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The effect of potential electronic nicotine delivery system regulations on nicotine product selection
Author(s) -
Pesko Michael F.,
Kenkel Donald S.,
Wang Hua,
Hughes Jenna M.
Publication year - 2016
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.13257
Subject(s) - nicotine , medicine , electronic cigarette , percentage point , demography , food and drug administration , harm reduction , smoking cessation , tobacco control , point of sale , environmental health , statistics , public health , nursing , pathology , sociology , mathematics , world wide web , computer science
Abstract Aims To estimate the effect of potential regulations of electronic nicotine delivery systems (ENDS) among adult smokers, including increasing taxes, reducing flavor availability and adding warning labels communicating various levels of risk. Design We performed a discrete choice experiment (DCE) among a national sample of 1200 adult smokers. We examined heterogeneity in policy responses by age, cigarette quitting interest and current ENDS use. Our experiment overlapped January 2015 by design, providing exogenous variation in cigarette quitting interest from New Year resolutions. Setting KnowledgePanel, an online panel of recruited respondents. Participants A total of 1200 adult smokers from the United States . Measurements Hypothetical purchase choice of cigarettes, nicotine replacement therapy and a disposable ENDS. Findings Increasing ENDS prices from $3 to $6 was associated with a 13.6 percentage point reduction in ENDS selection ( P < 0.001). Restricting flavor availability in ENDS to tobacco and menthol was associated with a 2.1 percentage point reduction in ENDS selection ( P < 0.001). The proposed Food and Drug Administration (FDA) warning label was associated with a 1.1 percentage point reduction in ENDS selection ( P < 0.05) and the MarkTen warning label with a 5.1 percentage point reduction ( P < 0.001). We estimated an ENDS price elasticity of −1.8 ( P < 0.001) among adult smokers. Statistically significant interaction terms ( P < 0.001) imply that price responsiveness was higher among adult smokers 18–24 years of age, smokers who have vaped over the last month and smokers with above the median quitting interest. Young adult smokers were 3.7 percentage points more likely to choose ENDS when multiple flavors were available than older adults ( P < 0.001). Young adult smokers and those with above the median cigarette quitting interest were also more likely to reduce cigarette selection and increase ENDS selection in January 2015 ( P < 0.001), potentially in response to New Year's resolutions to quit smoking. Conclusions Increased taxes, a proposed US Food and Drug Administration warning label for electronic nicotine delivery systems and a more severe warning label may discourage adult smokers from switching to electronic nicotine delivery systems. Reducing the availability of flavors may reduce ENDS use by young adult smokers.