Nicotine reduction as an increase in the unit price of cigarettes: A behavioral economics approach

Smith, Tracy T.; Sved, Alan F.; Hatsukami, Dorothy K.; Donny, Eric C.

doi:10.1016/j.ypmed.2014.07.005

Cited by 22 publications

(21 citation statements)

References 58 publications

(70 reference statements)

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“…This observation suggests that the presence or absence of a particular product in the ETM can, in part, determine the interactions that occur among the available products. 19 This complex interaction of alternate product availability and resulting consumption would be difficult to model in traditional behavioral economic methods involving choice between, at most, three products.…”

Section: Discussionmentioning

confidence: 99%

The Experimental Tobacco Marketplace I: Substitutability as a Function of the Price of Conventional Cigarettes

Quisenberry

Koffarnus

Hatz

et al. 2015

NICTOB

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Introduction: Behavioral economic studies of nicotine product consumption have traditionally examined substitution between two products and rarely examined substitution with more products. Increasing numbers of tobacco products available for commercial sale leads to more possible cross-product interactions, indicating a need to examine substitution in more complex arrangements that closely mirror the tobacco marketplace. Methods: The experimental tobacco marketplace (ETM) is an experimental online store that displays pictures, information, and prices for several tobacco products. Smokers were endowed with an account balance based on their weekly tobacco purchases. Participants then made potentially real purchases for seven (Experiment 1) or six (Experiment 2) tobacco/nicotine products under four price conditions for conventional cigarettes while prices for other products remained constant. Smokers returned 1 week later to report tobacco/nicotine use and return unused products for a refund. Results: In Experiment 1 (n = 22), cigarette purchasing decreased as a function of price. Substitution was greatest for electronic cigarettes and cigarillos and significant for electronic cigarettes. Experiment 2 (n = 34) was a replication of Experiment 1, but with cigarillos unavailable in the ETM. In Experiment 2, cigarette purchases decreased as a function of price. Substitution was robust and significant for electronic cigarettes and Camel Snus. Conclusions: The ETM is a novel, practical assay that mimics the real-world marketplace, and functions as a simple research tool for both researchers and participants. Across the two experiments the product mix in the ETM altered which products functioned as substitutes suggesting complex interactions between purchasing and product availability. Implications: This article adds a novel method of collecting purchasing data that mimics real world purchasing to the existing literature. The ETM is a practical avenue by which to study both hypothetical and potentially real purchasing.

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Section: Discussionmentioning

confidence: 99%

The Experimental Tobacco Marketplace I: Substitutability as a Function of the Price of Conventional Cigarettes

Quisenberry

Koffarnus

Hatz

et al. 2015

NICTOB

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“…The 2009 Family Smoking Prevention and Tobacco Control Act gave the U.S. Food and Drug Administration regulatory authority over tobacco products, including the authority to set nicotine levels in cigarettes. Further leveraging the utility of the reinforcement analysis, the Smith et al (2014–in this issue) contribution to this Special Issue demonstrates how the effects of varying nicotine levels in cigarettes can be understood within a behavioral economic analysis of unit price, allowing for relatively precise quantification of those effects as well as a rich set of testable predictions on potential impacts.…”

Section: Behavior Change Health and Health Disparitiesmentioning

confidence: 99%

Behavior change, health, and health disparities: An introduction

Higgins

2014

Preventive Medicine

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This Special Issue of Preventive Medicine (PM) focuses on behavior change, health, and health disparities, topics of fundamental importance to improving population health in the U.S. and other industrialized countries. While the U.S. health care system and those of other industrialized countries were developed to manage infectious disease and acute illnesses, it is chronic health conditions that most need to be understood and managed in the 21st century. The evidence is clear that personal behavior patterns like cigarette smoking and physical inactivity/obesity are critically important proximal causes of chronic disease (cardiovascular disease, site-specific cancers, type-2 diabetes) and as such behavior change will need to be a key component of their management. As the outstanding contributions to this Special Issue illustrate, substantial headway is being made in advancing knowledge including developing effective prevention and treatment strategies, with cigarette smoking being an excellent example that change is possible. That said, cigarette smoking continues to be responsible for approximately 480,000 premature deaths annually in the U.S. alone and 5 million globally. So more needs to be done, especially in economically disadvantaged populations. The same certainly applies to the challenges of the obesity epidemic, which of course is a more recent problem and understandably efforts to curtail it are in earlier stages of development.

