The impact of vaping and regulatory environment on cigarette demand: behavioral economic perspective across four countries

BACKGROUND AND AIMS: Government regulations of nicotine vaping products (NVP) have evolved rapidly over the past decade. The impact of NVP regulatory environment and vaping on cigarette demand in unknown. The current study aims to investigate whether or not respondents’ reported cigarette demand, as measured by a hypothetical cigarette purchase task, varies with 1) smoking status, 2) vaping status, or 3) NVP regulatory environment (country used as proxy). PARTICIPANTS: 10,316 adult smokers. SETTING: Australia (AU), Canada (CA), England (EN), and the Untied States (US). DESIGN: Cross-sectional survey data from Wave 1 of the International Tobacco Control (ITC) Four Country Smoking and Vaping (4CV) Survey (2016). METHODS: Data for this cross-sectional study were from 10,316 adult smokers who participated in Wave 1 of the International Tobacco Control (ITC) Four Country Smoking and Vaping (4CV) Survey, which was conducted in 2016 in Australia (AU), Canada (CA), England (EN), and the United States (US). The purchase task asked smokers to estimate how many cigarettes they would purchase for consumption in a single day across multiple cigarette prices. Overall sensitivity of cigarette consumption to price increases was quantified to index cigarette demand elasticity whereas estimated consumption when cigarettes are free was used to index cigarette demand intensity. MEASUREMENTS: A hypothetical purchase task asked smokers to estimate how many cigarettes they would purchase for consumption in a single day across multiple cigarette prices. Responses were used to derive measures of cigarette demand. Overall sensitivity of cigarette consumption to price increases was quantified to index cigarette demand elasticity whereas estimated consumption when cigarettes are free was used to index cigarette demand intensity. RESULTS: A majority of the non-daily smokers had previously smoked daily (72.3%); daily vapers were more likely to be former daily smokers (89.9%) compared to non-daily vapers (70.1%) and non-vapers (69.2%) (p.38). Intensity was higher in AU compared with all other countries (ps