Public Expectations for E-Cigarette Regulation in China

A Quantitative Study Using the Kano Model

Abstract

Objective To identify the expectation types and priorities of six e-cigarette regulatory policy attributes among adult respondents in a Chinese online sample using the Kano model, and to compare classification differences between users and non-users.

Methods A cross-sectional online survey was conducted. Six policy attributes were measured using standardized Kano dual-item scales. The revised Kano classification matrix was applied, Better-Worse coefficients were calculated with four-quadrant analysis, chi-square tests compared classification distributions between users and non-users, and multinomial logistic regression was performed for the flavor restriction attribute.

Results Age verification and mandatory standards and review emerged as core anchors of policy expectations. Online sales restrictions and packaging warnings exhibited baseline guarantee characteristics; advertising restrictions and flavor restrictions showed significant group differentiation. Four-quadrant analysis grouped the six attributes into a core priority group and an optimization adjustment group, while Kano classification revealed a differentiation pattern of must-be dominant, one-dimensional dominant, and indifferent dominant attributes. Significant classification differences between users and non-users were observed for most attributes, with flavor restriction showing the strongest divergence; usage status was a key factor associated with its classification.

Conclusions The public's expectations for e-cigarette regulatory policies exhibit a two-tier priority structure and multi-dimensional classification features. The two analytical perspectives complement each other, providing empirical reference for differentiated policy design.

Keywords: e-cigarette policy; Kano model; tobacco control; Better-Worse analysis; policy priority; China