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Addiction. 2019 Mar 13. doi: 10.1111/add.14610. [Epub ahead of print]

The impact of flavors, health risks, secondhand smoke and prices on young adults' cigarette and e-cigarette choices: a discrete choice experiment.

Author information

1
School of Public Health, Yale University, New Haven, CT, USA.

Abstract

AIMS:

To estimate young adults' preferences for cigarettes and e-cigarettes, and how preferences vary by policy-relevant factors. A related aim was to provide information on potential substitution/complementarity across cigarettes and e-cigarettes ahead of policy selection.

DESIGN:

An online discrete choice experiment (DCE) in which respondents chose their preferred option among cigarettes, two types of e-cigarettes (disposable/reusable), and "none." Each cigarette-type was characterized by policy-relevant attributes: flavors, short-term health risks to self, secondhand smoke risks, and price. A latent class model identified smoking types that respond differently to these.

SETTING:

U.S. tobacco market.

PARTICIPANTS:

2,003 young adults (ages 18-22) who ever-tried either cigarettes or e-cigarettes, recruited via the survey platform Qualtrics, matched to the 2015 National Health Interview Survey by age, gender, education and census region.

MEASUREMENTS:

Respondents' DCE choices.

FINDINGS:

Young adults fell into two broad categories. One latent group, termed 'prefer smoking group', preferred cigarettes and another, 'prefer vaping group', preferred e-cigarettes. The 'prefer smoking group' preferred lower prices and lower health harms more than other attributes. The 'prefer vaping group' valued these, though less intensely, but valued fruit/candy flavors more.

CONCLUSION:

Banning all flavors in cigarettes and e-cigarettes might improve the health of young adults who ever tried either cigarettes or e-cigarettes. Young-adult ever-triers might be deterred from smoking by increasing cigarette prices and encouraged to switch to e-cigarettes by reducing the health harms of e-cigarettes. Reducing health harms of e-cigarettes could also make the 'prefer vaping group' less likely to quit, resulting in increased health harm.

PMID:
30866132
DOI:
10.1111/add.14610

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