Adolescents’ and adults’ perceptions and intentions to use e-cigarettes following FDA authorization: insights from two survey experiments

Abstract

Background

In 2021, the U.S. Food and Drug Administration (FDA) authorized marketing of the first e-cigarette, Vuse Solo; subsequently, other e-cigarettes and related products were authorized or denied marketing. We examined how FDA authorization affects perceptions of and intentions to use e-cigarettes.

Methods

Cross-sectional survey of N = 6,098 participants 13–40 years old; embedded experiments: (1) Randomized to a statement indicating FDA authorized marketing of Vuse Solo (Treatment) or no statement (Control). Participants reported perceptions of Vuse Solo health harms, benefits, and intentions to use. (2) Viewed a fictional e-cigarette (“NovaStik”) with a brief description, including a randomized statement: NovaStik was “FDA authorized” (Condition 1), “Not FDA authorized” (Condition 2), or “FDA denied” (Condition 3). Participants reported perceptions of NovaStik and intentions to use. T-tests and ANOVAs evaluated differences in responses by condition; multi-variate regression examined differences in treatment effects by sex, age group, and past 30-day tobacco use.

Results

Experiment 1: treatment participants perceived Vuse Solo as less harmful than control participants (p’s < 0.01); there were no differences in perceptions of addictiveness or intentions to use Vuse Solo by condition. Experiment 2: there were statistically significant differences in all NovaStik perceptions and intentions items (p’s < 0.001). Participants in the FDA-authorized condition reported more positive perceptions and intentions compared to those in the “Not Authorized” or “Denied” conditions.

Discussion

Viewing information that e-cigarettes were FDA-authorized was associated with lower perceptions of health harms and higher intentions to use. Findings suggest that stated FDA authorization can have unintended effects on e-cigarette perceptions and intentions.