, and risk perceptions of VLNC and e-cigarette use among this population.

Key Points:

* The study was conducted with participants who were randomly assigned to one of four study conditions for 16 weeks: normal nicotine content research cigarettes, VLNC cigarettes only, VLNC cigarettes + tobacco-flavor e-cigarettes, or VLNC cigarettes + preferred-flavor e-cigarettes.
* Participants were interviewed about their sensory experiences, harm perceptions, and contexts of product use.
* Most participants found VLNC cigarettes unpalatable and held mixed beliefs about their harms.
* Participants had varied opinions about the harms of e-cigarettes, with some perceiving them as a healthier alternative to conventional cigarettes and others feeling they were more harmful or equally harmful.
* E-cigarette use was influenced by convenience and perceived ability to circumvent smoking prohibitions.
* There was little consistency across risk perceptions with e-cigarettes, suggesting that participants may lack information or have difficulty comparing the relative harms of these products.
* Participants had mixed levels of knowledge about e-cigarettes and their risks.

Main Message:
The study suggests that should a nicotine reduction policy be implemented with e-cigarettes concurrently available on the market, tailored messaging for people with anxiety and depression disorders may be necessary to educate them about the availability of alternative sources of nicotine, such as e-cigarettes, as well as the relative risk of VLNC cigarettes and e-cigarettes. This is especially important given the mixed levels of knowledge and risk perceptions about e-cigarettes among this population.

DeAtley T, Harrison A, Cassidy R, Kuo C, Higgins ST, Tidey JW. Subjective experiences, contexts, and risk perceptions of very low nicotine content cigarettes and electronic cigarettes among people with depression and anxiety disorders who smoke. Drug and alcohol dependence. 2023;244:109767. doi:10.1016/j.drugalcdep.2023.109767