Assessing Smoking Cessation Messages with a Discrete Choice Experiment

Thrasher, James F.; Anshari, Dien; Lambert, Victoria; Islam, Farahnaz; Mead, Erin L.; Popova, Lucy; Salloum, Ramzi G.; Moodie, Crawford; Louviere, Jordan J.; Lindblom, Eric N.

doi:10.18001/trs.4.2.7

Cited by 29 publications

(21 citation statements)

References 64 publications

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“…This study used an online discrete choice experiment (DCE) to examine trade-offs of young adults across cigarettes and e-cigarettes and key policy-relevant attributes. The DCE approach enabled gathering of preference data in advance of a regulatory decision, which is useful for informing policy prior to implementation [9][10][11][12][13][14][15][16]. Other approaches used experimental markets [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

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

Buckell

Sindelar

2019

Addiction

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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-US tobacco market. Participants-A total of 2003 young adults (aged 18-22 years) 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, although price less intensely, and valued health and 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.

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Section: Introductionmentioning

confidence: 99%

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

Buckell

Sindelar

2019

Addiction

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“…Prior applications of discrete choice methods in tobacco control have focused on adults 5,6,24 and/or recruited participants through online panels 6,7,24,25 . Previously reported findings include a preference for non-tobacco flavors both in e-cigarettes 6,25 and waterpipe tobacco 5 , as well as identifying warning labels as a factor reducing product interest 5,25 .…”

Section: Discussionmentioning

confidence: 99%

Electronic cigarette and moist snuff product characteristics independently associated with youth tobacco product perceptions

Chaffee¹,

Couch²,

Urata³

et al. 2020

Tob. Induc. Dis.

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Use of non-cigarette tobacco is increasing among youth. Past 30-day use of electronic cigarettes (e-cigarettes) among US high school students recently rose substantially, more than doubling in two years, from 11.7% in 2017 to 27.5% in 2019 1,2. Similarly, the use of conventional smokeless (spit) tobacco in 2018 nearly equaled the prevalence of cigarette smoking among male US high school students (smokeless: 8.4%; cigarettes: 8.8%) 1. Use of ABSTRACT INTRODUCTION Tobacco product characteristics convey product attributes to potential users. This study aimed to assess independent contributions of specific e-cigarette and smokeless tobacco product characteristics to adolescents' perceptions about these products. METHODS In 2019-2020, students (N=1003) attending a convenience sample of 7 high schools in California (USA) were individually randomized to one of two discrete choice experiments, featuring either electronic cigarettes (e-cigarettes) or moist snuff. Participants were presented like-product pairs of randomlygenerated hypothetical tobacco products differing in device type, flavor, vapor cloud, and nicotine amount (for e-cigarettes) or differing in brand, flavor, cut, and price (for moist snuff). Within pairs, participants were asked about which product they were more curious, was more dangerous, would give a greater 'buzz,' and would be easier to use. Conditional logistic regression was used to quantify independent associations of product characteristics to participants' choices. RESULTS Each e-cigarette and moist snuff characteristic was independently associated with multiple product perceptions. All non-tobacco flavors were associated with more curiosity and perceived ease-of-use but lower perceived danger. Tank and pod-type e-cigarettes were viewed as easier to use and garnered more curiosity than 'cigalike' or 'drip-mod' devices. Smaller vapor cloud e-cigarettes and lower-price moist snuff were viewed as less dangerous, less buzz-inducing, and easier to use. Product ever users held stronger perceptions than never users about device type (e-cigarettes) and brands (moist snuff), while product naïve participants more strongly associated flavor with danger and buzz. CONCLUSIONS Tobacco product characteristics convey product attributes to adolescents that may increase appeal. Restricting specific characteristics, including flavors, could reduce positive perceptions of these products among youth.

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“…25 Testimonial warnings may also be able to form a stronger connection with smokers by providing support that may not be gained from warnings that only communicate factual information, as well as increase message engagement and motivation to quit. 26,27 A testimonial warning used on packs in Canada features Barb Tarbox (who following her diagnosis with terminal lung cancer decided to share her story), showed an image of her in the late stages of her illness and read: "This is what dying of lung cancer looks like. Barb Tarbox died at 42 of lung cancer caused by cigarettes."…”

Section: Discussionmentioning

confidence: 99%

Smokers’ Perceptions of Cigarette Packaging With Audio Warning Messages: A Focus Group Study in Scotland

Mitchell

Moodie

Bauld

2019

Nicotine &Amp; Tobacco Research

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Aims The use of audio pack cues or messages is a recent trend in packaging design. There is scope to use audio technology to communicate health and cessation messages via cigarette packaging. We explored how smokers responded to cigarette packs which played audio health messages. Methods Twenty focus groups were conducted in Scotland in 2015 with smokers (n = 120) segmented by age (16–17, 18–24, 25–35, 36–50, >50), gender and social grade. Perceptions of cigarette packs which played audio warnings were explored, with four messages used: (1) a cessation message with a quitline number, (2) mortality message, (3) fertility message, and (4) message about ageing skin. Results Audio warnings were thought to increase message impact, particularly among younger smokers, as they would be hard to ignore or avoid, and repetition may lead to the messages being memorized. The warnings were considered annoying or embarrassing, and participants suggested they may discard the packs and use alternative storage. Some participants suggested that the audio warnings were off-putting and may alter their smoking behavior, with the mortality message deemed most effective and was considered relatable and felt personal. Older smokers were least likely to believe that audio warnings would affect their smoking behavior, although some thought that they may enhance cessation attempts among smokers seeking to quit, and could deter new or potential smokers, for example, young people. Conclusions Cigarette packs with audio messaging may have a role to play, now or in the future, as a novel way of communicating health and cessation information. Implications There is a lack of research exploring smokers’ perceptions of cigarette packs which play audio health messages. This focus group study provides an understanding of smokers’ immediate responses to cigarette packs which played a short health message when opened. Smokers generally viewed them as annoying or embarrassing, and some suggested the use of alternative storage. Audio warnings were thought to increase message salience, memorability, and impact, for younger smokers in particular, and some suggested that they be off-putting for themselves or others.

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Assessing Smoking Cessation Messages with a Discrete Choice Experiment

Cited by 29 publications

References 64 publications

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

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

Electronic cigarette and moist snuff product characteristics independently associated with youth tobacco product perceptions

Smokers’ Perceptions of Cigarette Packaging With Audio Warning Messages: A Focus Group Study in Scotland

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