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ChengK- W, etal. Tob Control 2020;0:1–4. doi:10.1136/tobaccocontrol-2019-055344
Costs of vaping: evidence from ITC Four Country
Smoking and VapingSurvey
Kai- Wen Cheng ,1,2 Ce Shang,3 Hye Myung Lee,2 Frank J Chaloupka,2
Geoffrey T Fong ,4,5 Ron Borland ,6,7 Bryan W Heckman ,8,9
Sara C Hitchman ,10 Richard J O’Connor,11 David T Levy ,12
K. Michael Cummings 8,9
Original research
To cite: ChengK- W,
ShangC, LeeHM, etal.
Tob Control Epub ahead of
print: [please include Day
Month Year]. doi:10.1136/
tobaccocontrol-2019-055344
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For numbered affiliations see
end of article.
Correspondence to
Dr Kai- Wen Cheng, Department
of Health Administration,
Governors State University,
University Park, IL 60466, USA;
kcheng@ govst. edu
Received 21 August 2019
Revised 12 November 2019
Accepted 19 November 2019
© Author(s) (or their
employer(s)) 2020. Re- use
permitted under CC BY- NC. No
commercial re- use. See rights
and permissions. Published
by BMJ.
ABSTRACT
Study objectives To compare the prices paid for
nicotine vaping products (NVPs) and supplies among
current NVP users to prices paid for cigarettes among
current smokers.
Data The 2016 International Tobacco Control Four
Country Vaping and Smoking Survey (4CV1). Key
measures included: (1) self- reported prices paid for
reusable NVPs (eg, rechargeable devices with cartridges
and tank system devices with e- liquids) in the 3- month
period prior to the survey among current NVP users, (2)
prices paid for disposable NVPs, cartridges and e- liquids
purchased in the last 30 days among current NVP users
and (3) self- reported prices paid for cigarettes among
current smokers.
Results Disposable NVP price was higher than the
price of a comparable unit for combustible cigarettes in
England (EN), USA and Canada (CA). Prefilled cartridge
price was higher than the price of a comparable unit of
cigarettes in USA and CA, but lower in EN and Australia.
E- liquid price was consistently lower than the price of
a comparable unit of cigarettes across four countries.
For start- up costs, price of a rechargeable device is
approximately 3–5 times higher than a pack of cigarettes
in four countries.
Conclusion NVP prices were generally higher
than prices of combustible cigarettes, especially the
high upfront NVP devices. The high upfront costs of
purchasing a reusable NVP may discourage some
smokers from switching to vaping. However, the average
lower costs of cartridges and e- liquids relative to a
package of cigarettes make switching to a NVP an
attractive alternative to smoking in the long term so long
as smokers switch completely to vaping.
INTRODUCTION
While cigarettes are the most frequently used nico-
tine product among adults around the world, use
of non- cigarette nicotine products and multiple
products is growing in popularity.1 Among the non-
cigarette nicotine products, nicotine vaping prod-
ucts (NVPs), a vaping device or vaporiser delivering
nicotine in vapour or aerosol form, have gained
substantial global market share. In 2017, North
America was the largest NVP product market in the
world, followed by Western Europe, led by the UK,
Eastern Europe, Asia Pacific and then the rest of
the world.2 In 2018, global sales of NVP reached
US$13 billion and are expected to continue their
rapid growth over the coming years.2 An estimated
35 million people were NVP users in 2016, a
number projected to grow to 55 million by 2021.2
Several factors may be driving the growing popu-
larity of NVPs. Among them, the relatively lower cost
of vaping compared with smoking is thought to be
a key factor. Recent evidence suggests that NVP use
and sales are price- sensitive, such that an increase of
NVP price is associated with a decrease in NVP sales
and use prevalence.3–7 In addition to being sensitive
to its own price, NVP sales and use are sensitive to the
prices of other nicotine products. A change in relative
prices among nicotine products, such as cigarettes,
cigars, NVPs (disposable, open system device, closed
system device) may lead users to switch to using the
alternatives with lower prices.3–5
The relative price of NVPs compared with ciga-
rettes is likely an important factor in driving growth
of NVPs. However, limited empirical work has
measured and described the prices of NVP products
compared with cigarettes in different markets. A
review of global data found that NVP users’ impres-
sions of cost were inconsistent such that some
thought NVPs saved money while others believed
that NVPs cost more money.8 Jackson et al9 used
England household survey and found the expen-
diture on nicotine products among NVP users is
approximately one third of the expenditure among
cigarette smokers.9
Liber et al (2017) used data from multiple coun-
tries and comparing prices of NVPs with respect to
combustible cigarettes. They found that global NVP
prices are generally much higher than those of ciga-
rettes, while e- liquids (mL) cost less, particularly in
high- income countries.
