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      The impact of price and tobacco control policies on the demand for electronic nicotine delivery systems

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          Abstract

          Background

          While much is known about the demand for conventional cigarettes, little is known about the determinants of demand for electronic nicotine delivery systems (ENDS or e-cigarettes). The goal of this study is to estimate the own and cross-price elasticity of demand for e-cigarettes and to examine the impact of cigarette prices and smoke-free policies on e-cigarette sales.

          Methods

          Quarterly e-cigarette prices and sales and conventional cigarette prices from 2009 to 2012 were constructed from commercial retail store scanner data from 52 US markets, for food, drug and mass stores, and from 25 markets, for convenience stores. Fixed-effects models were used to estimate the own and cross-price elasticity of demand for e-cigarettes and associations between e-cigarette sales and cigarette prices and smoke-free policies.

          Results

          Estimated own price elasticities for disposable e-cigarettes centred around −1.2, while those for reusable e-cigarettes were approximately −1.9. Disposable e-cigarette sales were higher in markets where reusable e-cigarette prices were higher and where less of the population was covered by a comprehensive smoke-free policy. There were no consistent and statistically significant relationships between cigarette prices and e-cigarette sales.

          Conclusions

          E-cigarette sales are very responsive to own price changes. Disposable e-cigarettes appear to be substitutes for reusable e-cigarettes. Policies increasing e-cigarette retail prices, such as limiting rebates, discounts and coupons and imposing a tax on e-cigarettes, could potentially lead to significant reductions in e-cigarette sales. Differential tax policies based on product type could lead to substitution between different types of e-cigarettes.

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          Most cited references5

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          Notes from the field: electronic cigarette use among middle and high school students - United States, 2011-2012.

          (2013)
          Electronic cigarettes, or e-cigarettes, are battery-powered devices that provide doses of nicotine and other additives to the user in an aerosol. Depending on the brand, e-cigarette cartridges typically contain nicotine, a component to produce the aerosol (e.g., propylene glycol or glycerol), and flavorings (e.g., fruit, mint, or chocolate). Potentially harmful constituents also have been documented in some e-cigarette cartridges, including irritants, genotoxins, and animal carcinogens. E-cigarettes that are not marketed for therapeutic purposes are currently unregulated by the Food and Drug Administration, and in most states there are no restrictions on the sale of e-cigarettes to minors. Use of e-cigarettes has increased among U.S. adult current and former smokers in recent years; however, the extent of use among youths is uncertain.
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            Electronic nicotine delivery system (electronic cigarette) awareness, use, reactions and beliefs: a systematic review.

            We sought to systematically review the literature on electronic nicotine delivery systems (ENDS, also called electronic cigarettes) awareness, use, reactions and beliefs. We searched five databases for articles published between 2006 and 1 July 2013 that contained variations of the phrases 'electronic cigarette', 'e-cigarette' and 'electronic nicotine delivery'. Of the 244 abstracts identified, we excluded articles not published in English, articles unrelated to ENDS, dissertation abstracts and articles without original data on prespecified outcomes. Two reviewers coded each article for ENDS awareness, use, reactions and beliefs. 49 studies met inclusion criteria. ENDS awareness increased from 16% to 58% from 2009 to 2011, and use increased from 1% to 6%. The majority of users were current or former smokers. Many users found ENDS satisfying, and some engaged in dual use of ENDS and other tobacco. No longitudinal studies examined whether ENDS serve as 'gateways' to future tobacco use. Common reasons for using ENDS were quitting smoking and using a product that is healthier than cigarettes. Self-reported survey data and prospective trials suggest that ENDS might help cigarette smokers quit, but no randomised controlled trials with probability samples compared ENDS with other cessation tools. Some individuals used ENDS to avoid smoking restrictions. ENDS use is expanding rapidly despite experts' concerns about safety, dual use and possible 'gateway' effects. More research is needed on effective public health messages, perceived health risks, validity of self-reports of smoking cessation and the use of different kinds of ENDS. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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              Awareness and ever-use of electronic cigarettes among U.S. adults, 2010-2011.

              Electronic cigarettes, or e-cigarettes, were introduced into the U.S. market in recent years. However, little is known about the health impact of the product or the extent of its use. This study assessed the prevalence and correlates of awareness and ever-use of e-cigarettes among U.S. adults during 2010-2011. Data were obtained from the HealthStyles survey, a national consumer-based survey of U.S. adults aged ≥18 years old. In 2010, data collection for the HealthStyles survey was both mail-based (n = 4,184) and web-based (n = 2,505), and in 2011, web-based (n = 4,050) only. Estimates of awareness and ever-use of e-cigarettes were calculated overall and by sex, age, race/ethnicity, educational attainment, household income, region, and smoking status. In 2010, overall awareness of e-cigarettes was 38.5% (mail survey) and 40.9% (web survey); in 2011, awareness was 57.9% (web survey). Ever-use of e-cigarettes among all respondents was 2.1% in the 2010 mail survey, 3.3% in the 2010 web survey, and 6.2% in the 2011 web survey. Ever-use of e-cigarettes was significantly higher among current smokers compared with both former and never-smokers, irrespective of survey method or year. During 2010-2011, ever-use increased among both sexes, those aged 45-54 years, non-Hispanic Whites, those living in the South, and current and former smokers. Awareness and ever-use of e-cigarettes increased among U.S. adults from 2010 to 2011. In 2011, approximately 1 in 5 current smokers reported having ever-used e-cigarettes. Continued surveillance of e-cigarettes is needed for public health planning.
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                Author and article information

                Journal
                Tob Control
                Tob Control
                tobaccocontrol
                tc
                Tobacco Control
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                0964-4563
                1468-3318
                July 2014
                24 April 2014
                : 23
                : Suppl 3 , Electronic Nicotine Delivery Systems (ENDS): New Evidence from the State and Community Tobacco Control Research Initiative
                : iii41-iii47
                Affiliations
                [1 ]Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago , Chicago, Illinois, USA
                [2 ]Department of Economics, University of Illinois at Chicago , Chicago, Illinois, USA
                Author notes
                [Correspondence to ] Dr Jidong Huang, Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, 1747 West Roosevelt Rd., Chicago, IL 60608, USA; jhuang12@ 123456uic.edu
                Article
                tobaccocontrol-2013-051515
                10.1136/tobaccocontrol-2013-051515
                4145658
                24935898
                1438cfd2-ad30-4a43-b057-92e1ce58a443
                Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

                History
                : 8 January 2014
                : 27 March 2014
                Categories
                1506
                Original Article
                Custom metadata
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                Public health
                electronic nicotine delivery devices,economics,price
                Public health
                electronic nicotine delivery devices, economics, price

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