Willingness to Change Nicotine Use Behaviors in Response to Price Increases: A Cross-sectional Study of Midwestern University Students

Objective: We examined the willingness of university students who use nicotine products including cigarette smokers, vapers, and dual users to change their consumption behaviors in response to hypothetical price increases and identified predictors. Methods: We conducted a cross-sectional survey from September 2023 to March 2024 at a midwestern university in the United States. A non-probability sample of 278 current nicotine users completed a 20-item questionnaire adapted from the Global Youth Tobacco Survey and prior taxation research. Multivariable logistic regression identified predictors of willingness to quit, reduce use, switch products, or make no change in response to price increases. Results: Vaping was the most common form of use (61%) reported. Overall, 87% expressed willingness to modify behavior: 37% would switch products, 31% would reduce use, and 16% would quit entirely. Older age predicted higher odds of quitting (AOR = 1.12, 95% CI: 1.00-1.25). Female (AOR = 3.17, 95% CI: 1.64-6.12) and white participants (AOR = 2.48, 95% CI: 1.14-5.39) were more likely to reduce use, while longer nicotine use history predicted lower odds of quitting. Conclusions: Most students reported modifying their behavior in response to price increases, although few intended to quit, highlighting the complexity of price sensitivity among young adults.