Michael F Pesko1, Donald S Kenkel2, Hua Wang2, Jenna M Hughes1. 1. Department of Healthcare Policy and Research, Weill Cornell Medical College, Cornell University, New York, NY, USA. 2. Department of Policy Analysis and Management, Cornell University, Ithaca, NY, USA.
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.
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.
Authors: David Hammond; Geoffrey T Fong; Ron Borland; K Michael Cummings; Ann McNeill; Pete Driezen Journal: Am J Prev Med Date: 2007-03 Impact factor: 5.043
Authors: R Borland; N Wilson; G T Fong; D Hammond; K M Cummings; H-H Yong; W Hosking; G Hastings; J Thrasher; A McNeill Journal: Tob Control Date: 2009-06-28 Impact factor: 7.552
Authors: John F P Bridges; A Brett Hauber; Deborah Marshall; Andrew Lloyd; Lisa A Prosser; Dean A Regier; F Reed Johnson; Josephine Mauskopf Journal: Value Health Date: 2011-04-22 Impact factor: 5.725
Authors: Maciej Lukasz Goniewicz; Jakub Knysak; Michal Gawron; Leon Kosmider; Andrzej Sobczak; Jolanta Kurek; Adam Prokopowicz; Magdalena Jablonska-Czapla; Czeslawa Rosik-Dulewska; Christopher Havel; Peyton Jacob; Neal Benowitz Journal: Tob Control Date: 2013-03-06 Impact factor: 7.552
Authors: Lauren R Pacek; Olga Rass; Maggie M Sweitzer; Jason A Oliver; F Joseph McClernon Journal: Subst Use Misuse Date: 2019-07-15 Impact factor: 2.164
Authors: Allison M Glasser; Lauren Collins; Jennifer L Pearson; Haneen Abudayyeh; Raymond S Niaura; David B Abrams; Andrea C Villanti Journal: Am J Prev Med Date: 2016-11-30 Impact factor: 5.043
Authors: Ce Shang; Scott R Weaver; Justin S White; Jidong Huang; James Nonnemaker; Kai-Wen Cheng; Frank J Chaloupka Journal: Tob Regul Sci Date: 2020-01