摘要：Objectives. We explored young adults’ perceptions of snus (spitless moist snuff packed in porous bags), dissolvable tobacco products, and electronic cigarettes and intention to try these products. Methods. We conducted 11 focus group discussions involving a total of 66 young adults (18–26 years old) on these new tobacco products (e.g., harmfulness, potential as quit aids, intention to try) held between July and December 2010. We analyzed discussions using a thematic approach. Results. Participants generally reported positive perceptions of the new products, particularly because they came in flavors. Few negative perceptions were reported. Although some participants believed these products were less harmful than cigarettes and helpful in quitting smoking, others thought the opposite, particularly regarding electronic cigarettes. Participants also commented that these products could be gateways to cigarette smoking. Half of the participants, including a mix of smokers and nonsmokers, admitted they would try these products if offered by a friend. Conclusions. Young adults perceive the new tobacco products positively and are willing to experiment with them. Eliminating flavors in these products may reduce young adults’ intentions to try these products. Tobacco control policies have been effective in reducing the prevalence of cigarette smoking and per capita cigarette consumption, 1 and contribute to recent decline in cigarette sales in the United States. 2 Probably because of this decline and clean indoor air laws, tobacco companies have introduced new smokeless tobacco products to the United States. 3–9 These products include snus (spitless moist snuff packed in porous bags) and dissolvable tobacco products (spitless, dissolvable oral tobacco products in the shape of breath mint, breath strip, and toothpick). In addition, electronic cigarettes (e-cigarettes; devices that vaporize nicotine to be inhaled) recently have been introduced to the United States. These yet-to-be-regulated products have gained popularity: 10.4% of adult smokers in the test markets for snus tried snus, 10 and in an experiment examining adult smokers’ intention to use smokeless tobacco and nicotine replacement therapies as alternatives for cigarettes, 55.1% of the participants preferred snus and dissolvable tobacco over nicotine lozenges. 11 Internet searches for e-cigarettes also have increased dramatically. 12 These products are a public health concern because they may act as gateways to cigarette smoking, 13 substitute for cigarettes in smokeless locations, or displace effective cessation treatment 14 and consequently obstruct further decline in the prevalence of tobacco use. Research focusing on public perceptions of newly introduced tobacco products has been limited. This presents a missed opportunity because behavioral theories posit that individuals’ perceptions and attitudes predict behavior changes, 15 and consumer research has found that perceptions of a product’s attributes are associated with intent to purchase. 16 It is particularly important to examine young adults’ perceptions of these new products because they have been a target of tobacco company marketing. 17 One study examining patrons’ posts on the Camel Snus Web site found that patrons liked the flavors of the product and the fact that they could use it in places where smoking is not allowed. 18 However, the investigators could not determine the ages of the patrons, and the study also lacked generalizability since it only included the subset of Camel Snus users who visited and posted comments. In another study, an online survey of 81 persons who visited a smoking cessation Web site showed that e-cigarettes are primarily used to help in quitting cigarette smoking 19 ; however, the sample was highly selective and largely European, which restricts generalizing the findings to the United States. We did not identify any research on perceptions of dissolvable tobacco products. To provide insights into young adults’ perceptions of these products, we recruited young adults to participate in a series of focus group discussions on their perceptions of snus, dissolvable tobacco products, and e-cigarettes and their intention to try these products. We also examined whether these perceptions differed by gender and socioeconomic level. We discuss implications for tobacco control policies.
