Adolescents’ and adults’ perceptions of ‘natural’, ‘organic’ and ‘additive-free’ cigarettes, and the required disclaimers

We sought to investigate adolescents’ and adults’ perceptions of an American Spirit advertisement with “natural,” “organic,” and “additive-free” descriptors and related disclaimers

Communicating about cigarette smoke constituents: an experimental comparison of two messaging strategies

Federal law now requires FDA to disseminate information on chemicals in cigarette smoke, but it is unclear how best to do so. In a 2 × 2 between-subjects experiment, participants received a message about chemicals in cigarette smoke (e.g., “Cigarette smoke has benzene.”) along with an additional randomly assigned messaging strategy: a “found-in” (e.g., “This is found in gasoline.”), a health effect (e.g., “This causes heart disease.”), both, or neither. Participants were U.S. probability phone samples of 5000 adults and 1123 adolescents, and an online convenience sample of 4130 adults. Adding a health effect elicited greater discouragement from wanting to smoke cigarettes (all p < .05) as did adding a found-in (all p < .05). However, including both messaging strategies added little or nothing above including just one. These findings can help the FDA and other agencies develop effective and parsimonious messages about cigarette smoke constituents

Brand switching and toxic chemicals in cigarette smoke: A national study

US law requires disclosure of quantities of toxic chemicals (constituents) in cigarette smoke by brand and sub-brand. This information may drive smokers to switch to cigarettes with lower chemical quantities, under the misperception that doing so can reduce health risk. We sought to understand past brand-switching behavior and whether learning about specific chemicals in cigarette smoke increases susceptibility to brand switching

Public understanding of cigarette smoke constituents: three US surveys

The Tobacco Control Act requires public disclosure of information about toxic constituents in cigarette smoke. To inform these efforts, we studied public understanding of cigarette smoke constituents

Interest in "organic," "natural," and "additive-free" cigarettes after hearing about toxic chemicals in cigarette smoke.

INTRODUCTION:The US Family Smoking Prevention and Tobacco Control Act requires the government to disseminate information about the toxic chemicals in cigarette smoke. We sought to understand how the descriptors "organic," "natural," or "additive-free" affect smokers' interest in cigarettes in the context of information about chemicals in cigarette smoke. METHODS:Participants were a national probability sample of 1,101 US adult (ages ≥18) smokers recruited in 2014-2015. A between-subjects experiment randomized participants in a telephone survey to 1 of 4 cigarette descriptors: "organic," "natural," "additive-free," or "ultra-light" (control). The outcome was expected interest in cigarettes with the experimentally assigned descriptor, after learning that 2 chemicals (hydrogen cyanide and lead) are in cigarette smoke. Experimental data analysis was conducted in 2016-2017. RESULTS:Smokers indicated greater expected interest in "organic," "natural," and "additive-free" cigarettes than "ultra-light" cigarettes (all p <.001) after learning that hydrogen cyanide and lead were in cigarette smoke. Smokers who intended to quit in the next 6 months expressed greater expected interest in the 4 types of cigarettes ("organic," "natural," "additive-free," and "ultra-light") compared to smokers not intending to quit (p <.001). CONCLUSIONS:Smokers, especially those intending to quit, may be more inclined towards cigarettes described as "organic," "natural," and "additive-free" in the context of chemical information. An accumulating body of evidence shows that the US should fully restrict use of "organic" and "natural" descriptors for tobacco products as it has done for "additive-free" and "light" descriptors

