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Analysis of on-pack messages for e-liquids: a discrete choice study
  1. Janet Hoek1,
  2. Philip Gendall1,
  3. Christine Eckert2,
  4. Jordan Louviere3,
  5. Pamela Ling4,
  6. Lucy Popova5
  1. 1 Department of Public Health, University of Otago, Wellington, New Zealand
  2. 2 School of Marketing, University of Technology Sydney, Sydney, New South Wales, Australia
  3. 3 Best-Worst Company, Seattle, Washington, USA
  4. 4 Centre for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California, USA
  5. 5 School of Public Health, Georgia State University, Atlanta, Georgia, USA
  1. Correspondence to Professor Janet Hoek, Department of Public Health, University of Otago, Wellington, New Zealand; janet.hoek{at}otago.ac.nz

Abstract

Background Policymakers wishing to encourage smokers unable to quit to switch to using electronic nicotine delivery systems (ENDS) also need to consider how to deter ENDS use among non-smokers. We examined whether reduced-risk messages could increase ENDS’ appeal among smokers and if increased-risk messages could decrease appeal among susceptible non-smokers, occasional and former smokers.

Methodology An online discrete choice experiment tested three attributes: information message, nicotine content (0 mg or 3 mg) and flavour (tobacco, menthol or fruit). The sample comprised 352 current smokers, 118 occasional and former smokers, and 216 ENDS-susceptible never smokers. Smokers viewed reduced-risk messages that encouraged switching to ENDS, while other groups viewed increased-risk messages that discouraged ENDS use. All groups saw a typical addiction warning. We analysed the data by estimating multinomial logit regression and adjusted latent class analysis models.

Results Relative to no message, reduced risk-messages increased the appeal of ENDS uptake among one class of smokers (33.5%) but decreased appeal among other smokers. However, among all smokers, reduced-risk messages increased preference more than a dissuasive addiction warning. By contrast, among occasional or former smokers, and susceptible non-smokers, all information messages discouraging ENDS use, including an addiction warning, decreased preference relative to no message.

Conclusions On-pack relative-risk messages about ENDS could make transition more attractive to smokers while increased-risk messages could deter ENDS uptake among susceptible non-smokers, occasional and former smokers. Communicating diverse messages via discrete channels could recognise heterogeneity among and between smokers and non-smokers.

  • public policy
  • packaging and labelling
  • electronic nicotine delivery devices

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/tobaccocontrol-2020-056033

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    Data availability statement

    All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Correction notice This article has been corrected since it first published. The provenance and peer review statement has been included.

    • Contributors JH conceptualised the project and obtained funding. PG and JH designed the research instrument; PG and JL designed the choice experiment; PL and LP provided feedback on the study instrument. PG managed the data collection and, with CE, analysed and interpreted the data; CE estimated the multi-nomial logit regression model and Latent Class models. PG and JH led the MS development and revisions; CE provided feedback on early versions of the MS; all other authors reviewed subsequent versions and have approved the final MS version. Authors are listed in descending order of contribution. JH and PG are guarantors of the MS.

    • Funding This project was funded by the Health Research Council of New Zealand (Grant 16/149).

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.