Herd immunity at what price? Using auctions to estimate what university students must be paid to get the flu vaccine.

There is significant resistance to vaccinations. Fewer than half of adults get a flu shot in the United States in a typical year, and a large minority of Americans say they will not get vaccinated against COVID-19. This resistance to vaccines creates challenges for both public health and the economy. The academic literature needs to consider potential policy solutions that might increase vaccination rates. In this study, we use experimental auctions to estimate how much university students need to be paid in exchange for agreeing to get a flu shot. These were real auctions where winners received compensation to get the flu shot. As found in prior research, the perceived stakes of such auctions incentivize participants to estimate the price at which they would engage in the auctioned behavior - in this instance, receiving a flu shot. We find that 50% require less than $1, and an additional 30% would get vaccinated for a payment of $20 or less. We also use a tobit regression to estimate bids as a function of participants' demographic characteristics. If low levels of compensation increase vaccination rates, this has significant public health implications. The government may be able to achieve higher vaccination rates at a relatively low cost, particularly in comparison with the economic harms caused by illness. This study demonstrates that experimental auctions may be useful for estimating how much a larger, more representative sample would need to be paid in exchange for agreeing to receive flu or COVID-19 vaccinations.

Estimating the price elasticity of demand for JUUL E-cigarettes among teens.

BACKGROUND: The widespread popularity of e-cigarettes, particularly JUUL, has led to an alarming increase in teen nicotine use, reversing a 40-year trend. One key question is how sensitive teens' demand for JUUL is to changes in price. METHODS: We estimate the price elasticity of demand using results from an experimental auction where teen nicotine users and nonusers bid on a JUUL kit. RESULTS: We find that a 10 % increase in price leads to as much as a 24 % reduction in JUUL demand among teens using nicotine, and as much as a 45 % reduction among teens not currently using nicotine. The teens in our study were more price sensitive than older adults who took part in a similar earlier study. CONCLUSIONS: From a public health standpoint, these are promising results. High e-cigarette taxes may dissuade relatively few older adult cigarette smokers from switching to e-cigarettes, but at the same time be highly effective at preventing teens from becoming e-cigarette users in the first place.

Which smokers adopt e-cigarettes and at what price? An experimental estimation of price elasticity of demand and factors correlated with e-cigarette adoption.

E-cigarette use has surged in recent years. Many of these new users are cigarette smokers. It is unclear whether e-cigarette adoption by smokers will lead to improved public health due to uncertainty about whether e-cigarettes help smokers quit using cigarettes and about whether ongoing dual use reduces exposure to toxins. A third source of uncertainty is whether providing cigarette smokers with sample e-cigarettes increases e-cigarette adoption. To provide insight into this final issue, we follow up with cigarette smokers who left an experimental auction with an e-cigarette, contacting them after two weeks, six weeks, and six months to determine which demographic and smoking-related characteristics predict continued e-cigarette use. We find that smokers who have made a serious quit attempt, have been advised to quit smoking, or have previously tried e-cigarettes are significantly more likely to report continued e-cigarette use. Women and smokers from racial and ethnic minority groups are significantly less likely to use e-cigarettes at follow up, as are those who said they would rather quit than switch to e-cigarettes. We also use experimental auction bids to estimate the price elasticity of demand for e-cigarettes, finding that a 10% increase in price results in a 5.6% reduction in quantity demanded. This suggests e-cigarette demand is less price sensitive than some earlier studies have found. While a tax on e-cigarettes can still be an effective tool for reducing e-cigarette demand, the reduction in demand may be smaller than some earlier studies would suggest.

How much is social media worth? Estimating the value of Facebook by paying users to stop using it.

Facebook, the online social network, has more than 2 billion global users. Because those users do not pay for the service, its benefits are hard to measure. We report the results of a series of three non-hypothetical auction experiments where winners are paid to deactivate their Facebook accounts for up to one year. Though the populations sampled and the auction design differ across the experiments, we consistently find the average Facebook user would require more than $1000 to deactivate their account for one year. While the measurable impact Facebook and other free online services have on the economy may be small, our results show that the benefits these services provide for their users are large.

Does Winning an Experimental Auction Change People's Behavior? An Application to E-cigarettes.

Experimental auctions allow researchers to estimate demand for products like e-cigarettes in a non-hypothetical environment where participants face real and immediate consequences for their bids. However, because auction winners actually purchase the product they bid on, participants may be introduced to a product they otherwise would not have discovered. Based on an experimental auction where 432 participants bid to buy e-cigarettes, we found that auction winners are significantly more likely to be using e-cigarettes two weeks, six weeks, and six months after the study but are no less likely to be daily cigarette smokers. This result holds even after controlling for prior e-cigarette use, strength of participants' initial demand for e-cigarettes, and demographic characteristics.

Effect of brand and advertising medium on demand for e-cigarettes: Evidence from an experimental auction.

