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Impact of flavours, device, nicotine levels and price on adult e-cigarette users’ tobacco and nicotine product choices
  1. Yong Yang1,
  2. Eric N. Lindblom2,
  3. Ramzi G. Salloum3,
  4. Kenneth D. Ward1
  1. 1School of Public Health, University of Memphis, Memphis, Tennessee, USA
  2. 2O'Neill Institute for National & Global Health Law, Georgetown University Law Center, Washington, DC, USA
  3. 3Department of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Yong Yang, School of Public Health, University of Memphis, Memphis, TN 38152, USA; yyang15{at}memphis.edu

Abstract

Introduction To understand the impact of e-cigarette devices, flavours, nicotine levels and prices on adult e-cigarette users’ choices among closed-system and open-system e-cigarettes, cigarettes and heated tobacco products (HTPs).

Methods Online discrete choice experiments were conducted among adult (≥18 years) e-cigarette users (n=2642) in August 2020. Conditional logit regressions were used to assess the relative impact of product attributes and the interactions between product attributes and user characteristics, with stratified analyses to examine differences by smoking status and primarily used e-cigarette device and flavour.

Results On average, participants preferred non-tobacco and non-menthol flavours most, preferred open-system over closed-system e-cigarettes and preferred regular nicotine level over low nicotine level. However, the preference varied by demographics, smoking status and the primarily used e-cigarette device and flavour. The differences in preference among products/devices were larger than the difference among flavours or nicotine levels. Participants who primarily used closed-system e-cigarettes exhibited similar preferences for closed-system and open-system e-cigarettes, but those who primarily used open-system e-cigarettes preferred much more open-system over closed-system e-cigarettes. HTP was the least preferred product, much lower than cigarettes in general, but participants living in states where IQOS is being sold had similar preferences to cigarettes and HTPs.

Conclusions People are unlikely to switch to another product/device because of the restriction of flavour or nicotine level. If non-tobacco and non-menthol flavours were banned from open-system e-cigarettes, users may switch to menthol flavour e-cigarettes. Intervention strategies should be tailored to specific groups.

  • electronic nicotine delivery devices
  • nicotine
  • price

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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Footnotes

  • Contributors YY designed the study, collected the data, conducted the analysis and drafted the manuscript. ENL, RGS and KW contributed to the design of the survey, the interpretation of the findings and the drafting of the manuscripts. All authors reviewed and approved the manuscript.

  • Funding This study was funded by Foundation for the National Institutes of Health (R03DA048460).

  • Competing interests None declared.

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

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