Jennifer L Pearson

• MPH, PhD
• Professor (Associate) at University of Nevada, Reno

Introduction This study describes the prevalence and correlates of beliefs that “organic” and “additive-free” tobacco products are less harmful than conventional tobacco products among US adults, stratified by smoking status and preference for Natural American Spirit (NAS), a brand that uses “organic” and historically used “additive-free.” Methods...

Introduction The tobacco industry has a long history of circumventing regulations to present their products, inaccurately, as less harmful. Greenwashing (portraying a product as natural/eco-friendly) is increasingly used by tobacco companies and may mislead consumers to believe that certain cigarettes are less harmful than others. This study assess...

Background Terms such as ‘natural’, ‘organic’ and ‘tobacco and water’ on cigarette packs may communicate misleading reduced harm messages to consumers. This study describes sales volume and price for brands that used these misleading descriptors in the USA by year, brand and state. Methods The data come from Information Resources Incorporated sale...

Background Substance use is a complex condition with multidimensional determinants. The present study aims to find the prevalence and determinants of substance use among young people attending primary healthcare centers in India. Methods A multicentric cross-sectional study was conducted across 15 states in India on 1,630 young people (10–24 years...

Introduction While previous research has examined misperceptions related to Natural American Spirit (NAS), a premium cigarette brand using ‘natural’-themed marketing, the longitudinal relationship between NAS-related harm beliefs and switching to NAS has not been established. Methods Using data from the PATH study, we modelled the longitudinal rel...

Introduction: The Natural American Spirit (NAS) brand has a history of marketing tactics that may convey reduced harm. While no longer allowed to use "additive-free" or natural terms/descriptors (except in the brand name), it continues promoting potentially misleading attributes. This study examined perceptions of NAS's newer "Sky" style, promoted...

Background: Sex and racial/ethnic identity specific cut-points for validating tobacco use using Wave 1 (W1) of the PATH Study were published in 2020. The current study establishes predictive validity of the W1 (2014) urinary cotinine and Total Nicotine Equivalents-2 (TNE-2) cut-points on estimating Wave 4 (W4; 2017) tobacco use. Methods: For exc...

An influx of laws permitting recreational cannabis sales in the US has allowed for increased advertising. The purpose of this study was to describe how adolescents perceive outdoor and print cannabis advertising and to identify aspects of advertising that are appealing or eye-catching, focusing on five themes: price promotion, sex appeal, wellness,...

Background: Research has identified many factors associated with past 30-day (P30D) marijuana use among youth, but has not assessed factors that may differentiate youth who use frequently from youth who do not. We took a multilevel approach to identify and compare risk and protective factors associated with frequent and non-frequent P30D marijuana...

This ad watch details new L&M cigarette marketing in the United States that now features the terms “simple” and “tobacco and water”, while continuing to highlight its affordable and premium qualities. This implicitly positions L&M as an affordable natural brand, which is new for the brand. From a public health standpoint, this warrants attention an...

Background The purpose of this study was to identify characteristics of people who respond to two or more overdoses (i.e., multiple overdose responders; MOR) compared to those who respond to zero or one, and the association between MOR status and changes in network size. Methods Secondary analysis of data from a randomized trial among 199 PWUD in...

Introduction This study examines predictors of trajectories of cigarette and e-cigarette use among a cohort of U.S. adolescents transitioning into young adulthood. Comparing trajectories of each tobacco product is important to determine if different intervention targets are needed to prevent progression to daily use. Methods Latent trajectory clas...

Exposure to adverse childhood experiences (ACEs) is a risk factor for adolescent cannabis use (CU). We explored whether family communication and school connectedness can offer direct protection (the compensatory model of resiliency) or moderating protection (the protective factors model of resiliency). Using cluster random sampling, a Youth Risk Be...

Introduction People believe that cigarettes using ‘organic,’ ‘additive-free’ or similar descriptors are less harmful than other cigarettes. Natural American Spirit (NAS) is the most popular US cigarette brand using these descriptors. This cohort study describes changes in US smokers’ odds of preferring NAS and changes in NAS smokers’ odds of believ...

Introduction: The purpose of this mixed method pilot study was to (1) examine whether the "organic" descriptor affects smokers' health risk expectancies, subjective ratings of smoking, and topography, and (2) describe how smokers interpret the "organic" descriptor and relate it to their subjective smoking experience. Methods: Twenty-two daily sm...