Print and television advertisements for e-cigarettes are currently legal in the United States. Given that e-cigarettes are a lower-risk alternative to cigarettes, these ads could have a positive public health impact if they motivate smokers to switch to e-cigarettes. However, the public health impact of e-cigarette ads could be negative if ads increase demand for both e-cigarettes and cigarettes. We use experimental auctions -in which participants bid in real auctions and winners pay for the items they purchase - to study the effect of print and TV e-cigarettes ads on demand for the brand from the ad, for another e-cigarettes brand, and for cigarettes. We ran experiments with 288 Pennsylvania smokers in November 2014-March 2015 and we found that in cases where an ad affects demand for e-cigarettes, the ad moves demand for cigarettes in the same direction. For example, the Blu print ad increases demand for Blu e-cigarettes and cigarettes among non-white participants. The Vuse TV ad reduces demand for both types of e-cigarettes and for cigarettes. We also find that non-white participants are willing to pay more for e-cigarettes in the absence of advertising, and that smokers who worry most about their health are willing to pay more for e-cigarettes. The results of this study point to the need for greater scrutiny of advertising for e-cigarette products such that they do not also induce demand for tobacco cigarettes.

Smokers' BMI and perceived health: Does the order of questions matter?

We surveyed 431 daily smokers between November 2014 and March 2015 to examine the impact of the order of questions on the response to a self-reported health question as part of a larger experimental study. We randomized the question order, with some respondents providing their weight prior to self-reporting their health, while others did the opposite. We found that self-reported health outcomes are worse when smokers are first asked to report their weight. However, the order of questions only seems to impact those who are overweight as we did not find evidence that the order of questions affected responses for those with a BMI below 25. These findings suggest that the order of asking self-rated health and weight questions appears to matter, at least for overweight current smokers.

Using Experimental Auctions to Examine Demand for E-Cigarettes.

BACKGROUND: E-cigarettes are the latest in a line of potentially reduced exposure products that have garnered interest among smokers. METHODS: In this paper, we use experimental auctions to estimate smokers' demand for e-cigarettes and to assess the impact of advertisements on willingness to pay. These are actual auctions, with winners and losers, which means hypothetical biases often seen in surveys are minimized. RESULTS: We find smokers have positive demand for e-cigarettes, and that the print advertisements used in our study had greater effectiveness than video ads (b = 2.00, p < .05) in terms of increasing demand for disposable e-cigarettes. Demand was greater for reusable versus disposable e-cigarettes. In multivariate models, demand for e-cigarettes was higher among non-white participants and among smokers willing to pay more for cigarettes. CONCLUSIONS: Our findings suggest that cigarette smokers are interested in e-cigarettes as alternatives to traditional products, particularly for reusable forms, and that this demand can be influenced by messaging/advertising. IMPLICATIONS: Given these reduced harm products are appealing, if smokers are able to switch completely to e-cigarettes, there is a good chance for accrual of significant harm reduction.

The impact of free trial acceptance on demand for alternative nicotine products: evidence from experimental auctions.

OBJECTIVES: This study explored the relationship between product trials and consumer demand for alternative nicotine products (ANP). METHODS: An experimental auction was conducted with 258 adult smokers, wherein participants were randomly assigned to one of four experimental conditions. The participants received the opportunity to try, but did not have to accept, one of three relatively novel ST products (i.e., snus, dissolvable tobacco, or medicinal nicotine), or they were placed into a control group (i.e., no trial). All the participants then bid on all three of these products, as well as on cigarettes. We assessed interest in using ANP based on both trial of the product and bids placed for the products in the experimental auction. RESULTS: Fewer smokers were willing to try snus (44%) than dissolvable tobacco (64%) or medicine nicotine (68%). For snus, we find modest evidence suggesting that willingness to try is associated with greater demand for the product. For dissolvable tobacco or medicinal nicotine, we find no evidence that those who accept the product trial have higher demand for the product. CONCLUSIONS: Free trials of a novel ANP were not strongly associated with product demand, as assessed by willingness to pay. Given the debate over the potential for ANP to reduce the harm from smoking, these results are important in understanding the impact of free trial offers on adoption of ST product as a strategy to reduce harm from tobacco use.

Examining the relationship between psychosocial and behavioral proxies for future consumption behavior: self-reported impact and bidding behavior in an experimental auction study on cigarette labeling.

Experimental and observational research often involves asking consumers to self-report the impact of some proposed option. Because self-reported responses involve no consequence to the respondent for falsely revealing how he or she feels about an issue, self-reports may be subject to social desirability and other influences that bias responses in important ways. In this article, we analyzed data from an experiment on the impact of cigarette packaging and pack warnings, comparing smokers' self-reported impact (four-item scale) and the bids they placed in experimental auctions to estimate differences in demand. The results were consistent across methods; however, the estimated effect size associated with different warning labels was two times greater for the four-item self-reported response scale when compared to the change in demand as indicated by auction bids. Our study provides evidence that self-reported psychosocial responses provide a valid proxy for behavioral change as reflected by experimental auction bidding behavior. More research is needed to better understand the advantages and disadvantages of behavioral economic methods and traditional self-report approaches to evaluating health behavior change interventions.

