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Standardized packaging may reduce the appeal of e-cigarettes for potential young users, while still maintaining their appeal among adults trying to quit smoking, a survey study from Great Britain suggested.

Youths ages 11 to 18 had significantly higher odds of reporting no interest among their peers in trying e-cigarettes that had standardized green packaging compared with branded packaging (35.8% vs 28.7%; adjusted OR 1.37, 95% CI 1.10-1.71, P=0.005), reported Eve Taylor, MSc, of King's College London, and co-authors.

However, this was not significant when youths were shown white standardized packaging versus branded packaging (aOR 1.16, 95% CI 0.93-1.44, P=0.20), they noted in .

Adult consumers, on the other hand, had lower odds of reporting no interest in trying the green-packaged e-cigarettes (aOR 0.85, 95% CI 0.73-0.99, P=0.046), and not the white-packaged e-cigarettes (aOR 1.05, 95% CI 0.89-1.23, P=0.59), compared with branded packaging.

Notably, youths who had never vaped or smoked were more likely to report no interest in trying e-cigarettes in green packaging compared with branded packaging (never vaped: aOR 1.34, 95% CI 1.07-1.69, P=0.01; never smoked: aOR 1.38, 95% CI 1.10-1.75, P=0.006).

"The findings of this survey study suggest that reducing brand imagery through standardized e-cigarette packaging is associated with decreased appeal of e-cigarette products among youths, specifically never smokers and never vapers, without reducing its appeal among adult smokers," Taylor and team concluded.

"e-Cigarette marketing, including packaging, has been found to influence the appeal of vaping products to youth and adult smokers," they wrote. "e-Cigarette packaging varies substantially, with several brands featuring vibrant colors to promote products. Such marketing techniques are the same as those previously used by tobacco companies; marketing via packaging is particularly prominent in jurisdictions where marketing via other forms, such as mass media, has been restricted."

Great Britain does not allow the sale of e-cigarettes or tobacco products , and all products must be by the Medicines and Healthcare products Regulatory Agency before they can be sold.

Last April that allowed the FDA to regulate tobacco products containing nicotine, regardless of the source. Products containing non-tobacco nicotine cannot be sold to consumers under the age of 21, cannot be given as free samples, and cannot be sold as "modified risk tobacco products" without the authorization of the FDA. At the time, companies making these products needed to seek FDA authorization.

While Taylor and colleagues noted that countries with different regulations than Great Britain would likely see different results on similar surveys, they stressed the importance of research regarding e-cigarettes.

"Future research should examine the association of standardized packaging with perceptions of vaping, specifically perceptions of vaping as effective smoking cessation," they wrote.

Taylor and team used the youth and adult versions of the 2021 Action on Smoking and Health Smokefree Great Britain online survey. A total of 2,469 youth participants were included. Mean age was 15 years, and 52.1% were girls. The adult cohort included 12,046 adults; mean age was 49.9, and 53.2% were women.

Participants were randomly assigned to look at a set of three e-cigarette packs from one of three different packaging designs: fully branded packs, white standardized packs with brand name, or green standardized packs with brand name.

The green packaging was given an olive green color to mimic a similar standardized packaging for traditional cigarettes, while the white was chosen based on previous data showing that tobacco products in light-colored packaging were sometimes seen as less harmful by consumers.

Among the youth participants, 38.2% stated that their peers would likely be interested in any of the products, 32.2% stated their peers would have no interest in any of the products shown, and 29.6% said that they were unsure which of the product types would be of interest to others their age.

Among the adults, 7.9% reported that they were interested in trying any of the products, 87.7% reported no interest in trying any of the products, and 4.4% reported that they did not know which of the products they would be most interested in trying.

Taylor and colleagues noted that there were some differences in wording between the youth and adult versions of the survey, which was a study limitation. In addition, their findings were limited to those in Great Britain, and may not be generalizable to other countries.

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