“Don’t Know” Responses for Nicotine Vaping Product Features among Adult Vapers: Findings from the 2018 and 2020 ITC Four Country Smoking and Vaping Surveys.

Introduction:
This article examines the responses of current vapers who chose "don't know" (DK) when asked about features of their nicotine vaping products (NVPs) in the 2018 and 2020 ITC Four Country Smoking and Vaping Surveys. The study aims to determine who chooses DK and whether DK for NVP features has implications for knowledge of addiction and relative health risks of NVP use. The analysis includes data from 4192 vapers in 2018 and 3894 vapers in 2020.

Key Points:

* DK responses for NVP features differed by vaping/smoking status, NVP description, NVP appearance, purchase location, and country.
* DK for brand was lowest among daily users, particularly exclusive daily vapers, and highest among nondaily users.
* DK for capacity was high even among exclusive daily vapers (26.9-31.9%).
* DK for nicotine content differed by vaping/smoking status, NVP description, NVP appearance, and purchase location.
* DK for consumption differed by vaping/smoking status, NVP description, and purchase location.
* DK index scores differed by vaping/smoking status, NVP description, NVP appearance, and purchase location.
* DK index scores were not correlated with the number of variables for which a vaper had missing data.
* DK for nicotine content was associated with DK for NVP relative addictiveness in 2018 and 2020.

Main Message:
The diversity of the NVP market and wide variation in how products are used makes it challenging to capture information from users about device features, such as nicotine content and capacity, in population surveys. DK responses to questions about NVP features generally differed by vaping and smoking status, NVP type, purchase location, and country. DK for nicotine content was associated with DK for NVP relative addictiveness, demonstrating a concerning implication for lacking awareness about NVP features. It is important to ensure vapers are aware of their NVP features, as those who were better informed were also more aware of the relative risks of NVPs compared to cigarettes.

Felicione NJ, Cummings KM, Gravely S, et al. “Don’t Know” Responses for Nicotine Vaping Product Features among Adult Vapers: Findings from the 2018 and 2020 ITC Four Country Smoking and Vaping Surveys. International journal of environmental research and public health. 2021;18(15). doi:10.3390/ijerph18157928