Impact of e-liquid packaging on vaping product perceptions among youth in England, Canada, and the United States; a randomised online experiment

Erikas Simonavicius, Katherine East, Eve Taylor, Matilda Nottage, Jessica L Reid, Deborah Arnott, Laura Bunce, Ann McNeill, David Hammond

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Abstract

Introduction
Vaping is not risk-free but can help those who smoke to reduce harm to health and stop smoking. However, packaging of vaping products, including e-liquids, appeals to youth and might facilitate vaping among nicotine-naïve people. Standardised packaging of vaping products could moderate the appeal of vaping among youth. This study assessed how youth interest in trying and perceived health harms of using e liquids are associated with branded or standardised (white or olive) e-liquid packaging with different nicotine levels displayed.

Methods
A between-subject experiment with 3 packaging and 2 nicotine level conditions included youth (n=13801) aged 16 to 19 from England, Canada and the United States as a part of a cross sectional online survey in August-September 2021. Participants’ interest in trying and perceived harm of e-liquids were analysed using logistic and multinomial regressions adjusted for age, sex, race/ethnicity, country, vaping and smoking status.

Results
Compared with branded e-liquid packs, more youth reported no interest in trying e liquids in white (aOR=1.48, 95% CI=1.34-1.64) or olive (aOR=1.62, 95% CI: 1.47-1.80) standardised packs. Compared with branded e liquid packs, more youth inaccurately perceived e liquids in white (aOR=1.22, 95% CI: 1.11-1.34) or olive (aOR=1.29, 95% CI: 1.18-1.41) standardised packs as equally or more harmful than smoking. E-liquid nicotine levels displayed on packs were not associated with youth interest in trying or harm perceptions of using e liquids.

Conclusion
Among 16- to 19-year-old youth from England, Canada and the US, standardised packaging of e-liquids was associated with lower interest in trying and higher health risk perceptions.
Original languageEnglish
JournalNicotine and Tobacco Research
Early online date5 Aug 2023
DOIs
Publication statusE-pub ahead of print - 5 Aug 2023

Keywords

  • youth
  • vaping
  • nicotine
  • e-liquid
  • standardised packaging
  • smoking
  • harm reduction

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