The 2009 Tobacco Control Act granted the Food and Drug Administration broad authority to regulate cigarettes and other tobacco products, which was further expanded in 2016 to include e-cigarettes. To study the impact of FDA tobacco regulations, we designed and conducted a discrete choice experiment to collect data on adult subjects' stated preferences for cigarettes, e-cigarettes, and quitting. We find evidence that enacted, pending, and potential FDA regulations may have important influences on adult smokers' choices. We estimate that when the long-delayed requirement of cigarette graphic warning labels is implemented, it could decrease the probability that adult smokers choose cigarettes by 5.30 percentage points. However, our results suggest that recent policy trends towards tighter regulation of e-cigarettes might work in the opposite direction. We estimate that the FDA-required warning label on e-cigarettes increases the probability of cigarette choices by 1.9 percentage points. Based on the estimated effect of a flavor ban, our results suggest that full enforcement of FDA marketing denial orders for almost all flavored e-cigarettes could increase the probability of cigarette choices by 2.8 percentage points. Finally, raising e-cigarette prices mainly moves respondents away from e-cigarettes towards combustible cigarettes rather than to attempting to quit tobacco products altogether.

Economic research has long focused on illegal markets and the consequences of prohibitions. We provide a case study of the proposed prohibition of menthol cigarettes, which are smoked by almost 19 million people in the U.S. Illegal markets for menthol cigarettes could not only blunt the prohibition's intended consequence to reduce smoking but could also lead to unintended consequences. We use data from a discrete choice experiment. Our mixed logit model predicts a substantial potential consumer demand for illegal menthol cigarettes, especially if menthol e-cigarettes are also illegal.

Heated tobacco products (HTPs) have gained popularity over the past decade and contributed significantly to the reduction of combustible cigarette smoking in Japan. While the increased popularity of HTPs suggests consumer preference for cigarette alternatives, there is a limited understanding of how consumers choose between different tobacco products. Understanding consumer choice is especially salient given the evolving policy landscape and proposals to increase HTP taxes. This study uses a large discrete choice experiment in Japan to examine the decision-making processes of individuals who smoke when choosing between cigarettes, HTPs, and quitting. We assess the influence of various product attributes such as prices, flavours, nicotine content, and warning messages on these choices. The findings reveal that prices and flavours significantly influence participants' preferences. Specifically, higher HTP prices tend to drive participants' back to combustible cigarettes and discourage them from choosing to quit. Additionally, there is some evidence that consumers prefer HTPs with a wide variety of flavours. Meanwhile, hypothetical policy situations that change warning messages or nicotine content do not affect consumers' choices.

Economics has long studied how consumers respond to the disclosure of information about firms. We study a case in which the disclosed information is unrelated to the firm's products or leadership, but which could still potentially affect consumer patronage through the mechanism of repugnance, as described in Roth (2007). The information in this case concerns the arrest of Jared Fogle, the well-known spokesman and advertising pitchman for the Subway sandwich franchise, who was arrested in 2015 on charges of sex with a minor and child pornography. We study how the disclosure of this information, which was widely covered in the media, affected patronage of Subway. We estimate synthetic control models using data from a large nationwide survey of consumers regarding the restaurants they patronize. Despite the close and long-standing association of Jared Fogle with Subway, and heavy publicity of his crimes, we consistently fail to detect any effect of the Jared Fogle scandal on the probability of visiting a Subway restaurant. These results contrast with predictions made at the time by industry observers as well as by the public in an original survey and are in contrast to several previous studies of the impact of negative information disclosure on firms. The absence of an effect in this case suggests that repugnance did not drive demand, and that consumers largely separated the offenses of a symbol of the firm from the products of the firm.

Context: Current use and potential future uptake of e -cigarettes among youth remain public health concerns in the U.S., even as people who smoke combustible cigarettes could benefit from switching completely to e -cigarettes. The U.S. Food and Drug Administration (FDA) is considering alternative warning messages, but warnings that discourage youth from use may also deter people who smoke from switching. This study tests ten preregistered hypotheses on effects of warning messages with national samples of youth overall and adults who smoke and/or vape. Methods: NORC recruited 1639 adults (ages 18+) who smoke, vape, or use both products, from their probabilitysampled AmeriSpeak Panel and augmented their AmeriSpeak Teen Panel with Lucid's nonprobability opt -in panel to recruit 1217 youth (ages 14-17) to participate in a web -based survey experiment. We randomly assigned respondents to view one of five warning label conditions and respond to measures of their e -cigarette risk beliefs, willingness to use e -cigarettes, and (among people who smoke or vape) considerations to quit these products. Findings: Relative to the current FDA warning about nicotine, warning messages about the harms of e -cigarette use for youth brain development did not influence risk beliefs or reduce willingness to use these products among youth. Brain development warning messages did increase beliefs about these harms among adults but did not increase quit considerations among people who vape, relative to the FDA warning. Warning messages with information about chemical constituents of vaping products and the harm of these chemicals produced higher ecigarette quit considerations than did the FDA warning among adults who vape. Conclusion: Potential alternative warning label messages were largely ineffective relative to the current FDA warning about nicotine, though limited evidence suggests some potential for chemical + harm messaging to encourage people who use both e -cigarettes and cigarettes to consider quitting both.