For the US study, most of the data on cigarette
and NVP prices comes from Nielsen Scanner
Track where studies show the trends in NVP prices
have decreased between 2012 and 2016 and the
price gaps for NVP devices and cigarettes has
narrowed.3 10 11
Liber et al (2017) used Euromonitor Interna-
tional data which provides only a selected sample
of NVP product prices, and it is uncertain whether
their prices for disposable NVPs and e- liquids can
be representative of all product prices in each
country.12 Nielsen Scanner Track data have the sales
information from participating retailers, which only
reflects about 1/3 or less of the NVP purchases.13
Our study extends previous studies reporting
on the price of NVPs by using the self- reported
prices of NVPs and cigarettes from NVP users
and smokers in the four countries (Australia (AU),
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Original research
Table 1 Average price of cigarettes and nicotine vaping products without outliers, 95% CI in brackets, dollar amount in local currency
Cigarette
(per stick)
Disposable
(per stick)
E- liquid Cartridge
E- liquid
(per ml)
Rechargeable
(per device)
Cartridge
(per mL)
Rechargeable
(per device)
Australia $0.91 (0.89 to 0.93) $9.90 (4.21 to 15.59) $0.47 (0.44 to 0.50) $85.61 (79.36 to 91.85) $2.23 (0.31 to 4.15) $57.59 (41.71 to 73.48)
Canada $0.49 (0.48 to 0.50) $11.84 (9.09 to 14.60) $0.85 (0.71 to 0.98) $58.20 (52.84 to 63.57) $3.84 (3.17 to 4.51) $38.16 (33.64 to 42.68)
England £0.41 (0.40 to 0.42) £8.93 (6.68 to 11.17) £0.34 (0.32 to 0.37) £25.10 (23.16 to 27.04) £1.67 (1.42 to 1.92) £16.86 (15.28 to 18.44)
USA $0.39 (0.37 to 0.41) $14.85 (11.06 to 18.63) $0.91 (0.75 to 1.04) $44.81 (39.73 to 49.60) $3.49 (2.94 to 4.03) $34.16 (29.62 to 38.69)
Canada (CA), England (EN) and the USA), which represents a
majority of global NVP sale. Using self- reported prices allows
us collect prices of NVPs obtained from different purchase loca-
tions (eg, retailers, vape shops and online). Our study aims to (1)
assess the unit comparable prices of NVPs, by standardising the
self- reported nicotine content/volume in different types of NVPs
and (2) assess the upfront cost of rechargeable NVP device.
METHODS
Data
Data were obtained from the international tobacco control (ITC)
Four Country Smoking and Vaping Survey Wave 1 (2016) (ITC
4CV1). Details about this survey can be found in Thompson et
al (2019).14
The ITC 4CV1 Survey provided information on self- reported
prices of reusable vaping devices (eg, rechargeable devices with
cartridges and tank system devices with e- liquids) among the ever
NVP users who purchased a vaping device in the past 3 months.
The survey also provided information on self- reported prices of
disposable NVPs, cartridges and e- liquids among the ever NVP
users who had purchased any disposable, cartridges and/or e- liquid
in the last 30 days. Current smokers who reported using factory-
made cigarettes provided their cigarette price information.
After removing outliers (±2 SD from the mean; n=152(2%)
for the removed price outliers and n=53 (4%) for the removed
NVP device price outliers), our final sample size is 9125 for ciga-
rette price, disposable price, e- liquid price, cartridge price and
1200 for rechargeable device with cartridges and tank system
device with e- liquids for AU, CA, EN and USA (online supple-
mentary tables A-1 and A-2).
Measures
Cigarette prices per stick
Current smokers who smoked and purchased combustible
and factory- made cigarettes were asked in which form they
purchased cigarettes: by the stick, pack, carton or bag. Based
on these purchase forms as well as the reported number of ciga-
rettes per pack, carton or bag, price per stick was calculated. A
small number of respondents (AU=4, CA=6, EN=14, USA=15)
reported that they purchased factory- made cigarette loose out of
packs. For those who purchased loose cigarettes, cigarette prices
were divided by the number of cigarettes purchased.
