Randomised experiment for the effect of ‘Tobacco-Free Nicotine’ messaging on current e-cigarette users’ perceptions, preferences and intentions

• Published in: Tobacco control Vol. 33; no. 4; pp. 441 - 448
• Main Authors: Ratnapradipa, Kendra, Samson, Kaeli, Dai, Hongying Daisy
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 01.07.2024; BMJ Publishing Group LTD
• Subjects: Cigarette industry; Cigarettes; Consumers; Electronic cigarettes; Electronic nicotine delivery devices; Federal regulation; Impurities; Marketing; Messages; Multivariable control; Nicotine; Original research; Perception; Perceptions; Preferences; Public policy; Randomization; Rural populations; Surveillance and monitoring; Tobacco; Vaping; Willingness to pay; United States > US; Electronic nicotine delivery devices; Public policy; Surveillance and monitoring
• ISSN: 0964-4563; 1468-3318; 1468-3318
• DOI: 10.1136/tc-2022-057507

BackgroundIt is unclear whether emerging synthetic tobacco-free nicotine superiority messages such as ‘better flavor and better experience’ and ‘no residual impurities of tobacco-derived nicotine’ may impact consumer perception and product choice between synthetic and tobacco-derived nicotine vaping products.MethodsThrough a 2022 online survey of current e-cigarette users, we identified synthetic nicotine never users for randomisation into an embedded between-subjects experiment. The test group (n=186) viewed a tobacco-free nicotine message versus no message control (n=168). Multivariable regressions assessed messaging effects on three comparative measures between tobacco-free and tobacco-derived nicotine: harm perception, purchase intention and willingness to pay.ResultsParticipants (n=354; age, mean (SD)=34.6 (11.1) years old) were recruited from geographically diverse regions with 27.7% rural residents. The overall sample comprised 44.1% females, 73.5% non-Hispanic white and 71.8% daily e-cigarette users. Sociodemographics and tobacco use status were not significantly different between two randomised groups. The test group (vs control) reported a higher intention to use tobacco-free than tobacco-derived nicotine vaping products (adjusted OR (AOR)=2.4, 95% CI 1.3 to 4.4, p=0.006) and willingness to pay more for tobacco-free nicotine vaping products (AOR=2.6, 95% CI 1.2 to 5.8, p=0.02). Urban (vs rural) synthetic-naïve vapers had lower harm perception (AOR=2.0, 95% CI 1.1 to 3.6, p=0.02) and higher intention to use tobacco-free than tobacco-derived nicotine vaping products (AOR=2.2, 95% CI 1.1 to 4.5, p=0.04); infrequent vapers were more willing to pay more for tobacco-free nicotine vaping products (AOR=1.1, 95% CI 1.03 to 1.17, p=0.002).ConclusionTobacco-free nicotine marketing message may prompt the transition to and promote a price premium for such products. With the proliferation of products in the market, comprehensive regulation of emerging synthetic vaping products is needed.