More than 18.5 million current smokers in the United States usually smoke menthol cigarettes. The Food and Drug Administration recently proposed a tobacco product standard to prohibit menthol as a characterizing flavor in cigarettes. We explore whether there are internality-based market failures that provide an applied welfare economics rationale to prohibit menthol. Our empirical approach provides descriptive evidence from the 2018 to 2019 Tobacco Use Supplement to the Current Population Survey on how menthol use is associated with smokers' market demand along multiple intensive and extensive margins. We also use measures of smoking-related misinformation and internalities, and stated preference data, from a 2021 Cornell Online Survey. We acknowledge that the associations we document in observational data might reflect bias due to self-selection into menthol use. We leave it to the reader whether there is convincing evidence that differential levels of internality-based market failures are a sufficient justification for the proposed prohibition of menthol cigarettes.

The Food and Drug Administration has proposed to prohibit menthol cigarettes, which are smoked by almost 19 million people in the U.S. Illegal markets for menthol cigarettes could not only blunt the prohibition’s intended consequence to reduce smoking but could also lead to unintended consequences. We use data from a discrete choice experiment to estimate a mixed logit model which predicts that the prohibition of menthol cigarettes would substantially increase the fraction of menthol smokers who attempt to quit. However, our model also predicts a substantial potential consumer demand for illegal menthol cigarettes. Depending on the impact of illegality on product prices, our model predicts the potential demand-side of an illegal market for menthol cigarettes could be 59-92 percent the size of the status quo market if menthol e-cigarettes are legal, and 69-100 percent the size of the status quo market if menthol e-cigarettes are also illegal. Our mixed logit model estimated in willingness to pay space implies that the mean WTP to avoid an illegal retail market is equivalent to a tax of $8.44 per pack. In our partial cost-benefit analysis, the opportunity costs of prohibition exceed the value of the reduction in mortality risks from secondhand smoke by $15.4 billion annually. Institutional subscribers to the NBER working paper series, and residents of developing countries may download this paper without additional charge at www.nber.org.

The U.S. Food and Drug Administration (FDA) currently requires a warning about the addictive nature of nicotine to be placed on electronic cigarette advertisements and packaging. To consider the value of additional warning messages on public health outcomes, this study examines the additive effect of new warnings that are based on recent claims from U.S. federal authorities. We conducted a secondary analysis of recent data from 1,202 U.S. youth ages 14-17 to test the impact of exposure to additional warnings placed on advertisements for vaping products on cognitive elaboration, fear, and willingness to vape and smoke. This investigation also looked closely at effects on youth who may have increased risk of future vaping due to prior vaping experiences or having friends who vape. Exposure to the alternative warnings did not amplify cognitive elaboration compared to the current FDA warning alone, but it did increase fear. Youth elaboration on both the benefits and risks of vaping was associated with willingness to both vape and smoke, but fear was not associated with either outcome. The effects of warning label exposure and cognitive elaboration varied by prior vaping experience and having at least one friend who vapes. We conclude by discussing the implications of this contingent pattern of effect and association.

We study the impact of an information shock created by an outbreak of lung injuries apparently related to e-cigarettes. We use data from multiple sources: surveys of risk perceptions conducted before, during, and after the outbreak; an in-depth survey on risk perceptions and vaping and smoking behavior; and national aggregate time-series sales data. We find that after the outbreak, consumer perceptions of the riskiness of e-cigarettes sharply increased. From our estimated e-cigarette demand models, we conclude that the information shock reduced e-cigarette demand and the use of e-cigarettes for smoking cessation by about 30 percent.

Australia had adopted a novel approach to e-cigarette policy by requiring a physician's prescription to lawfully obtain nicotine e-cigarettes. We conducted an online discrete choice experiment to gauge how adult Australian smokers made hypothetical choices between cigarettes, prescription e-cigarettes, non-prescription e-cigarettes and quitting. We estimate a mixed logit model, which allows us to predict the market shares under different policy scenarios. The mixed logit model also provides estimates of consumer willingness to pay for the benefits from the prescription status of e-cigarettes and the costs of illegal e-cigarette markets. We estimate that the average utility loss from an illegal retail market is worth AU$7.90 per pack equivalent. We use the corresponding estimates of the compensating variations in income to conduct cost-benefit analyses of possible reforms to Australian e-cigarette regulation. In aggregate, we estimate that the benefits of allowing but not requiring prescriptions of e-cigarettes are AU$1.8 billion per year. Our paper provides a novel contribution to research on e-cigarette regulation and provides a case study for the policy implementation in Australia. Our paper is also part of our research agenda to explore and develop methods to conduct policy analysis and cost-benefit analysis of regulatory policies that might create illegal markets.