Estimating demand for alternatives to cigarettes with online purchase tasks.

OBJECTIVES: To explore how advertising affects demand for cigarettes and potential substitutes, including snus, dissolvable tobacco, and medicinal nicotine. METHODS: A Web-based experiment randomized 1062 smokers to see advertisements for alternative nicotine products or soft drinks, then complete a series of purchase tasks, which were used to estimate demand elasticity, peak consumption, and cross-price elasticity (CPE) for tobacco products. RESULTS: Lower demand elasticity and greater peak consumption were seen for cigarettes compared to all alternative products (p < .05). CPE did not differ across the alternative products (p ≤ .03). Seeing relevant advertisements was not significantly related to demand. CONCLUSIONS: These findings suggest significantly lower demand for alternative nicotine sources among smokers than previously revealed.

The impact of product information and trials on demand for smokeless tobacco and cigarettes: evidence from experimental auctions.

INTRODUCTION: Epidemiological and toxicological evidence suggests lower risk of smokeless tobacco (ST) products compared to cigarettes. Less is known, however, about consumer perceptions and use of novel forms of ST, including snus and dissolvable tobacco. METHODS: In this study, we conducted in-person experimental auctions in Buffalo, NY, Columbia, SC, and Selinsgrove, PA with 571 smokers to test the impact of information and product trials on smokers' preferences. Auctions were conducted between November 2010-November 2011. RESULTS: We found no evidence of an impact of product trials on demand in our auctions. Anti-ST information increased demand for cigarettes when presented alone, but when presented with pro-ST information it decreased demand for cigarettes. It did not decrease demand for ST products. Anti-smoking information increased demand for ST products, but did not affect cigarette demand. CONCLUSIONS: These findings suggest that credible and effective communications about tobacco harm reduction should reinforce the negative effects of smoking.

What do consumer surveys and experiments reveal and conceal about consumer preferences for genetically modified foods?

Assessing consumer perceptions and willingness to pay for genetically modified (GM) foods has been one of the most active areas of empirical research in agricultural economics. Researchers over the past 15 years have delivered well over 100 estimates of consumers' willingness to pay for GM foods using surveys and experimental methods. In this review, we explore a number of unresolved issues related to three questions that are critical when considering the sum of the individual contributions that constitute the evidence on consumer preferences for GM foods.

Estimating the impact of pictorial health warnings and "plain" cigarette packaging: evidence from experimental auctions among adult smokers in the United States.

OBJECTIVE: To estimate differences in demand for cigarette packages with different packaging and health warning label formats. METHODS: Adult smokers (n=404) in four states participated in experimental auctions. Participants bid on two of four experimental conditions, each involving a different health warning label format but with the same warning message: (1) text on 50% of pack side; (2) text on 50% of the pack front and back; (3) text with a graphic picture on 50% of the pack front and back; and (4) same as previous format, but without brand imagery. RESULTS: Mean bids decreased across conditions (1: $3.52; 2: $3.43; 3: $3.11; 4: $2.93). Bivariate and multivariate random effects models indicated that there was no statistically significant difference in demand for packs with either of the two text only warnings; however, demand was significantly lower for both packs with prominent pictorial warnings, with the lowest demand associated with the plain, unbranded pack. CONCLUSIONS: Results suggest that prominent health warnings with graphic pictures will reduce demand for cigarettes. Regulators should not only consider this type of warning label, but also plain packaging policies for tobacco products.

Estimating the impact of different cigarette package warning label policies: the auction method.

The study estimated the reduction in demand associated with implementing cigarette package warning labels that contain imagery illustrating the consequences of smoking. The experimental auction method was used, wherein adult smokers in Mexico (n=89) placed separate bids on two packs of cigarettes: one with a text-only warning label and the other with a warning label that included text and a graphic image. Differences in the values attributed to each pack were assessed using t-tests and multivariate regression. The pack with the graphic image had a mean attributed value which was 17% lower ($3.21 pesos) than the pack with the text-only warning, and this difference remained statistically significant within subgroups defined by sociodemographics, amount of smoking, number of quit attempts, and levels of perceived smoking risks. In the multivariate model, the difference in attributed values was greater among females than males, but no such differences were found for other sociodemographic or smoking-related variables. The consistently lower value that smokers attributed to cigarette packages with the graphic warning label indicates that these labels are likely to reduce cigarette demand.

Decomposing the value of cigarettes using experimental auctions.

Using a new brand of cigarettes with less nicotine content than conventional cigarettes, we conducted experimental auctions at two grocery stores to estimate smokers' value of nicotine. Our approach is novel because the brand of cigarettes auctioned was new to the market and the cigarette's nicotine content is reduced using genetic modification, with no effect on the taste of the cigarettes. We found smokers would be willing to pay US$1.25-$1.45 for a pack of cigarettes with no nicotine and $1.59-$1.66 for a pack of cigarettes with low levels of nicotine.