NVP prices
Current NVP users who purchased a reusable vaping device
(eg, replaceable prefilled cartridges and tank system filled with
liquids) in the last 3 months were asked to report the price for
the rechargeable device (rechargeables with cartridges and tank
systems with e- liquids).
NVP users who used prefilled cartridges most/last and
answered that they had made a purchase in the last 30 days were
asked to report price per cartridge. NVP users who answered
that they used tanks filled with liquid most/last were asked to
report price per bottle of e- liquid. Those who used disposables
most/last were asked to report the price per disposable NVP.
Capacity of e-liquid bottles and prefilled cartridges
For e- liquid bottles and prefilled cartridges, capacity/volume was
reported in millilitres (continuous variable) by users. Price per
bottle (or cartridge) was divided by the capacity/volume (ml) of
each bottle (or cartridge) in order to obtain the price per mL of
e- liquid (or cartridge).
Comparable price measures
We used the unit- standardised approaches suggested by Liber et
al (2017) to standardise NVP prices to a comparable unit, with
prices per pack of 20 cigarettes as an anchor. A single stick of
disposable NVP is a comparable unit for a pack of cigarettes, as
previous studies identified that a single stick of disposable NVP
produced a comparable number of puffs to a pack of combustible
cigarettes (150 puffs).15 16 For e- liquids, 3.55 mL is a comparable
unit for a pack of cigarettes, as its consumption time was equal
to the time in which typical pack- per- day smokers consume their
normal daily ratio of cigarettes.17 18 Using similar logic to calcu-
late a comparable unit for cartridges, the cartridge’s volume/
capacity is taken into account and a cartridge with 3.55 mL is
considered equivalent to a pack of 20 cigarettes.
Price ratio
Using this comparable unit standard, such that one pack of
cigarettes was considered to represent the equivalent level of
consumption as one disposable, 3.55 mL of e- liquid or 3.55 mL of
cartridge,19 three types of price ratios were generated with stan-
dardised cigarette price as the base: price ratios of disposables to
cigarettes, e- liquids to cigarettes and cartridges to cigarettes.
RESULTS
Prices for rechargeable devices
The average prices of e- liquid rechargeable device were AUD
85.61 (US$63.65), CAD 58.20 (US$43.92), £25.10 (US$33.87)
and US$44.81, in AU, CA, EN and the USA, respectively. The
average prices of rechargeable devices for cartridges were AUD
57.59 (US$42.81), CAD 38.16 (US$28.80), £ 16.86 (US$22.75)
and US$34.16, in AU, CA, EN and the USA, respectively. The
2016 currency exchange rate from OECD exchange rate data-
base was used to obtain device prices in US$ (table 1).
Price ratio: comparable prices for disposables, e-liquids and
cartridges
In AU, price ratios were 0.54 for disposables, 0.09 for e- liquid and
0.43 for cartridges. Interestingly, cigarettes were more expensive
than any NVP products in AU. In CA, the ratios were 1.21, 0.31
and 1.39, respectively. In EN, they were 1.09, 0.15 and 0.72,
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ChengK- W, etal. Tob Control 2020;0:1–4. doi:10.1136/tobaccocontrol-2019-055344
Original research
Table 2 Average price per comparable unit of cigarettes and nicotine vaping products, dollar amount in local currency
Cigarette (per pack) Disposable (per stick) E- liquid (for 3.55 mL) Cartridge (for 3.55 mL)
Australia $18.20 (17.80–18.60) $9.90 (4.21–15.59) $1.67 (1.56–1.78) $7.92 (1.10–14.73)
Canada $9.80 (9.60–10.00) $11.84 (9.09–14.60) $3.02 (2.52–3.48) $13.63 (11.25–16.01)
England £8.20 (8.00–8.40) £8.93 (6.68–11.17) £1.21 (1.14–1.31) £5.93 (5.04–6.82)
USA $7.80 (7.40–8.20) $14.85 (11.06–18.63) $3.23 (2.66–3.69) $12.39 (10.44–14.31)
Figure 1 Price ratios using cigarette price as the base: price ratios of
cigarettes to cigarettes, disposables to cigarettes, e- liquids to cigarettes
and cartridges to cigarettes in AU, CA, EN, and USA, respectively.