In recent years, there have been numerous recalls of frozen vegetable products due to Listeria monocytogenes contamination, which causes listeriosis. In pregnant women, listeriosis can cause miscarriage, stillbirth, and other serious complications. Manufacturing guidelines are created with the intention that frozen vegetables will be cooked prior to consumption. However, consumers may prepare and eat frozen vegetables without prior cooking. Therefore, it is necessary to assess behaviors that could be risky for L. monocytogenes exposure. A 10- question online survey was distributed to women between the ages of 18-54 to investigate frozen vegetable consumption behaviors. The prevalence of uncooked frozen vegetable consumption, reading preparation instructions, and listeriosis knowledge was assessed. Data were analyzed using logistic and ordered logit regression. Of 1,001 complete responses, 531 (53%) indicated that they consumed frozen vegetables in the past week, and of those 35.6% (n = 189) indicated that they consumed frozen vegetables without prior heating. Women who had not heard of listeriosis and had not read preparation instructions had significantly higher odds of uncooked frozen vegetable consumption (Odds Ratio (OR): 2.30, 95% Confidence Interval (CI): 1.48, 3.55; OR: 1.85, 95% CI: 1.13, 3.01, respectively). These results will guide future research on safe food handling practices for frozen vegetable products. The findings support the need for updating public health guidelines to include frozen vegetables as foods that are risky for listeriosis in pregnancy. Additionally, these findings have implications for future research to inform food policy governing labeling regulation on frozen vegetable products to reflect current consumer behavior.

E-cigarette use among youth presents a public health risk. Yet, cigarette smokers who substantially reduce their smoking or switch completely from traditional combustible cigarettes could benefit. As science about e-cigarettes is continually emerging, any potential warnings are likely to contain uncertain language. Hedged verbiage may impact decision making. To assess reactions, we conducted 16 online focus groups; 8 with youth (n = 32, grouped by gender and by vaping experience) and 8 with adult tobacco users (n = 37, grouped by smokers, dual users of e-cigarettes and cigarettes, and former smokers who switched to e-cigarettes). Each focus group viewed and discussed 8 potential warnings messages. We conducted an inductive thematic analysis of the reactions to warning messages that contain uncertain language. Respondents’ reactions were often negative, but varied based on specific usages of uncertainty, existing beliefs about uncertainty in law and science, and smoking/vaping use patterns that supported the use of uncertainty related to e-cigarettes. Many youth (and some adults) believed that uncertain language enabled audiences to minimize the likelihood of harm or interpreted it as meaning there are both healthy and unhealthy e-cigarettes. This qualitative study provides evidence that the use of types of uncertain language, the frequency of that use, and/or the selection of particular words in warnings, might not achieve the intended public health aims of increasing understanding of risk, deterring youth uptake, and/or facilitating a substantial switch from cigarettes. The use of certain types of uncertain language appears to have significant potential to bring unintended consequences. Suggestions for research and policy are included.

AimsA warning on e-cigarette packaging is one way the U.S. government can inform the public of known harms of e-cigarette use. Currently, the only required warning on these products is: "WARNING: This product contains nicotine. Nicotine is an addictive chemical." This exploratory study aims to inform potential future investigations and FDA decisions regarding alternative warnings that may generate fear in addition to being intentionally informational. MethodData were obtained from responses by 16 online focus groups with adult (N = 47, age range = 18-64) and youth (N = 32, age range 14-16) participants with various smoking and vaping experiences. We showed each focus group a set of hypothetical e-cigarette warning labels to determine how they respond to currently existing public statements that communicate information on the toxicity of ingredients in e-cigarettes, potential health risks, addiction to nicotine, and the uncertainty of the science regarding health effects of using these products. The focus group interviews were audio recorded and transcribed. Transcripts were subjected to a multiphase coding process to identify common response themes. Codes derived from the Extended Parallel Processing Model were then applied to understand impact of potentially fear-inducing language by warning category and age group. ResultsFor adults, all warnings-except those about addiction-gave rise to spontaneous danger control (intended) responses, such as quit intentions. Warnings highlighting cognitive and uncertain effects may be particularly promising for adult consumers of tobacco products because both gengerated danger control and response efficacy without evidence of fear control. However, responses also suggest that warnings risk discouraging some adults who use combustible cigarettes from transitioning to e-cigarettes for harm reduction. For youth, while evidence of response efficacy and danger control emerged among youth exposed to messages in all warning categories but one-addiction-unproductive reactions indicative of fear control were also prevalent among youth respondent across most warning types. On average, youth were more skeptical than adults about the harms of using e-cigarettes. Policy implicationsImplications of study findings for the development of future effective e-cigarette warning messages are explored.