Association of Fully Branded and Standardized e-Cigarette Packaging With Interest in Trying Products Among Youths and Adults in Great Britain

Eve Taylor; Deborah Arnott; Hazel Cheeseman; David Hammond; Jessica L Reid; Ann McNeill; Pete Driezen; Katherine East

doi::10.1001/jamanetworkopen.2023.1799

Association of Fully Branded and Standardized e-Cigarette Packaging With Interest in Trying Products Among Youths and Adults in Great Britain

Eve Taylor^*, Deborah Arnott, Hazel Cheeseman, David Hammond, Jessica L Reid, Ann McNeill, Pete Driezen, Katherine East

^*Corresponding author for this work

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Abstract

IMPORTANCE e-Cigarette vaping among youths and adults has increased in Great Britain. The design of e-cigarette packagingmay appeal to youths. Regulations that reduce the appeal of e-cigarettes to youths may deter adult smokers from trying e-cigarettes to help them quit smoking. OBJECTIVE To examine the association of fully branded and standardized e-cigarette packaging with interest in trying products among youths and adults in Great Britain. DESIGN, SETTING, AND PARTICIPANTS In this survey study comprising 2 surveys, the online Action on Smoking and Health Smokefree Great Britain survey collected data between March 25 and April 16, 2021, from a representative sample of 2469 youths (aged 11-18 years) and between February 18 and March 18, 2021, from a representative sample of 12 046 adults (aged_18 years). INTERVENTIONS A between-individuals experimental design was used to examine participants' perceptions of e-cigarette packs that were digitally altered to remove brand imagery and color. Participants were randomly assigned to view a set of 3 e-cigarette packs from 1 of 3 different packaging conditions: (1) fully branded packs (control), (2) white standardized packs with brand name, or (3) green standardized packs with brand name. MAIN OUTCOMES AND MEASURES Youth participants were asked which product people their age would be most interested in trying, while adult participants were asked which product they would be most interested in trying. All participants could respond "no interest" or "don't know." Logistic regression models tested whether reporting no interest in trying the e-cigarettes differed between the pack conditions. RESULTS This study included 2469 youths (1286 female youths [52.1%]; mean [SD] age, 15.0 [2.3] years) and 12 046 adults (6412 female [53.2%]; mean [SD] age, 49.9 [17.4] years). Youths had higher odds of reporting no interest among people their age in trying the e-cigarettes packaged in green (292 of 815 [35.8%]; adjusted odds ratio [AOR], 1.37; 95%CI, 1.10-1.71; P = .005) but not white (264 of 826 [32.0%]; AOR, 1.16; 95%CI, 0.93-1.44; P = .20) standardized packaging compared with the fully branded packaging (238 of 828 [28.7%]). Adults had lower odds of reporting no interest in trying e-cigarettes in green standardized packaging (3505 of 4040 [86.8%]; AOR, 0.85; 95%CI, 0.73-0.99; P = .046) but not white packaging (3532 of 4006 [88.2%]; AOR, 1.05; 95%CI, 0.89-1.23; P = .59) compared with branded packaging (3526 of 4000 [88.1%]). Youths who had never vaped (275 of 699 [39.3%]; AOR, 1.34; 95%CI, 1.07-1.69; P = .01) and youths who had never smoked (271 of 676 [40.1%]; AOR, 1.38; 95%CI, 1.10-1.75; P = .006) were more likely to report no interest in trying e-cigarettes in green packaging compared with branded packaging (224 of 688 [32.6%] never vaping; 216 of 662 [32.6%] never smoking). There were no significant differences by vaping or smoking status among adults.

Original language	English
Article number	e231799
Pages (from-to)	e231799
Journal	JAMA Network open
Volume	6
Issue number	3
DOIs	https://doi.org/:10.1001/jamanetworkopen.2023.1799
Publication status	Published - 19 Mar 2023

Keywords

E-cigarettes
standardised packaging
youth smoking
branded packaging
nicotine

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@article{3e1601e886cd4839a6ea7fc3a326c9c8,

title = "Association of Fully Branded and Standardized e-Cigarette Packaging With Interest in Trying Products Among Youths and Adults in Great Britain",

