The Effect of Product Characteristics on Perceptions of E-cigarettes among Canadians

1. The Effect of Product Characteristics on Perceptions of E-cigarettes among Canadians Christine Czoli, PhD Student May 28, 2014

2. Background Source: Alderman L. (2013). E-Cigarettes are in vogue and at a crossroads. Retrieved from: http://www.nytimes.com/2013/06/13/business/e-cigarettes-are-in-vogue-and-at-a-crossroads.html?pagewanted=1&_r=0

3. Background • Debate: public health benefit or harm? • Limited research evidence

4. Background • E-cigarette regulatory frameworks • Targets for regulation?

5. Research Objective • To examine the relative importance offlavour, nicotine content, health warnings, and price among Canadians’: a) Perceptions of product taste b) Perceptions of product harm c) Perceptions of product efficacy in smoking cessation • To examine the extent to which outcomes a-d are moderated by smoking status, gender, and age.

6. Methods Study Design & Protocol • Online survey + discrete choice experiment • November 2013 • 1,188 Canadians, aged 16+

7. Methods Discrete Choice Experiment • Random utility theory • Tested 4 product attributes

8. Methods Product Attributes Product Attribute Levels FlavourTobacco Menthol Coffee Cherry

9. Methods Product Attributes Product Attribute Levels Nicotine contentNone (0 mg) Low (6-8 mg) Medium (10-12 mg) High (16 mg)

10. Methods Product Attributes Product Attribute Levels Health warningNone “Health Canada has not approved this product for quitting smoking.” [HC] “This product is intended for use by existing smokers. It contains nicotine which is a highly addictive substance.” [EC1] “This product is intended for use by existing smokers aged 18 or over as an alternative to tobacco cigarettes. It contains nicotine which is a highly addictive substance. Consult your doctor if you are pregnant, breast feeding, allergic to nicotine or propylene glycol, or have high blood pressure.” [EC2]

11. Methods Product Attributes Product Attribute Levels Price Low ($ 7.99) High ($ 9.99)

12. Methods Product Attributes Product Attribute Levels FlavourTobacco Menthol Coffee Cherry Nicotine contentNone Low Medium High Health warningNone HC EC1 EC2 Price Low ($ 7.99) High ($ 9.99)

13. Methods Product Attributes Product Attribute Levels FlavourTobacco Menthol Coffee Cherry Nicotine contentNone Low Medium High Health warningNone HCEC1EC2 PriceLow ($ 7.99) High ($ 9.99) $ 9.99

14. Methods Discrete Choice Experiment – Design Fractional factorial main effects design • 16 pack profiles • Arranged into 20 choice sets • Each set containing 4 pack profiles + “none” Source: Kuhfeld, W. (2010). Marketing research methods in SAS.

15. Methods Choice Set #1

16. Methods Which one of these products do you think would taste better?

17. Methods Which one of these products do you think would be less harmful?

18. Methods Which one of these products do you think would help someone quit smoking?

19. Methods Analyses Multinomial logit models 1. Attribute-level importance 2. Attribute importance

20. Results

21. Results Sample Characteristics (n = 1,188)

22. Perceptions of product taste Attribute-Level Importance

23. Perceptions of product taste Attribute-Level Importance • E-cigarettes with the following characteristics were perceived as better-tasting: • Cherryflavour(p < 0.0001); • Low nicotine(p < 0.0001); • No health warning (p < 0.0001) and the EC2 health warning (p < 0.0001); • Lower price (p < 0.0001)

24. Perceptions of product taste Attribute Importance

25. Perceptions of product taste Attribute Importance

26. Perceptions of product taste Attribute Importance

27. Perceptions of product harm Attribute-Level Importance • E-cigarettes with the following characteristics were perceived as less harmful: • Menthol(p < 0.0001) and coffee(p < 0.0001) flavours; • Lownicotine (p < 0.0001); • Nohealth warning (p < 0.0001) and the EC2 health warning (p < 0.0001); • Lowerprice (p < 0.0001)

28. Perceptions of product harm Attribute Importance

29. Perceptions of product quit efficacy Attribute-Level Importance • E-cigarettes with the following characteristics were believed to help someone quit smoking: • Menthol(p < 0.0001) and coffee(p < 0.0001) flavours; • Lownicotine (p < 0.0001); • Nohealth warning (p < 0.0001) and the EC2 health warning (p < 0.0001); • Lowerprice (p < 0.0001)

30. Perceptions of product quit efficacy Attribute Importance

31. Summary • Health warnings were the most influential drivers of participants’ perceptions of product quit efficacy • Flavourwas the strongest predictor of perceptions of taste • Flavourand health warnings significantly predicted perceptions of product harm

32. Strengths & Limitations Strengths • DCE design Limitations • Design did not include all attribute-level combinations • Testing of a subset of attributes • Use of a non-probability-based sample

33. Implications Regulatory Framework for E-cigarettes • Potential targets for regulation • Flavourand health warnings

34. Acknowledgements Research Team • David Hammond, MaciejGoniewicz, Towhidul Islam, Kathy Kotnowski Funding Sources

35. Thank you Christine D Czoli, PhD Student School of Public Health & Health Systems cczoli@uwaterloo.ca

36. Perceptions of product taste • Which one of these products do you think would taste better? Pack Utility $ 9.99 Utility = 0.38

37. Perceptions of product taste Pack Utility

38. Perceptions of product taste Pack Utility

39. Perceptions of product taste Pack Utility

40. Perceptions of product harm Pack Utility

41. Perceptions of product harm Pack Utility

42. Perceptions of product harm Pack Utility

43. Perceptions of product quit efficacy Pack Utility

44. Perceptions of product quit efficacy Pack Utility