Delay Discounting and Smokers' E-cigarette Preferences

Existing literature shows that delay discounting, a type of decision-making biases, is associated with cigarette smoking. However, very limited evidence exists on how delay discounting is associated with e-cigarette preferences among smokers. If delay discounting is a factor for transitions from smoking to vaping, decision-making biases may further exacerbate health disparities by encouraging those who are less subject to decision-making biases to quit smoking using e-cigarettes. To study how delay discounting is associated with e-cigarette preferences and smokers’ interest in trying, we conducted a discrete choice experiment (DCE) using a sample of adult smokers who also participated in the 2016 and 2017 Georgia State University Tobacco Products and Risk Perceptions Surveys. In this experiment, delay discounting was assessed using multiple price lists (MPL) with hypothetical monetary tradeoff payment between a smaller reward awarded today and a larger reward in the future (e.g. $19 today vs. $20 awarded 5 weeks from today). Both the magnitude of delay discounting (discount rates) and hyperbolic discounting that suggests present biases were measured or identified. In the DCE, other important attributes, including prices, flavors, cessation efficacy, relative risks, and nicotine strength were varied across choice tasks. Conditional regression results further show that while the e-cigarette attributes and demographics such as ages drive the preferences for e-cigarettes, decision-making biases measured as discount rates and hyperbolic discounting were not significantly associated with preferences for e-cigarettes among smokers. These preliminary results indicate that, although smokers are more likely to have decision-making biases compared with non-smokers, these biases may not affect their transition into e-cigarettes. The results further show that smokers prefer e-cigarettes that pose less health risks than cigarettes, are effective in helping quitting, cheaper, and tobacco flavored, and have a lower nicotine strength. Information and policies encourage smokers to completely switch to e-cigarettes therefore hold the potential to reduce smoking and achieve welfare gains.