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“…However, smoke exposure is the most relevant outcome from a public health perspective, and it is important to note that the relationship between nicotine consumption and smoke exposure is different for increases in cigarette cost and decreases in nicotine content. In the present self-administration paradigm, nicotine infusions might be thought of as analogous to smoke exposure (Smith et al 2014). However, when unit price is increased through decreases in the nicotine content of cigarettes, cumulative smoke exposure will not track with the changes in nicotine consumption.…”

Section: Discussionmentioning

confidence: 99%

“…A behavioral economics framework may be useful for researchers and policy makers interested in nicotine reduction (Donny et al 2012; Smith et al 2014). Within the framework of behavioral economics, changes in the consumption of a reinforcer occur as a function of the unit price of that reinforcer, and unit price can be manipulated through changes in reinforcer cost and reinforcer magnitude (unit price = reinforcer cost / reinforcer magnitude).…”

Section: Introductionmentioning

confidence: 99%

“…Because nicotine is the primary reinforcing constituent in cigarettes, a reduction in nicotine content may be considered a reduction in reinforcer magnitude and an increase in the unit price of cigarettes. Viewing nicotine reduction as an increase in unit price allows for the application of existing literature regarding how changes in unit price affect reinforcer consumption to be applied to nicotine reduction (Smith et al 2014). Decreases in nicotine content may be functionally equivalent to an increase in the cost of cigarettes because both manipulations increase the unit price of nicotine.…”

Section: Introductionmentioning

confidence: 99%

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Characterizing the relationship between increases in the cost of nicotine and decreases in nicotine content in adult male rats: implications for tobacco regulation

et al. 2016

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BACKGROUND A large reduction in the nicotine content of cigarettes may benefit public health by reducing the rate and the prevalence of smoking. A behavioral economics framework suggests that a decrease in nicotine content may be considered an increase in the unit price of nicotine (unit price = reinforcer cost / reinforcer magnitude). Increasing the price of cigarettes (i.e., increasing reinforcer cost) would be considered an equivalent change in unit price to reducing nicotine content (i.e., reducing reinforcer magnitude). OBJECTIVES The goal of the present experiments was to characterize the relationship between increases in nicotine cost and decreases in nicotine dose. MATERIALS AND METHODS A rat self-administration model was used to assess this relationship across three experiments, with an emphasis on very low nicotine doses to model a potential nicotine reduction policy. Cost was manipulated via changes in the number of responses required to earn an infusion. RESULTS Results show that increases in the cost of nicotine and decreases in nicotine content were not equivalent manipulations. Nicotine consumption was more sensitive to nicotine dose than to nicotine cost. Nicotine consumption was also not equivalent across a variety of cost and dose combinations forming a single unit price. CONCLUSIONS Results of the present studies suggest that nicotine reduction is likely to have a large impact on nicotine exposure from cigarettes.

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Nicotine reduction as an increase in the unit price of cigarettes: A behavioral economics approach

Cited by 22 publications

References 58 publications

The Experimental Tobacco Marketplace I: Substitutability as a Function of the Price of Conventional Cigarettes

The Experimental Tobacco Marketplace I: Substitutability as a Function of the Price of Conventional Cigarettes

Behavior change, health, and health disparities: An introduction

Characterizing the relationship between increases in the cost of nicotine and decreases in nicotine content in adult male rats: implications for tobacco regulation

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