BACKGROUND: The European Union (EU) issued its most recent tobacco product regulation recommendation in November 2022, expanding smoking restrictions to emerging nicotine products. This recommendation bans products that contain characterising flavours and packaging designed to alter the sensory experience. This study examines the perceptions of e-cigarettes and heated tobacco products (HTPs) among never-tobacco and nicotine users, and how these perceptions vary across socioeconomic subgroups, aiming to inform the EU’s efforts to refine its regulatory framework.
METHODS: We conducted a cross-sectional analysis of the Special Eurobarometer 99.3 (May-June 2023) across the EU among never-tobacco and nicotine users (n=13436). We estimated the weighted prevalence of four perceptions of e-cigarettes and HTPs: appeal, perceived effectiveness in aiding smoking cessation, views on whether they should be regulated like cigarettes, and support for keeping them out of sight in retail settings. Multi-level Poisson regression models, adjusted for sociodemographic factors, examined associations with perceptions of emerging nicotine products.
RESULTS: Perceptions of e-cigarettes and HTPs varied across EU Member States (MS) and societal groups. Men and younger age groups were more likely to find these products appealing. While younger age groups viewed these products as effective aids for smoking cessation, students, housepersons, and retirees were less convinced. In contrast, women, those with higher education, those without financial difficulty, and those living with children were supportive of regulating e-cigarettes and HTPs as strictly as cigarettes and keeping them out of sight in retail settings.
CONCLUSIONS: Our findings reveal variations in perceptions of e-cigarettes and HTPs across EU MS and population subgroups. These insights can guide the EU's regulatory updates, particularly in light of the recent revision of smoke-free environment guidelines, helping MS design targeted policies that engage relevant groups, increase public support for regulation, and prevent the uptake of these products among never-users.