E-cigarette price sensitivity among middle- and high-school students: evidence from monitoring the future

Aims We estimated associations between e-cigarette prices (both disposable and refill) and e-cigarette use among middle and high-school students in the United States. We also estimated associations between cigarette prices and e-cigarette use. Design We used regression models to estimate the associations between e-cigarette and cigarette prices and e-cigarette use. In our regression models, we exploited changes in e-cigarette and cigarette prices across four periods of time and across 50 markets. We report the associations as price elasticities. In our primary model, we controlled for socio-demographic characteristics, cigarette prices, tobacco control policies, market fixed effects and year-quarter fixed effects. Setting United States of America. Participants A total of 24370 middle- and high-school students participating in the Monitoring the Future Survey in years 2014 and 2015. Measurements Self-reported e-cigarette use over the last 30 days. Average quarterly cigarette prices, e-cigarette disposable prices and e-cigarette refill prices were constructed from Nielsen retail data (inclusive of excise taxes) for 50 US markets. Findings In a model with market fixed effects, we estimated that a 10% increase in e-cigarette disposable prices is associated with a reduction in the number of days vaping among e-cigarette users by approximately 9.7% [95% confidence interval (CI)=-17.7 to 1.8%; P=0.02] and is associated with a reduction in the number of days vaping by the full sample by approximately 17.9% (95% CI=-31.5 to -4.2%; P=0.01). Refill e-cigarette prices were not statistically significant predictors of vaping. Cigarette prices were not associated significantly with e-cigarette use regardless of the e-cigarette price used. However, in a model without market fixed effects, cigarette prices were a statistically significant positive predictor of total e-cigarette use. Conclusions Higher e-cigarette disposable prices appear to be associated with reduced e-cigarette use among adolescents in the US.