Article Text

Costs of vaping: evidence from ITC Four Country Smoking and Vaping Survey
  1. Kai-Wen Cheng1,2,
  2. Ce Shang3,
  3. Hye Myung Lee2,
  4. Frank J Chaloupka2,
  5. Geoffrey T Fong4,5,
  6. Ron Borland6,7,
  7. Bryan W Heckman8,9,
  8. Sara C Hitchman10,
  9. Richard J O'Connor11,
  10. David T Levy12,
  11. K. Michael Cummings8,9
  1. 1 Department of Health Administration, Governors State University, University Park, Illinois, USA
  2. 2 Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois, USA
  3. 3 Department of Pediatrics and Oklahoma Tobacco Research Center, University of Oklahoma Stephenson Cancer Center, Oklahoma City, Oklahoma, USA
  4. 4 Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada
  5. 5 Ontario Institute for Cancer Research, Toronto, Ontario, Canada
  6. 6 School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
  7. 7 Cancer Council Victoria, Melbourne, Victoria, Australia
  8. 8 Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
  9. 9 Hollings Cancer Center, Medical University of South Carolina, Charleston, South Carolina, US
  10. 10 Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, London, UK
  11. 11 Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York, USA
  12. 12 Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA
  1. Correspondence to Dr Kai-Wen Cheng, Department of Health Administration, Governors State University, University Park, IL 60466, USA; kcheng{at}


Study objectives To compare the prices paid for nicotine vaping products (NVPs) and supplies among current NVP users to prices paid for cigarettes among current smokers.

Data The 2016 International Tobacco Control Four Country Vaping and Smoking Survey (4CV1). Key measures included: (1) self-reported prices paid for reusable NVPs (eg, rechargeable devices with cartridges and tank system devices with e-liquids) in the 3-month period prior to the survey among current NVP users, (2) prices paid for disposable NVPs, cartridges and e-liquids purchased in the last 30 days among current NVP users and (3) self-reported prices paid for cigarettes among current smokers.

Results Disposable NVP price was higher than the price of a comparable unit for combustible cigarettes in England (EN), USA and Canada (CA). Prefilled cartridge price was higher than the price of a comparable unit of cigarettes in USA and CA, but lower in EN and Australia. E-liquid price was consistently lower than the price of a comparable unit of cigarettes across four countries. For start-up costs, price of a rechargeable device is approximately 3–5 times higher than a pack of cigarettes in four countries.

Conclusion NVP prices were generally higher than prices of combustible cigarettes, especially the high upfront NVP devices. The high upfront costs of purchasing a reusable NVP may discourage some smokers from switching to vaping. However, the average lower costs of cartridges and e-liquids relative to a package of cigarettes make switching to a NVP an attractive alternative to smoking in the long term so long as smokers switch completely to vaping.

  • price
  • non-cigarette tobacco products
  • electronic nicotine delivery devices

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  • Contributors K-WC wrote the original manuscript, conducted the empirical analysis and revised the manuscript. CS provided valuable insight on the analysis. HML managed the data and conducted statistical run. The other authors all took an active role in developing the original ideas for the study, critiquing the analysis and revising the manuscript.

  • Funding The ITC Four Country Smoking and Vaping Wave 2 Survey was supported by grants from the US National Cancer Institute (P01 CA200512) and the Canadian Institutes of Health Research (FDN-148477). The ITC Australia Project was supported by National Health and Medical Research Council of Australia (APP1106451). Additional support was provided to BWH by National Institute on Drug Abuse (NIDA) of the National Institutes of Health (K23 DA041616) and to GTF from a Senior Investigator Award from the Ontario Institute for Cancer Research.

  • Competing interests KMC has received grant funding from Pfizer, Inc. to study the impact of a hospital-based tobacco cessation intervention. KMC also receives funding as an expert witness in litigation filed against the tobacco industry. GTF has served as an expert witness on behalf of governments in litigation involving the tobacco industry.

  • Patient consent for publication Not required.

  • Ethics approval The survey protocols and all materials, including the survey questionnaires, were cleared for ethics by Institutional Review Board, Medical University of South Carolina; Research Ethics Office, King's College London, UK; Office of Research Ethics, University of Waterloo, Canada and Human Research Ethics, Cancer Council Victoria, Australia.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. The data are public. The authors will make these data available to all who request it.

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