Background Electronic cigarettes (e-cigarettes) are being advertised and sold with synthetic nicotine. Little research has examined youth awareness of synthetic nicotine or the impact of synthetic nicotine descriptors on perceptions of e-cigarettes.
Methods Participants were a sample of 1603 US adolescents (aged 13–17 years) from a probability-based panel. The survey assessed knowledge of nicotine source in e-cigarettes (from ‘tobacco plants’ or ‘other sources besides tobacco plants’) and awareness of e-cigarettes containing synthetic nicotine. Then, in a between-subjects experiment with a 2×3 factorial design, we manipulated descriptors on e-cigarette products: (1) nicotine label (inclusion of the word ‘nicotine’: present or absent) and (2) source label (inclusion of a source: ‘tobacco-free’, ‘synthetic’ or absent).
Results Most youth were either unsure (48.1%) or did not think (20.2%) that nicotine in e-cigarettes comes from tobacco plants; similarly, most were unsure (48.2%) or did not think (8.1%) that nicotine in e-cigarettes comes from other sources. There was low-to-moderate awareness of e-cigarettes containing synthetic nicotine (28.7%), with higher awareness among youth who use e-cigarettes (48.0%). While no main effects were observed, there was a significant three-way interaction between e-cigarette status and the experimental manipulations. The ‘tobacco-free nicotine’ descriptor increased purchase intentions relative to ‘synthetic nicotine’ (simple slope: 1.20, 95% CI 0.65 to 1.75) and ‘nicotine’ (simple slope: 1.20, 95% CI 0.67 to 1.73) for youth who use e-cigarettes.
Conclusions Most US youth do not know or have incorrect beliefs about the sources of nicotine in e-cigarettes and describing synthetic nicotine as ‘tobacco-free nicotine’ increases purchase intentions among youth who use e-cigarettes.
- packaging and Labelling
- electronic nicotine delivery devices
Data availability statement
Data are available on reasonable request to SMN at firstname.lastname@example.org.
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Presented at The article contents were presented at the March 2023 annual meeting of the Society for Research on Nicotine and Tobacco.
Contributors SDK, AS, CR and SMN conceptualised the study. SMN acquired funding and CR conducted project administration. SDK analysed the data and drafted the first version of the manuscript. All authors interpreted the data and critically revised the manuscript for important intellectual content. SMN serves as the guarantor for the study.
Funding This project was supported by grant number R01DA049155 from the National Institute on Drug Abuse and FDA Center for Tobacco Products (CTP). SDK’s work on this paper was supported by the National Cancer Institute and FDA CTP under grant number K01CA265886.
Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH or the Food and Drug Administration.
Competing interests SMN served as a paid expert witness in litigation against tobacco and e-cigarette companies.
Provenance and peer review Not commissioned; externally peer reviewed.
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