Exposure to trauma increases the risk of engaging in detrimental health behaviors such as tobacco and substance use. In response, the United States Substance Abuse and Mental Health Services Administration developed Trauma-Informed Care (TIC), an organizational framework for improving the provision of behavioral health care to account for the role...

Background: Determine the overall, sex-, and racially/ethnically-appropriate population-level cotinine and total nicotine equivalents (TNE-2, the molar sum of the two major nicotine metabolites) cut-points to distinguish tobacco users from non-users across multiple definitions of use (e.g., exclusive vs. polytobacco, and daily vs. non-daily). Met...

The purpose of this study was to explore the impact of cultural food insecurity on identity and well-being in second-generation American and international university students. Thirty-one semi-structured interviews were conducted from January–April 2020. Audio transcripts were analyzed using continuous and abductive thematic analysis. Students indic...

Food contributes to an individual's physical and mental well-being and expresses one's cultural identity through preparation, sharing, and consumption (i.e., foodways). Inadequate access to cultural foods can create cultural stress and affect one's identity and well-being. In particular, second-generation U.S. American student populations may have...

Background As states continue to legalize the sale of recreational cannabis, there is a need to study attitudes and behaviors regarding driving after cannabis use. The purpose of this study was to describe US adults' attitudes and behaviors regarding driving after cannabis use by state-level legal sale of recreational cannabis, and to determine whe...

Background Only July 1, 2017, Nevada became the fifth US state to allow the legal sale of recreational cannabis products for adults ages of 21 and over. This study investigates young adults’ cannabis-related attitudes, perceptions, and behaviors in a state where recreational and medical cannabis use was recently legalized. Methods We conducted 8 f...

Importance The prevalence of electronic nicotine delivery systems (ENDS) use, including e-cigarettes, among US young adults (YAs) has raised questions about how these products may affect future tobacco and nicotine use among YAs. Given this prevalence and that young adulthood is a critical period for the establishment of tobacco and nicotine use, i...

Introduction This study examined in youth (12-17 years), young adults (18-24 years), and adults (25+ years) the: 1) prevalence of first menthol cigarette and menthol/mint cigar use among new tobacco users; 2) association between first menthol/mint use, subsequent tobacco use, and nicotine dependence approximately one year later compared to first no...

Low harm perceptions of tobacco products have been associated with use of those products in youth and adults, but this relationship has not been assessed for nicotine beliefs. This study used data from a national sample of adults aged 18–40 in Wave 9 (Spring 2016) of the Truth Initiative Young Adult Cohort Study to examine correlations and prospect...

Background Only July 1, 2017, Nevada became the fifth state to allow the legal sale of recreational cannabis products for adults over the age of 21 years. This study investigates young adults’ cannabis-related attitudes, perceptions, and behaviors in a state where recreational and medical cannabis use was recently legalized. Methods We conducted 8...

Background Only July 1, 2017, Nevada became the fifth U.S. state to allow the legal sale of recreational cannabis products for adults ages of 21 and over. This study investigates young adults’ cannabis-related attitudes, perceptions, and behaviors in a state where recreational and medical cannabis use was recently legalized. Methods We conducted 8...

Introduction: Based on arguments for harm reduction and health benefits, tobacco companies in the United States can apply for regulatory authorization to make "modified risk tobacco product" (MRTP) marketing claims. The impact of future MRTP claims may depend on whether they are noticed, believed and lead to smokers switching products. This study...

Background Debate continues over how e-cigarettes have impacted the health of young people, and what regulatory policies should be enacted. The debate has appropriately been informed by quantitative studies, often focused on initiation, prevalence, and product transition among the general population and demographic segments. Factors driving cessati...

Introduction: This study examined the association between the introduction of an e-cigarette and subsequent change in cigarette smoking among smokers who were not immediately interested in quitting. Methods: The Moment Study was a 21-day intensive longitudinal study with an online follow-up survey at 30 days. After observing baseline cigarette s...

Introduction: According to the National Youth Tobacco Survey (NYTS), youth e-cigarette use (vaping) rose between 2017-2018. Frequency of vaping and concurrent past 30-day (p30d) use of e-cigarettes and tobacco products have not been reported. Methods: We analyzed the 2018 NYTS (N=20,189) for vaping among all students (middle and high school; 6-1...