abstract = "IMPORTANCE e-Cigarette vaping among youths and adults has increased in Great Britain. The design of e-cigarette packagingmay appeal to youths. Regulations that reduce the appeal of e-cigarettes to youths may deter adult smokers from trying e-cigarettes to help them quit smoking. OBJECTIVE To examine the association of fully branded and standardized e-cigarette packaging with interest in trying products among youths and adults in Great Britain. DESIGN, SETTING, AND PARTICIPANTS In this survey study comprising 2 surveys, the online Action on Smoking and Health Smokefree Great Britain survey collected data between March 25 and April 16, 2021, from a representative sample of 2469 youths (aged 11-18 years) and between February 18 and March 18, 2021, from a representative sample of 12 046 adults (aged_18 years). INTERVENTIONS A between-individuals experimental design was used to examine participants' perceptions of e-cigarette packs that were digitally altered to remove brand imagery and color. Participants were randomly assigned to view a set of 3 e-cigarette packs from 1 of 3 different packaging conditions: (1) fully branded packs (control), (2) white standardized packs with brand name, or (3) green standardized packs with brand name. MAIN OUTCOMES AND MEASURES Youth participants were asked which product people their age would be most interested in trying, while adult participants were asked which product they would be most interested in trying. All participants could respond {"}no interest{"} or {"}don't know.{"} Logistic regression models tested whether reporting no interest in trying the e-cigarettes differed between the pack conditions. RESULTS This study included 2469 youths (1286 female youths [52.1%]; mean [SD] age, 15.0 [2.3] years) and 12 046 adults (6412 female [53.2%]; mean [SD] age, 49.9 [17.4] years). Youths had higher odds of reporting no interest among people their age in trying the e-cigarettes packaged in green (292 of 815 [35.8%]; adjusted odds ratio [AOR], 1.37; 95%CI, 1.10-1.71; P = .005) but not white (264 of 826 [32.0%]; AOR, 1.16; 95%CI, 0.93-1.44; P = .20) standardized packaging compared with the fully branded packaging (238 of 828 [28.7%]). Adults had lower odds of reporting no interest in trying e-cigarettes in green standardized packaging (3505 of 4040 [86.8%]; AOR, 0.85; 95%CI, 0.73-0.99; P = .046) but not white packaging (3532 of 4006 [88.2%]; AOR, 1.05; 95%CI, 0.89-1.23; P = .59) compared with branded packaging (3526 of 4000 [88.1%]). Youths who had never vaped (275 of 699 [39.3%]; AOR, 1.34; 95%CI, 1.07-1.69; P = .01) and youths who had never smoked (271 of 676 [40.1%]; AOR, 1.38; 95%CI, 1.10-1.75; P = .006) were more likely to report no interest in trying e-cigarettes in green packaging compared with branded packaging (224 of 688 [32.6%] never vaping; 216 of 662 [32.6%] never smoking). There were no significant differences by vaping or smoking status among adults.",

keywords = "E-cigarettes, standardised packaging, youth smoking, branded packaging, nicotine",

author = "Eve Taylor and Deborah Arnott and Hazel Cheeseman and David Hammond and Reid, {Jessica L} and Ann McNeill and Pete Driezen and Katherine East",

note = "Funding Information: Funding/Support: This study was supported by project grant PPRCTAGPJT\100008 from Cancer Research UK. The work of Action on Smoking and Health is funded by the British Heart Foundation and Cancer Research UK. Dr East is also a recipient of fellowship funding from the Society for the Study of Addiction. Ms Taylor is funded by the National Institute for Health and Care Research Health Protection Research Unit in Environmental Exposures and Health, a partnership between the UK Health Security Agency and Imperial College London. Publisher Copyright: {\textcopyright} 2023 American Medical Association. All rights reserved.",

year = "2023",

month = mar,

day = "19",

doi = ":10.1001/jamanetworkopen.2023.1799",

language = "English",

volume = "6",

pages = "e231799",

journal = "JAMA Network open",

issn = "2574-3805",

publisher = "American Medical Association",

number = "3",

}

TY - JOUR

T1 - Association of Fully Branded and Standardized e-Cigarette Packaging With Interest in Trying Products Among Youths and Adults in Great Britain

AU - Taylor, Eve

AU - Arnott, Deborah

AU - Cheeseman, Hazel

AU - Hammond, David

AU - Reid, Jessica L

AU - McNeill, Ann

AU - Driezen, Pete

AU - East, Katherine

N1 - Funding Information: Funding/Support: This study was supported by project grant PPRCTAGPJT\100008 from Cancer Research UK. The work of Action on Smoking and Health is funded by the British Heart Foundation and Cancer Research UK. Dr East is also a recipient of fellowship funding from the Society for the Study of Addiction. Ms Taylor is funded by the National Institute for Health and Care Research Health Protection Research Unit in Environmental Exposures and Health, a partnership between the UK Health Security Agency and Imperial College London. Publisher Copyright: © 2023 American Medical Association. All rights reserved.

