Abstract：
OBJECTIVE: To explore the effects of prices and flavour availability on the appeal of different tobacco and nicotine products, including conventional cigarettes, Electronic Nicotine Delivery Systems (ENDS) and Heated Tobacco Systems (HTS) among an adult population in Switzerland.
METHODS: We performed a Discrete Choice Experiment among a group of Swiss aged ≥18 years via the online recruiting platform Prolific in a convenience sample. Our sample included both non-smokers and smokers. We used a within-subject, alternative-specific block design in a series of choice sets including different smoking products. We fixed the attributes of nicotine content (high or medium) and harmfulness (in years of life lost) for each product. Attributes of interest included price (ranging from CHF 5 to 25 in increments of 5) and flavour (fruity/menthol vs none/tobacco flavour). We performed a conditional logistic regression on the attributes\' influence on the appeal of cigarettes, ENDS and HTS.
RESULTS: A total of 108 out of 153 participants (n = 25 smokers and n = 83 non-smokers, completion rate = 71%) successfully completed our pilot survey experiment. We found that, in general, increasing the price of combustible cigarettes, ENDS and HTS by one standard deviation (around CHF 7) reduced their appeal by approximately 66% (relative risk [RR]: 0.34; 95% CI: 0.28-0.42). Unflavoured alternative nicotine products were found to be less appealing than flavoured products, especially for non-smokers, with a 86% decrease in appeal (RR: 0.14; 95% CI: 0.13-0.16). For non-smokers, an increase in price by one standard deviation was associated with a decrease in the appeal of any product by approximately 19% (RR: 0.81; 95% CI: 0.72-0.92). For smokers, the effect sizes were smaller, but overall, the appeal of all products decreased with increasing prices and reduced flavours.
CONCLUSIONS: Our Discrete Choice Experiment suggests that, for the Swiss context, limiting the availability of flavours for alternative smoking products has the potential to reduce their appeal to non-smokers by 86% and that a small but significant increase in prices to CHF 15 for cigarettes, ENDS and HTS could lead to a major (around 66%) decrease in their appeal.
METHODS: We performed a Discrete Choice Experiment among a group of Swiss aged ≥18 years via the online recruiting platform Prolific in a convenience sample. Our sample included both non-smokers and smokers. We used a within-subject, alternative-specific block design in a series of choice sets including different smoking products. We fixed the attributes of nicotine content (high or medium) and harmfulness (in years of life lost) for each product. Attributes of interest included price (ranging from CHF 5 to 25 in increments of 5) and flavour (fruity/menthol vs none/tobacco flavour). We performed a conditional logistic regression on the attributes\' influence on the appeal of cigarettes, ENDS and HTS.
RESULTS: A total of 108 out of 153 participants (n = 25 smokers and n = 83 non-smokers, completion rate = 71%) successfully completed our pilot survey experiment. We found that, in general, increasing the price of combustible cigarettes, ENDS and HTS by one standard deviation (around CHF 7) reduced their appeal by approximately 66% (relative risk [RR]: 0.34; 95% CI: 0.28-0.42). Unflavoured alternative nicotine products were found to be less appealing than flavoured products, especially for non-smokers, with a 86% decrease in appeal (RR: 0.14; 95% CI: 0.13-0.16). For non-smokers, an increase in price by one standard deviation was associated with a decrease in the appeal of any product by approximately 19% (RR: 0.81; 95% CI: 0.72-0.92). For smokers, the effect sizes were smaller, but overall, the appeal of all products decreased with increasing prices and reduced flavours.
CONCLUSIONS: Our Discrete Choice Experiment suggests that, for the Swiss context, limiting the availability of flavours for alternative smoking products has the potential to reduce their appeal to non-smokers by 86% and that a small but significant increase in prices to CHF 15 for cigarettes, ENDS and HTS could lead to a major (around 66%) decrease in their appeal.
摘要：
目的：探讨价格和风味可获得性对不同烟草和尼古丁产品吸引力的影响，包括传统香烟，瑞士成年人口中的电子尼古丁输送系统（ENDS）和加热烟草系统（HTS）。
方法：我们通过在线招聘平台Prolific在方便的样本中对一组年龄≥18岁的瑞士人进行了离散选择实验。我们的样本包括非吸烟者和吸烟者。我们使用了一个内部主题，一系列选择集包括不同吸烟产品的替代特定块设计。我们确定了每种产品的尼古丁含量（高或中）和危害性（以寿命损失为单位）的属性。感兴趣的属性包括价格（5至25瑞士法郎，增量为5）和风味（果味/薄荷醇vs无/烟草风味）。我们对属性对香烟吸引力的影响进行了条件逻辑回归，ENDS和HTS。
结果：153名参与者中共有108名（n=25名吸烟者和n=83名不吸烟者，完成率=71%)成功完成了我们的试点调查实验。我们发现,总的来说,提高可燃香烟的价格，ENDS和HTS降低了一个标准差（约7瑞士法郎），使其吸引力降低了约66％（相对风险[RR]：0.34；95％CI：0.28-0.42）。发现无味替代尼古丁产品的吸引力不如调味产品，特别是对于不吸烟者，上诉率下降86%（RR：0.14；95%CI：0.13-0.16）。对于非吸烟者来说，价格上涨一个标准差与任何产品的吸引力下降约19%相关(RR:0.81;95%CI:0.72-0.92).对于吸烟者来说，效果大小较小，但总的来说,随着价格的上涨和口味的减少，所有产品的吸引力都下降了。
结论：我们的离散选择实验表明，在瑞士的背景下，限制替代吸烟产品的口味供应有可能使其对非吸烟者的吸引力降低86％，并且卷烟价格小幅但显着上涨至15瑞士法郎，ENDS和HTS可能导致其吸引力大幅下降（约66％）。
方法：我们通过在线招聘平台Prolific在方便的样本中对一组年龄≥18岁的瑞士人进行了离散选择实验。我们的样本包括非吸烟者和吸烟者。我们使用了一个内部主题，一系列选择集包括不同吸烟产品的替代特定块设计。我们确定了每种产品的尼古丁含量（高或中）和危害性（以寿命损失为单位）的属性。感兴趣的属性包括价格（5至25瑞士法郎，增量为5）和风味（果味/薄荷醇vs无/烟草风味）。我们对属性对香烟吸引力的影响进行了条件逻辑回归，ENDS和HTS。
结果：153名参与者中共有108名（n=25名吸烟者和n=83名不吸烟者，完成率=71%)成功完成了我们的试点调查实验。我们发现,总的来说,提高可燃香烟的价格，ENDS和HTS降低了一个标准差（约7瑞士法郎），使其吸引力降低了约66％（相对风险[RR]：0.34；95％CI：0.28-0.42）。发现无味替代尼古丁产品的吸引力不如调味产品，特别是对于不吸烟者，上诉率下降86%（RR：0.14；95%CI：0.13-0.16）。对于非吸烟者来说，价格上涨一个标准差与任何产品的吸引力下降约19%相关(RR:0.81;95%CI:0.72-0.92).对于吸烟者来说，效果大小较小，但总的来说,随着价格的上涨和口味的减少，所有产品的吸引力都下降了。
结论：我们的离散选择实验表明，在瑞士的背景下，限制替代吸烟产品的口味供应有可能使其对非吸烟者的吸引力降低86％，并且卷烟价格小幅但显着上涨至15瑞士法郎，ENDS和HTS可能导致其吸引力大幅下降（约66％）。