In 2015, the FDA formally warned Santa Fe Natural Tobacco Company that their “natural” and “additive-free” claims for its Natural American Spirit cigarettes conveyed reduced harm to consumers. In a settlement, Santa Fe was allowed to continue using the word “natural” in the brand name and the phrase “tobacco and water”. The company also uses eco-fr...

Background: Pervasive misperceptions about nicotine may influence uptake of quit smoking aids and the impact of policies addressing nicotine as a tobacco product constituent. Methods: Latent class analyses were conducted using four items on nicotine beliefs asked of 4037 adults aged 18-40 in wave 9 (February-March 2016) of the Truth Initiative Y...

Introduction Inequalities in smoking by socio-economic status (SES) are well-known. A growing body of literature has demonstrated additional inequalities in smoking by sexual orientation. This study used an intersectional lens to examine smoking at the intersection of sexual orientation and education. Methods Data come from 28,362 adult participan...

Objective: Affective features of depression are uniquely involved in the depression-smoking relationship, and it follows that smokers with depression are likely to use cigarettes to alleviate negative affect. However, most ecological momentary assessment (EMA) studies demonstrate no relationship between mood and smoking, in general. Conversely, a...

Background The ability of an electronic cigarette (e-cigarette) to deliver nicotine effectively may be dependent on features of the device, the liquid and the user. Some of these features have been examined in previous work (eg, liquid nicotine concentration and puff topography), while others have not (eg, nicotine dependence and demographic charac...

Background: Evidence is accumulating that youth who try Electronic Nicotine Delivery Systems (ENDS, e-cigarettes) may go on to try cigarettes. This analysis examines the bidirectional patterns of ENDS and cigarette use among US youth over one year and uses propensity score matching (PSM) to examine frequency of ENDS use on changes in cigarette smo...

Background: Socio-economic and sexual orientation inequalities in cigarette smoking are well-documented; however, there is a lack of research examining the social processes driving these complex inequalities. Using an intersectional framework, the current study examines key processes contributing to inequalities in smoking between four intersectio...

Background Socio-economic and sexual orientation inequalities in cigarette smoking are well-documented; however, there is a lack of research examining the social processes driving these complex inequalities. Using an intersectional framework, the current study examines key processes contributing to inequalities in smoking between four intersectiona...

Background: Several jurisdictions in the US and abroad limit the minimum number of cigars that can be sold per package. Research has not evaluated whether small packages might result in cigar use initiation, or whether adding cigars to packages might result in purchasers smoking more cigars. Methods: Using nationally representative US adult data...

Introduction: Nicotine is not a human carcinogen and combustion compounds in tobacco smoke, rather than nicotine, cause tobacco-related cardiovascular disease. Few recent studies examine the public's beliefs about nicotine in relation to smoking. Methods: Participants aged 18-40 (n = 4,091) in Wave 10 (Fall 2016) of the Truth Initiative Young Ad...

Introduction: The heterogeneity of e-cigarette products and e-liquids pose challenges to surveillance of e-cigarette exposure. The goal of this study was to evaluate the internal consistency of e-cigarette use frequency, quantity, and duration measures in a national population-based survey. Methods: Data were drawn from the 2012-2013 for the Nat...

This Letter to the Editor is in response to a letter from Ms. Flannery, titled, “Disregarding the impact of nicotine on the developing brain when evaluating costs and benefits of noncombustible nicotine products”. In our response, we address some concerns raised by Ms. Flannery, and reiterate our position in our original article. In particular, we...

Significance: U.S. smokers of Natural American Spirit, a brand marketed as "organic" and "additive-free," are more likely than other cigarette smokers to believe that their brand might be less harmful than other brands. This paper: 1) describes the prevalence of belief that "organic" and "additive-free" tobacco is less harmful than regular tobacco...

Introduction: JUUL, an e-cigarette from PAX Labs, has captured 70% of the e-cigarette market. The current study examines JUUL use patterns and reasons for initiation in a large convenience sample of U.S. adults. Methods: Respondents were 979 U.S. adults registered on Amazon Mechanical Turk (MTurk) who reported ever using JUUL. Items included fre...

Background Few Internet smoking cessation programs specifically address the impact of alcohol use during a quit attempt, despite its common role in relapse. This study used topic modeling to describe the most prevalent topics about alcohol in an online smoking cessation community, the prevalence of negative sentiment expressed about alcohol use in...

