Katrina Lee, Contributing Writer
Researchers at VCU will conduct a study in early 2022 to examine electronic cigarette flavor regulations and their effect on African American menthol smokers.
VCU Massey Cancer Center researchers Caroline Cobb and Andrew Barnes were awarded a three-year grant of $1.3 million on July 1 from the National Institution on Drug Abuse to conduct this study, according to the researchers.
Cobb and Barnes’ previous collaborative work explores tobacco use behaviors, including e-cigarette and cigar smoking. Through this work, they noted a high prevalence of menthol cigarettes being used by adults and youth living in Virginia, with a focus on African American and lower-income communities.
Cobb explained how there is limited data surrounding communities where menthol cigarette use is prevalent. She also recognized how tobacco harms specific groups more than others, such as African Americans and low-income communities.
“I want to use my research to help reduce these disparities by informing equitable tobacco regulatory policy that will maximize health-promoting effects and minimize unintended consequences among African American smokers,” Cobb stated in an email.
Barnes said that the study will give more insight on the connection between African American menthol cigarette smokers and their relationship with e-cigarettes in an effort to reduce smoking.
“We expect that having access to menthol-flavored e-cigarettes may promote higher levels of e-cigarette use during the intervention period, resulting in reduced smoking and reduced exposure to tobacco-related toxins,” Barnes said.
The university adopted a smoke- and tobacco-free campus policy in June of 2019, to “provide a safe and healthy working and learning environment for faculty, students, staff and visitors on its campus.”
Junior business student Connor Murphy said he started using e-cigarettes because all of his friends were doing it and it seemed like the “cool thing to do.”
“When I first started smoking, certain vape flavors were more enticing than others. The flavors I liked were mango, cucumber and fruit medley Juul pods. I am not sure I would be addicted to nicotine right now if it wasn’t for the good-tasting flavors,” Murphy said. “Now, flavors don’t affect my decision to smoke. I do it for the nicotine it provides.”
Murphy also stated he would like to quit using nicotine soon if he can, but believes that due to the accessibility of vape devices, it will be difficult to quit.
In a 2020 tobacco survey conducted by the U.S. Food and Drug Administration, 3.6 million young adults are currently users of e-cigarettes. More than eight out of 10 of these smokers use flavored e-cigarettes, including mint, fruit and menthol flavors.
Cobb and Barnes will be conducting a short-term clinical trial beginning in early 2022 due to COVID-19 related setbacks. This study involves study participants being randomly grouped into one of three conditions. These conditions are: access to menthol and tobacco-flavored e-cigarettes, access to tobacco-flavored e-cigarettes and access to unflavored e-cigarettes.
Participants are asked to replace their cigarettes with their assigned e-cigarette product as much as they can, but they are not penalized or incentivized for using their assigned product. Cobb and Barnes said they do this to see if smokers will replace their cigarettes with e-cigarettes for their nicotine intake and reduce their smoking of tobacco toxins.
The tobacco plant is the main ingredient in cigarettes, chewing tobacco and more, according to the U.S National Library of Medicine. Nicotine is the chemical found in tobacco leaves, which is highly addictive. E-cigarettes do not contain tobacco; instead they are made up of the chemical nicotine, flavors and other chemicals that are converted into vapor.
The primary measures of this clinical trial are through the participants self-reporting their smoking and e-cigarette use, physiological measures of tobacco and e-cigarette exposure, and behavioral measures of abuse liability.
The participants will also be interviewed throughout the process. Cobbs and Barnes will ask questions about their experiences using the e-cigarette they were provided during the study, what they like and don’t like about it and what makes it easier or harder for them to use it instead of smoking their own brand of menthol cigarette.
In January of 2020, the FDA issued an enforcement policy to limit the sale of e-cigarette flavor options, including mint and fruit flavors, due to its appeal to kids. However, menthol-flavored e-cigarettes remain on the market as of now, according to the FDA.
“If e-cigarettes are intended to serve as cigarette substitutes for adults and not initiate products for youth, tobacco regulatory science research is needed among all populations, but particularly those at risk for tobacco-health disparities like African American smokers,” Cobb stated in an email.