What this paper adds
What is already known on this subject
►Use of non- cigarette nicotine products and multiple products
are growing in popularity around the world.
►Nicotine vaping product (NVP) use and sales are sensitive to
its own price and also the prices of other nicotine products.
What important gaps in knowledge exist on this topic
►Limited empirical work has measured and described the
prices of NVP products compared with cigarettes in different
markets.
What this paper adds
►NVP prices were generally higher than prices of combustible
cigarettes, especially the high upfront NVP devices that may
discourage some smokers from switching to vaping.
►However, the average lower costs of cartridges and e-
liquids relative to a package of cigarettes makes completely
switching to a NVP an attractive alternative to smoking in the
long term.
respectively. CA and EN showed similar relative prices, except
cartridges were more expensive than cigarettes in CA, while in
EN cartridges were cheaper than cigarettes. In the USA, price
ratios were 1.90, 0.41 and 1.59, respectively. Generally, USA had
the highest relative prices for disposable NVPs and cartridges
among the four countries, with disposable NVPs nearly twice as
expensive as conventional cigarettes (table 2 and figure 1).
DISCUSSION
This study provides the first evidence using self- reported prices
paid for NVP devices and supplies compared with cigarettes in
four countries. In general, we found price of disposable NVPs
to be higher than the price of a comparable unit for combustible
cigarettes in EN, USA and CA. Price of prefilled cartridges is
higher than the price of a comparable unit of combustible ciga-
rettes in USA and CA. By contrast, price of e- liquid is lower than
the price of a comparable unit of combustible in all four coun-
tries. In AU, price of all NVP types is consistently lower than the
price of a comparable unit of combustible, in part due to the very
high cigarette prices there.
For startup costs, the cost of purchasing a rechargeable NVP
with refilled cartridges or e- liquids is approximately 3–5 times
higher than purchasing a pack of cigarettes across all four
countries. For an average daily smoker who smokes around 15
cigarettes per day (CPD), it takes the equivalent of around 7
packs of 20 cigarettes to pay for the device, meaning the cost of
purchasing a rechargeable device could be recovered in approx-
imately 9–10 days.
In addition, our data indicate that while the startup price of
using rechargeable NVPs is relatively high, once the starter kit is
purchased, the additional cost for prefilled cartridges or bottles
of e- liquids may be a financially attractive alternative to factory-
made cigarettes, especially for smokers from AU and EN. The high
upfront costs of purchasing a reusable NVP may discourage some
smokers from switching to vaping. However, the average lower
costs of cartridges and e- liquids relative to a package of cigarettes
makes switching to a NVP an attractive alternative to smoking in
the long term so long as smokers switch completely to vaping.
The findings from this study underscores the importance of
policy makers considering how policies they implement might
impacting the relative price differential between NVPs and ciga-
rettes. For example, policies that restrict where NVPs are sold
could inadvertently increase the cost of NVPs relative to ciga-
rettes making NVPs less attractive as cigarette substitutes. Regu-
lators should consider tax systems for NVPs which imposes taxes
high enough to discourage initiation among young people, but
also keep the prices of NVPs low relative to the costs of ciga-
rettes which pose a greater risk to health.20
This study does have several limitations that needed to be
considered when interpreting the findings. First, our price
data came from the single year of 2016. Some of the price data
reported in this study when broken down by country and type
of product purchased are based on relatively small samples of
users which may yield unreliable price estimates. Second, this
study only examined factory- made cigarette prices and does not
take into account that many smokers report being able to obtain
cigarettes at cheap prices, such as through the use of (roll your
own) RYO.21 Thus, the price benefits from switching to NVPs for
RYO smokers are likely less than for smokers of factory- made
cigarettes. Third, NVP prices were standardised to a comparable
and equivalent unit for nicotine volume, but the standardised
nicotine unit does not imply that the delivered nicotine level is
equivalent or that the nicotine salts are relevant across products.
Future studies may benefit from complementing NVP prices
from multiple data sources and using larger- scale and longitu-
dinal data to explore the impact of relative prices on changes in
use patterns between cigarettes and NVPs.
