Should flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experiment
Should flavours be banned in cigarettes and e-cigarettes? Evidence on adult smokers and recent quitters from a discrete choice experiment
复制标题
DOI：
10.1136/tobaccocontrol-2017-054165
复制
发表时间：
2019-03-01
期刊：
影响因子：
5.2
通讯作者：
Sindelar, Jody L.
中科院分区：
文献类型：
--
作者：
Buckell, John;Marti, Joachim;Sindelar, Jody L.
目的提供替代口味禁令对成年吸烟者和近期戒烟者对卷烟和电子烟的偏好和需求的影响的政策相关估计。方法采用最佳离散选择实验（DCE），引出吸烟者和近期戒烟者对卷烟和电子烟的口味、价格、健康影响和尼古丁水平的偏好。研究了烟草产品的选择和选择退出的选择。有效的设计产生了36个选择集。估计了分解的logit选择模型。口味禁令建模通过限制风味系数在估计model.Setting和参与者的样本2031成年吸烟者和最近戒烟者被招募完成在线调查和DCE.Results当前吸烟者和最近戒烟者，平均而言，更喜欢香烟和薄荷香烟口味的电子烟。然而，年轻人（18-25岁）、种族/民族和受过高等教育的受访者的偏好差异很大。我们的预测表明，禁止薄荷香烟将使香烟的选择减少最多（-5.2%），但伴随着电子烟使用的增加（3.8%）。相比之下，禁止电子烟中的香料，同时允许卷烟中含有薄荷醇，将导致卷烟选择的最大增加（8.3%），以及电子烟使用的下降（-11.1%）。禁止所有口味，但这两种产品中的烟草将增加最多的“选择退出”（5.2%），但也会增加香烟的选择（2.7%）减少电子烟的选择结论单独禁止调味电子烟可能会增加吸烟者对香烟的选择，可以说这是获得尼古丁的更有害的方式，而单单禁止薄荷香烟可能会更有效地减少香烟的选择。禁止这两种产品中的所有口味可能会降低吸烟率，但香烟的使用量将高于现状。政策制定者应该根据他们对这两种产品的潜在健康影响的立场，利用这些结果来指导口味禁令的选择。
Objectives To provide the policy-relevant estimates of impacts of alternative flavour bans on preferences and demand for cigarettes and e-cigarettes in adult smokers and recent quitters.Methods A best-best discrete choice experiment (DCE) is used to elicit smokers' and recent quitters' preferences for flavours, price, health impact and nicotine level in cigarettes and e-cigarettes. Choice of tobacco products and an opt-out option were examined. An efficient design yielded 36 choice sets. Exploded logit choice models were estimated. Flavour bans are modelled by restricting flavour coefficients in the estimated model.Setting and participants A sample of 2031 adult smokers and recent quitters was recruited to complete an online survey and DCE.Results Current smokers and recent quitters, on average, prefer cigarettes and menthol cigarettes over flavoured e-cigarettes. However, there is substantial preference heterogeneity by younger adults (ages 18-25), race/ethnicity and respondents with higher education. Our predictions suggest that a ban on menthol cigarettes would produce the greatest reduction in the choice of cigarettes (-5.2%), but with an accompanying increase in e-cigarettes use (3.8%). In contrast, banning flavours in e-cigarettes, while allowing menthol in cigarettes would result in the greatest increase in the selection of cigarettes (8.3%), and a decline in the use of e-cigarettes (-11.1%). A ban on all flavours, but tobacco in both products would increase ' opting-out' the most (5.2%) but would also increase choice of cigarettes (2.7%) and decrease choice of e-cigarettes (-7.9%).Conclusions A ban on flavoured e-cigarettes alone would likely increase the choice of cigarettes in smokers, arguably the more harmful way of obtaining nicotine, whereas a ban on menthol cigarettes alone would likely be more effective in reducing the choice of cigarettes. A ban on all flavours in both products would likely reduce the smoking/vaping rates, but the use of cigarettes would be higher than in the status quo. Policy-makers should use these results to guide the choice of flavour bans in light of their stance on the potential health impacts both products.