The effect of potential electronic nicotine delivery system regulations on nicotine product selection.

TitleThe effect of potential electronic nicotine delivery system regulations on nicotine product selection.
Publication TypeJournal Article
Year of Publication2016
AuthorsPesko MF, Kenkel DS, Wang H, Hughes JM
JournalAddiction
Volume111
Issue4
Pagination734-44
Date Published2016 Apr
ISSN1360-0443
KeywordsAdolescent, Adult, Age Factors, Drug Labeling, Electronic Nicotine Delivery Systems, Female, Flavoring Agents, Humans, Male, Nicotine, Tobacco Products, Tobacco Use Cessation Products, United States, Young Adult
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.

DOI10.1111/add.13257
Alternate JournalAddiction
PubMed ID26639526
PubMed Central IDPMC4801654
Grant ListU01 CA154248 / CA / NCI NIH HHS / United States
U01 CA154254 / CA / NCI NIH HHS / United States
1U01CA154248-04 / CA / NCI NIH HHS / United States
U01CA154254 / CA / NCI NIH HHS / United States
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Faculty Publication