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4ChengK- W, etal. Tob Control 2020;0:1–4. doi:10.1136/tobaccocontrol-2019-055344
Original research
CONCLUSION
NVP prices were generally higher than prices of combustible
cigarettes, especially the high upfront NVP devices, which
may create for current smokers a barrier to switching to NVPs.
However, the average lower costs of e- liquids relative to a
package of cigarettes makes switching to a NVP an attractive
alternative to smoking in the long term so long as smokers
switch completely to vaping. Our study is relevant for policy-
makers who are considering policies that could impact the cost
of NVPs such as excise taxes. We suggest that, while taxes should
be set high enough to discourage the initiation of any nicotine
products among nonusers, the tax rates applied on combustible
and NVPs should be differentiated, creating a price advantage
for NVPs relative to combustible cigarettes.
Author affiliations
1Department of Health Administration, Governors State University, University Park,
Illinois, USA
2Health Policy Center, Institute for Health Research and Policy, University of Illinois at
Chicago, Chicago, Illinois, USA
3Department of Pediatrics and Oklahoma Tobacco Research Center, University of
Oklahoma Stephenson Cancer Center, Oklahoma City, Oklahoma, USA
4Department of Psychology and School of Public Health and Health Systems,
University of Waterloo, Waterloo, Ontario, Canada
5Ontario Institute for Cancer Research, Toronto, Ontario, Canada
6School of Psychological Sciences, University of Melbourne, Melbourne, Victoria,
Australia
7Cancer Council Victoria, Melbourne, Victoria, Australia
8Psychiatry and Behavioral Sciences, Medical University of South Carolina,
Charleston, South Carolina, USA
9Hollings Cancer Center, Medical University of South Carolina, Charleston, South
Carolina, United States
10Department of Addictions, Institute of Psychiatry, Psychology & Neuroscience,
King’s College London, London, UK
11Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, New York,
USA
12Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown
University, Washington, District of Columbia, USA
Contributors K- WC wrote the original manuscript, conducted the empirical
analysis and revised the manuscript. CS provided valuable insight on the analysis.
HML managed the data and conducted statistical run. The other authors all took an
active role in developing the original ideas for the study, critiquing the analysis and
revising the manuscript.
Funding The ITC Four Country Smoking and Vaping Wave 2 Survey was
supported by grants from the US National Cancer Institute (P01 CA200512) and
the Canadian Institutes of Health Research (FDN-148477). The ITC Australia
Project was supported by National Health and Medical Research Council of
Australia (APP1106451). Additional support was provided to BWH by National
Institute on Drug Abuse (NIDA) of the National Institutes of Health (K23
DA041616) and to GTF from a Senior Investigator Award from the Ontario
Institute for Cancer Research.
Competing interests KMC has received grant funding from Pfizer, Inc. to study
the impact of a hospital- based tobacco cessation intervention. KMC also receives
funding as an expert witness in litigation filed against the tobacco industry. GTF
has served as an expert witness on behalf of governments in litigation involving the
tobacco industry.
Patient consent for publication Not required.
Ethics approval The survey protocols and all materials, including the survey
questionnaires, were cleared for ethics by Institutional Review Board, Medical
University of South Carolina; Research Ethics Office, King’s College London, UK;
Office of Research Ethics, University of Waterloo, Canada and Human Research
Ethics, Cancer Council Victoria, Australia.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request. The data
are public. The authors will make these data available to all who request it.
Open access This is an open access article distributed in accordance with the
Creative Commons Attribution Non Commercial (CC BY- NC 4.0) license, which
permits others to distribute, remix, adapt, build upon this work non- commercially,
and license their derivative works on different terms, provided the original work is
properly cited, appropriate credit is given, any changes made indicated, and the use
is non- commercial. See:http:// creativecommons. org/ licenses/ by- nc/ 4. 0/.
ORCID iDs
Kai- WenCheng http:// orcid. org/ 0000- 0002- 5508- 2280
Geoffrey TFong http:// orcid. org/ 0000- 0001- 9098- 6472
RonBorland http:// orcid. org/ 0000- 0003- 0059- 178X
Bryan WHeckman http:// orcid. org/ 0000- 0003- 4148- 2467
Sara CHitchman http:// orcid. org/ 0000- 0001- 6155- 6916
David TLevy http:// orcid. org/ 0000- 0001- 5280- 3612
K. MichaelCummings http:// orcid. org/ 0000- 0002- 7103- 7017
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