Vaporized Nicotine Product Initiation Among Youth in the US, Canada, and England: Methods to Predict Uptake and Policy Efficacy

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PROEJCT SUMMARY/ABSTRACT The global nicotine market is rapidly evolving due to the emergence of vaporized nicotine products (VNPs). Regulators are considering a range of policies to minimize youth uptake of VNPs, particularly with regards to restrictions on forms of promotion and product attributes that may enhance appeal among youth. The current project seeks to increase the understanding of the factors that predict VNP uptake among youth and to examine policy measures that may prevent uptake among non-smokers. Specific aims include: 1) to examine international variations in VNP uptake among youth in the US, Canada, and England; 2) to estimate the influence of policy measures on consumer demand for VNPs among youth, using methods from the fields of marketing (discrete choice experiments) and economics (auction experiments); and, 3) to develop the methodological framework for policy evaluation and pre-market testing of nicotine products. Prospective cohort surveys will be conducted at baseline and 12-month follow-up among youth (aged 14 to 18) in three countries: the US (n=9,000), Canada (n=9,000), and England (n=9,000). Participants will be recruited through Neilsen's consumer panel, using the same methodology across the three countries. Quotas will be used to recruit equal proportions of “never” smokers and “experimental” smokers in each country. After completing baseline survey measures, participants will be randomized to one of the following: 1) a discrete choice experiment, 2) an auction experiment, or 3) a “no experiment” control condition. The discrete choice experiment and auction experiments will be used to assess the overall level of VNP demand for each participant, as well as to test how promotion and product attributes affect VNP demand. Due to the number of attributes that will be tested, the project will be conducted in two sequential studies, with separate cohorts used in each study. Study 1 (n=4,500 in each country) will examine the influence of five product attributes: product type, nicotine level, flavor, brand, and price. A separate cohort will be recruited using the same methods for Study 2 (n=4,500 in each country), which will examine the influence of three promotional attributes— advertisements, modified risk claims on packaging, and health warnings—in the context of price and product type. Analyses will consist of the following: 1) tests between countries to examine differences in VNP uptake between baseline and follow-up; 2) analysis of the discrete choice and auction experiments at baseline to estimate the effect of product and promotional attributes on consumer demand; 3) tests to examine which of the baseline measures is best able to predict individual-level VNP uptake at 12-month follow-up: measures of susceptibility assessed in the “no experiment” control group, or aggregate measures of demand from the discrete choice and auction studies. Overall, the proposed project would be the first to directly compare differences in VNP uptake among youth across countries. The project also has the potential to advance the methodological framework for predicting youth uptake and estimating the efficacy of policy measures prior to their implementation.