Introduction Evidence indicates that one reason cigarette smokers value e-cigarettes is the ability to use them in places where smoking is not permitted. We sought to: 1) explore adult daily smokers’ experiences using e-cigarettes in the context of smoke-free places; and 2) describe smokers’ perceptions of bystanders’ reactions. Methods Twenty adu...

More than half of adult tobacco users in the United States (U.S.) transitioned in tobacco product use between 2013–2014 and 2014–2015. We examine how characteristics of adult tobacco users in the U.S. relate to transitions in tobacco product use. Population Assessment of Tobacco and Health (PATH) Study data were analyzed from 12,862 adult current t...

In 2013–2014, nearly 28% of adults in the United States (U.S.) were current tobacco users with cigarettes the most common product used and with nearly 40% of tobacco users using two or more tobacco products. We describe overall change in prevalence of tobacco product use and within-person transitions in tobacco product use in the U.S. between 2013–...

Introduction: Improved understanding of the distribution of traditional risk factors of cigarette smoking among youth who have ever used or are susceptible to e-cigarettes and cigarettes will inform future longitudinal studies examining transitions in use. Methods: Multiple logistic regression analysis was conducted using data from youth (ages 1...

Introduction: A diverse class of products, "e-cigarettes" present surveillance and regulatory challenges due to nonstandard terminology used to describe subtypes, especially among young adults, where occasional e-cig use is most prevalent. Methods: Young adults (n=3,364) in Wave 9 (Spring 2016) of the Truth Initiative Young Adult Cohort were ran...

Online smoking cessation communities help hundreds of thousands of smokers quit smoking and stay abstinent each year. Content shared by users of such communities may contain important information that could enable more effective and personally tailored cessation treatment recommendations. This study demonstrates a novel approach to determine indivi...

Background and Objectives This study identified the most common patterns of current alcohol and marijuana use with the spectrum of tobacco products (cigarettes, hookah, e‐cigarettes, cigars/little cigars, and other products), among US young adults and older adults and examined associations of mental health and substance use problems with each patte...

Introduction: As cigarette smoking has decreased among youth and young adults (YAs) in the United States, the prevalence of other tobacco and nicotine product use has increased. Methods: This study identified common past 30-day patterns of tobacco and nicotine product use in youth (grades 6-12) and YAs (aged 18-24). Using data from the 2011-2015...

Commentary to: Evaluating clinical stop-smoking services globally: towards a minimum data set

Background: Little is known about the influence of online peer interactions on health behavior change. This study examined the relationship between exposure to peer sentiment about nicotine replacement therapy (NRT) in an online social network for smoking cessation and NRT use. Methods: Participants were 3297 current smokers who enrolled in an I...

Tobacco control has made strides in prevention and cessation, but deaths will not decline rapidly without massive behavior change. Currently, inhaled smoke from combusting tobacco is chiefly responsible for prematurely killing 7.2 million people worldwide and 530,000 in the United States annually. An array of noncombustible nicotine products (NNPs)...

Introduction This study assessed patterns of e-cigarette and cigarette use from Wave 1 to Wave 2 among adult e-cigarette users at Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study. Methods We examined changes in e-cigarette use frequency at Wave 2 among adult e-cigarette users at Wave 1 (unweighted n=2835). Adjusted prevalence...

Inhalation of the toxic smoke produced by combusting tobacco products, primarily cigarettes, is the overwhelming cause of tobacco-related disease and death in the United States and globally. A diverse class of alternative nicotine delivery systems (ANDS) has recently been developed that do not combust tobacco and are substantially less harmful than...

Implications: This study identifies the effects of question type, order, and inclusion of product images on tobacco use estimates in a national sample of young adults. Ever use and past 30-day use prevalence estimates of specific products were impacted by respondents answering breakout items or breakout items with images compared to respondents an...

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Commentary to: How do we determine the impact of e-cigarettes on cigarette smoking cessation or reduction? Review and recommendations for answering the research question with scientific rigor

Background Rather than providing participants with study-specific data collection devices, their personal mobile phones are increasingly being used as a means for collecting geolocation and ecological momentary assessment (EMA) data in public health research. Objective The purpose of this study was to (1) describe the sociodemographic characteristi...

