Estimating Uptake for Reduced-nicotine Cigarettes Using Behavioral Economics

Abstract

Objectives: Lowering the nicotine content in combustible cigarettes may be a viable strategy for reducing dependence and toxin exposure. Understanding how marketing and education may affect initial uptake is an important avenue of inquiry prior to any policy change. There has yet to be an investigation of how framing reductions in nicotine may affect intentions to purchase and consume these cigarettes using the behavioral economic framework.

Methods: Participants from Amazon Mechanical Turk completed several tasks, including the Cigarette Purchase Task and Experimental Tobacco Marketplace, under conditions in which a new, reduced-nicotine cigarette alternative is the only cigarette available.

Results: Cigarette purchasing was largely unaffected by stated nicotine concentration, but lower concentrations suggested the potential of small estimated compensatory purchasing. Exposure to a narrative detailing how others have perceived the negative subjective effects of lower nicotine cigarettes (eg, less satisfaction) significantly reduced the perceived value of cigarettes.

Conclusions: These results suggest information about nicotine content alone is unlikely to reduce initial uptake without accompanying narratives about the effects of this reduced-nicotine content.

Keywords: behavioral economics; cigarette purchase task; cigarettes; demand; experimental tobacco marketplace; humans; nicotine reduction.

Figure 1:

Derived intensity (Q₀; top panel) and elasticity (ɑ; bottom panel) for variable-nicotine cigarettes after accounting for baseline Cigarette Purchase Task intensity and elasticity, respectively. Although intensity increased nominally with concentration group, elasticity was statistically significantly higher after exposure to the Narrative. Symbols and error bars indicate mean and standard error of the mean. Note the logarithmic y-axis (bottom panel).

Figure 2:

Usual-brand cigarette demand (square symbols) and variable-nicotine cigarette substitution (circle symbols), fixed at $0.25 per cigarette, as a function of increasing price of usual-brand cigarettes. Variable-nicotine cigarettes in all three groups served as partial substitutes for usual-brand cigarettes with cigarettes under the Narrative condition demonstrating least substitution. Symbols and error bars indicate mean and standard error of the mean. Note the logarithmic x-axis.

Figure 3:

Estimated probability of choosing variable-nicotine cigarettes (set at a fixed $0.25 per cigarette) over usual-brand cigarettes (increasing in price) based on group. Participants in the 100% group switched to the variable-nicotine cigarette more rapidly as price increased compared to participants in the 2% and 2% Narrative groups. Participants in the 2% group were more likely to purchase variable-nicotine cigarettes regardless of price compared to the 2% Narrative group. Shaded curves represent 95% confidence intervals.