Flavor and product messaging are the two most important drivers of electronic cigarette selection in a choice-based task

Introduction: Electronic cigarette (“eCig”) use – vaping – is increasingly popular. Factors like flavor, nicotine level, and device style may influence an individual’s decision to use eCigs. Here, we use choice-based conjoint analysis to quantify factors that drive acceptability of eCigs in adults, including flavors, device style, customizability, nicotine level, and use of eCigs for weight/appetite control or to manage food craving. Methods: Individuals who vaped at least twice in the past year completed a series of choice-based conjoint tasks online. They also completed the Penn State Electronic Cigarette Dependence Inventory (PSECDI) and a subset of questions from the Wisconsin Inventory of Smoking Dependence Motives (WISDM-68) that had been modified to ask about eCigs. Conjoint analysis was used to determine the utility scores of each attribute, and participants were split by gender to assess differences in attribute importance. Results: 587 participants who vaped at least once per week were included in analyses. In conjoint analysis, Flavor was the most important attribute (48.13%), followed by product messaging (21.04%) and nicotine level (15.28%). Within the Flavor attribute, confectionery and fruit flavors had the highest utility scores, while classic menthol and tobacco flavors had the lowest. Men and women differed in the flavors, nicotine levels, and product messaging that appealed most to them. Conclusions: Flavor is the most important factor in eCig appeal. Gender is also a factor in whether a specific product appeals to an individual. Understanding why individuals choose particular eCig products should help inform public health efforts and policy making. Implications: Use of eCigs is rapidly growing. Although perhaps less risky than smoking combustible cigarettes, vaping still presents substantial risk, both for nicotine addiction and overall health. Accordingly, to provide a foundational evidence base for the potential regulation of these devices, it is critical to develop a better understanding of the role of various product attributes play in the selection and use of electronic cigarette products.