Introduction: User generated content (UGC) is a valuable but underutilized source of information about individuals who participate in online cessation interventions. This study represents a first effort to passively detect smoking status among members of an online cessation program using UGC. Methods: Secondary data analysis was performed on dat...

Introduction: Given the lack of regulation on marketing of electronic cigarettes (e-cigarettes) in the U.S. and the increasing exchange of e-cigarette-related information online, it is critical to understand how e-cigarette companies market e-cigarettes and how the public engages with e-cigarette information. Methods: Results are from a systemat...

Background Substance use and mental health are robustly associated with smoking and poor cessation outcomes, but not often examined in combination with menthol cigarette smoking, which is also associated with lower quit rates. This study identified classes of Black and White menthol and non-menthol cigarette smokers based on demographics, alcohol,...

Background The tobacco epidemic in the U.S. has matured in the past decade. However, due to rapidly changing social policy and commercial environments, tailored prevention and interventions are needed to support further reduction in smoking. Methods Using Tobacco Use Supplement to the Current Population Survey (TUS-CPS) 2002–2003 and 2010–2011 long...

Aims: To propose a hierarchy of methodological criteria to consider when determining whether a study provides sufficient information to answer the question of whether e-cigarettes can facilitate cigarette smoking cessation or reduction. Design: A PubMed search to 1 February 2017 was conducted of all studies related to e-cigarettes and smoking ce...

Introduction: The U.S. cigar market is diverse, yet until recently most research studies and tobacco surveillance systems have not reported behavioral and related outcomes by cigar type. Methods: The 2013-14 Population Assessment of Tobacco and Health Study collected data separately for filtered cigars (FCs), cigarillos and traditional cigars, w...

Introduction Use of online social networks for smoking cessation has been associated with abstinence. Little is known about the mechanisms through which the formation of social ties in an online network may influence smoking behavior. Using dynamic social network analysis, we investigated how temporal changes of an individual’s number of social net...

In-degree and out-degree-aware frequencies by social network utilization group. (DOCX)

In recent years, the United States observed a significant uptake in concurrent use of multiple tobacco products and alternative nicotine delivery devices among youth—a phenomenon identified as polytobacco use—making tobacco control efforts more complex for clinicians, policy makers, and scientists, alike.The present commentary stimulates new perspe...

Background and aims: The U.S. Family Smoking Prevention and Tobacco Control Act provides a pathway for manufacturers to market a modified risk tobacco product (MRTP). This study examines sociodemographic and tobacco use correlates of interest in a hypothetical MRTP in a nationally representative sample of U.S. adults. Design: Cross sectional Wav...

Background Electronic cigarette (e-cigarette) use in the USA is increasing. As such, it is critical to understand who uses e-cigarettes, how e-cigarettes are used and what types of products are prevalent. This study assesses patterns of current e-cigarette use among daily and non-daily adult users in the 2013–2014 Population Assessment of Tobacco a...

A consistent approach using standardised items to assess e-cigarette use in both youth and adult populations will aid cross-survey and cross-national comparisons of the effect of e-cigarette (and tobacco) policies and improve our understanding of the population health impact of e-cigarette use. Focusing on adult behaviour, we propose a set of e-cig...

Background: Assessing the frequency and intensity of e-cigarette use presents special challenges beyond those posed by cigarette use. Accurate measurement of e-cigarette consumption, puff duration, and the stability of these measures over time will be informative for estimating the behavioral and health effects of e-cigarette use. Objective: The...

Introduction: Despite smoker interest in e-cigarettes as a harm reduction or cessation aid, many smokers prematurely discontinue vaping after trying a product. This study explored the role of early subjective sensory experience in vaping persistence and desistence. Methods: African American menthol cigarette smokers aged ≥18 years (n=15; M=54.1...

Background and objectives: Non-cigarette tobacco marketing is less regulated and may promote cigarette smoking among adolescents. We quantified receptivity to advertising for multiple tobacco products and hypothesized associations with susceptibility to cigarette smoking. Methods: Wave 1 of the nationally representative PATH (Population Assessme...

The purpose of this study was to investigate susceptibility and ever use of tobacco products among adolescents and young adults in the US. Cross-sectional analysis of Wave 1(2013-2014) adolescent (12-17year-olds; n=13,651) and young adult (18-24year-olds; n=9112) data from the nationally-representative Population Assessment of Tobacco and Health (P...