A Novel Method for Evaluating the Acceptability of Substitutes for Cigarettes: The Experimental Tobacco Marketplace.

Objectives: The current study tests the substitutability of nicotine replacement therapy (NRT), electronic cigarettes (ECs), and very low nicotine cigarettes (VLNCs) in the context of an online experimental tobacco marketplace (ETM) that was designed to mimic the choices of smokers under 4 policy scenarios.

Methods: Dutch cigarette smokers (N = 840) completed an online survey in July 2015. The ETM was comprised of conventional cigarettes, VLNCs, ECs (disposable/cartridge/tank systems), and NRT (lozenges/patches/tabs). All participants completed a scenario in which conventional cigarettes were banned. To test additional policy scenarios participants were randomized to one of 3 experiments: 1) no VLNCs, 2) all products available, or 3) no ECs. Hypothetical weekly purchases were made when the cost for conventional cigarettes was ½ market price (MP), MP, 2x MP, and 4x MP. Substitutability was measured by the change in estimated consumption as cigarette prices increased.

Results: Tank and cartridge ECs and VLNCs were stronger cigarette substitutes than disposable ECs and NRT products. Substitution of ECs and NRT for cigarettes was dampened when VLNCs were available.

Conclusions: The ETM offers a method to predict how smokers might respond to policies that alter the availability of potentially substitutable products available in the marketplace.