PY - 2023/3/19

Y1 - 2023/3/19

N2 - IMPORTANCE e-Cigarette vaping among youths and adults has increased in Great Britain. The design of e-cigarette packagingmay appeal to youths. Regulations that reduce the appeal of e-cigarettes to youths may deter adult smokers from trying e-cigarettes to help them quit smoking. OBJECTIVE To examine the association of fully branded and standardized e-cigarette packaging with interest in trying products among youths and adults in Great Britain. DESIGN, SETTING, AND PARTICIPANTS In this survey study comprising 2 surveys, the online Action on Smoking and Health Smokefree Great Britain survey collected data between March 25 and April 16, 2021, from a representative sample of 2469 youths (aged 11-18 years) and between February 18 and March 18, 2021, from a representative sample of 12 046 adults (aged_18 years). INTERVENTIONS A between-individuals experimental design was used to examine participants' perceptions of e-cigarette packs that were digitally altered to remove brand imagery and color. Participants were randomly assigned to view a set of 3 e-cigarette packs from 1 of 3 different packaging conditions: (1) fully branded packs (control), (2) white standardized packs with brand name, or (3) green standardized packs with brand name. MAIN OUTCOMES AND MEASURES Youth participants were asked which product people their age would be most interested in trying, while adult participants were asked which product they would be most interested in trying. All participants could respond "no interest" or "don't know." Logistic regression models tested whether reporting no interest in trying the e-cigarettes differed between the pack conditions. RESULTS This study included 2469 youths (1286 female youths [52.1%]; mean [SD] age, 15.0 [2.3] years) and 12 046 adults (6412 female [53.2%]; mean [SD] age, 49.9 [17.4] years). Youths had higher odds of reporting no interest among people their age in trying the e-cigarettes packaged in green (292 of 815 [35.8%]; adjusted odds ratio [AOR], 1.37; 95%CI, 1.10-1.71; P = .005) but not white (264 of 826 [32.0%]; AOR, 1.16; 95%CI, 0.93-1.44; P = .20) standardized packaging compared with the fully branded packaging (238 of 828 [28.7%]). Adults had lower odds of reporting no interest in trying e-cigarettes in green standardized packaging (3505 of 4040 [86.8%]; AOR, 0.85; 95%CI, 0.73-0.99; P = .046) but not white packaging (3532 of 4006 [88.2%]; AOR, 1.05; 95%CI, 0.89-1.23; P = .59) compared with branded packaging (3526 of 4000 [88.1%]). Youths who had never vaped (275 of 699 [39.3%]; AOR, 1.34; 95%CI, 1.07-1.69; P = .01) and youths who had never smoked (271 of 676 [40.1%]; AOR, 1.38; 95%CI, 1.10-1.75; P = .006) were more likely to report no interest in trying e-cigarettes in green packaging compared with branded packaging (224 of 688 [32.6%] never vaping; 216 of 662 [32.6%] never smoking). There were no significant differences by vaping or smoking status among adults.

AB - IMPORTANCE e-Cigarette vaping among youths and adults has increased in Great Britain. The design of e-cigarette packagingmay appeal to youths. Regulations that reduce the appeal of e-cigarettes to youths may deter adult smokers from trying e-cigarettes to help them quit smoking. OBJECTIVE To examine the association of fully branded and standardized e-cigarette packaging with interest in trying products among youths and adults in Great Britain. DESIGN, SETTING, AND PARTICIPANTS In this survey study comprising 2 surveys, the online Action on Smoking and Health Smokefree Great Britain survey collected data between March 25 and April 16, 2021, from a representative sample of 2469 youths (aged 11-18 years) and between February 18 and March 18, 2021, from a representative sample of 12 046 adults (aged_18 years). INTERVENTIONS A between-individuals experimental design was used to examine participants' perceptions of e-cigarette packs that were digitally altered to remove brand imagery and color. Participants were randomly assigned to view a set of 3 e-cigarette packs from 1 of 3 different packaging conditions: (1) fully branded packs (control), (2) white standardized packs with brand name, or (3) green standardized packs with brand name. MAIN OUTCOMES AND MEASURES Youth participants were asked which product people their age would be most interested in trying, while adult participants were asked which product they would be most interested in trying. All participants could respond "no interest" or "don't know." Logistic regression models tested whether reporting no interest in trying the e-cigarettes differed between the pack conditions. RESULTS This study included 2469 youths (1286 female youths [52.1%]; mean [SD] age, 15.0 [2.3] years) and 12 046 adults (6412 female [53.2%]; mean [SD] age, 49.9 [17.4] years). Youths had higher odds of reporting no interest among people their age in trying the e-cigarettes packaged in green (292 of 815 [35.8%]; adjusted odds ratio [AOR], 1.37; 95%CI, 1.10-1.71; P = .005) but not white (264 of 826 [32.0%]; AOR, 1.16; 95%CI, 0.93-1.44; P = .20) standardized packaging compared with the fully branded packaging (238 of 828 [28.7%]). Adults had lower odds of reporting no interest in trying e-cigarettes in green standardized packaging (3505 of 4040 [86.8%]; AOR, 0.85; 95%CI, 0.73-0.99; P = .046) but not white packaging (3532 of 4006 [88.2%]; AOR, 1.05; 95%CI, 0.89-1.23; P = .59) compared with branded packaging (3526 of 4000 [88.1%]). Youths who had never vaped (275 of 699 [39.3%]; AOR, 1.34; 95%CI, 1.07-1.69; P = .01) and youths who had never smoked (271 of 676 [40.1%]; AOR, 1.38; 95%CI, 1.10-1.75; P = .006) were more likely to report no interest in trying e-cigarettes in green packaging compared with branded packaging (224 of 688 [32.6%] never vaping; 216 of 662 [32.6%] never smoking). There were no significant differences by vaping or smoking status among adults.

KW - E-cigarettes

KW - standardised packaging

KW - youth smoking

KW - branded packaging

KW - nicotine

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JO - JAMA Network open

JF - JAMA Network open

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M1 - e231799

ER -

Association of Fully Branded and Standardized e-Cigarette Packaging With Interest in Trying Products Among Youths and Adults in Great Britain

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