Effect of Flavors and Modified Risk Messages on E-cigarette Abuse Liability

Abstract

Objectives To measure e-cigarettes’ abuse liability compared to conventional tobacco cigarettes under flavor and message conditions amenable to regulation. Methods Two studies used 2×2 within-subjects designs with factors of e-cigarette flavor (Study 1: tobacco vs. menthol; Study 2: cherry vs. unflavored) and message (Study 1: reduced harm vs. no message; Study 2: reduced exposure to carcinogens vs. no message) with cigarette smokers (N(total) = 36). Linear mixed effects models assessed abuse liability for tobacco products. Outcomes included the price after which consumption is zero (the maximum amount participants would pay for a tobacco product) from the multiple choice procedure (MCP) and cigarette purchase task (CPT) and demand elasticity (price sensitivity) from the CPT. Results In the MCP, the price where consumption reached zero was significantly lower in all e-cigarette conditions except tobacco flavor (message or no message) compared to cigarettes (p < .05 each). Demand elasticity was significantly higher for menthol/no message and unflavored/reduced exposure message conditions relative to cigarettes (p < .05 each). Conclusions Flavors and modified risk messages included with e-cigarettes may affect e-cigarette abuse liability among smokers, suggesting regulatory pathways to influence demand for conventional and alternative tobacco products.

Impact of non-menthol flavours in e-cigarettes on perceptions and use: an updated systematic review

“…Eight studies were conducted among adults, including three laboratory experiments and one discrete choice experiment that examined the effect of e-cigarette flavours on factors such as ratings of taste and appeal 30–33. Four studies included relatively small convenience samples of adults, each finding similar results: flavours in e-cigarettes enhanced the rewarding and reinforcing value of e-cigarettes compared with unflavoured e-cigarettes,30 and the appealing sensory characteristics of flavours (ie, sweetness and coolness) were positively associated with liking of the product,32 33 the willingness to use again and an increase in amount willing to pay for the product 31 32. Similarly, in a cross-sectional survey of 765 current or former adult smokers, removal of flavours significantly reduced the price respondents were willing to pay for e-cigarettes, though this association was not observed among dual users of cigarettes and e-cigarettes 34.…”

‘The lesser devil you don’t know’: a qualitative study of smokers’ responses to messages communicating comparative risk of electronic and combusted cigarettes

“…Recently, researchers have begun evaluating messages about comparative risks of electronic and combusted cigarettes 17–24. Quantitative studies of comparative risk messages have reported mixed findings.…”

Effect of e-liquid flavor on electronic cigarette topography and consumption behavior in a 2-week natural environment switching study

“…The emerging literature on e-liquid flavor additives support the premise that flavor is an important factor in e-cigarette use [ 21 – 24 ] and some flavors, such as menthol, have known analgesic and sensory effects present in cigarettes and other tobacco products [ 25 ], while others have wide appeal such as sweet/fruity flavors [ 22 ] [ 26 ]. E-cigarette users and cigarette smokers report flavor and related sensory characteristics as reasons for using and valuing e-cigarettes [ 21 , 22 , 27 , 28 ].…”