Placing Health Warnings on E-Cigarettes: A Standardized Protocol

Health warnings for e-cigarettes are a promising and novel tobacco control intervention for reducing e-cigarette use. We developed a new protocol for evaluating e-cigarette warnings by placing them on users&rsquo; own devices to reflect real-world exposure. Study 1 participants were a national convenience sample of 606 U.S. adult e-cigarette users surveyed online in March 2017. Most Study 1 participants were willing to have their e-cigarette devices (87%) and refills (83%) labeled. Study 2 participants were a convenience sample of 22 adult e-cigarette users recruited in California, United States in April 2017. We applied the U.S. Food and Drug Administration&rsquo;s proposed e-cigarette warning to users&rsquo; own devices and refills. Most Study 2 participants (81%) reported using e-cigarette devices with our warning labels at least 90% of the time during the study. Nearly all (95%) said they would participate in the study again, and 100% would recommend the study to a friend. Conversations about e-cigarette harms, conversations about quitting e-cigarettes, and intentions to quit using e-cigarettes increased during the study (all p &lt; 0.05). These studies show that our naturalistic labeling protocol was feasible, acceptable to participants, and had high retention over three weeks. Using the protocol can yield important evidence on the impact of e-cigarette warnings to inform tobacco warning policies

Impact of e-cigarette health warnings on motivation to vape and smoke.

BACKGROUND: A prevailing hypothesis is that health warnings for electronic cigarettes (e-cigarettes) could drive people away from vaping and towards smoking cigarettes. We consider an alternative hypothesis that e-cigarette warnings discourage both vaping and smoking. METHODS: Participants were a national convenience sample of 2218 US adults who used e-cigarettes, cigarettes or both. In August 2018, we randomised participants to one of three warning (control text about littering, text-only e-cigarette warning or pictorial e-cigarette warning). We further randomised participants viewing e-cigarette warnings to one of three (nicotine addiction, health hazards of use, or both health hazards and harms of use). The preregistered primary outcome was intentions to quit vaping among e-cigarette users. Secondary outcomes included interest in smoking and Tobacco Warnings Model constructs: attention, negative affect, anticipated social interactions and cognitive elaboration. RESULTS: Text warnings elicited higher intentions to quit vaping than control among e-cigarette users (=0.44, p<0.001), and pictorial warnings elicited still higher intentions to quit vaping than text (=0.12, p<0.05). Text warnings elicited lower interest in smoking compared with control among smokers (p<0.05); warnings had no other effects on interest in smoking among smokers or non-smokers. Text warnings about health hazards elicited higher intentions to quit vaping than nicotine addiction warnings. E-cigarette warnings also increased Tobacco Warnings Model constructs. DISCUSSION: E-cigarette health warnings may motivate users to quit vaping and discourage smoking. The most promising warnings include health hazards (other than nicotine addiction) and imagery. We found no support for the hypothesis that e-cigarette warnings could encourage smoking cigarettes

Brand switching and toxic chemicals in cigarette smoke: A national study

<div><p>Introduction</p><p>US law requires disclosure of quantities of toxic chemicals (constituents) in cigarette smoke by brand and sub-brand. This information may drive smokers to switch to cigarettes with lower chemical quantities, under the misperception that doing so can reduce health risk. We sought to understand past brand-switching behavior and whether learning about specific chemicals in cigarette smoke increases susceptibility to brand switching.</p><p>Methods</p><p>Participants were US adult smokers surveyed by phone (<i>n</i> = 1,151, probability sample) and online (<i>n</i> = 1,561, convenience sample). Surveys assessed whether smokers had ever switched cigarette brands or styles to reduce health risk and about likelihood of switching if the smoker learned their brand had more of a specific chemical than other cigarettes. Chemicals presented were nicotine, carbon monoxide, lead, formaldehyde, arsenic, and ammonia.</p><p>Results</p><p>Past brand switching to reduce health risk was common among smokers (43% in phone survey, 28% in online survey). Smokers who were female, over 25, and current “light” cigarette users were more likely to have switched brands to reduce health risks (all <i>p</i> < .05). Overall, 61–92% of smokers were susceptible to brand switching based on information about particular chemicals. In both samples, lead, formaldehyde, arsenic, and ammonia led to more susceptibility to switch than nicotine (all <i>p</i> < .05).</p><p>Conclusions</p><p>Many US smokers have switched brands or styles to reduce health risks. The majority said they might or would definitely switch brands if they learned their cigarettes had more of a toxic chemical than other brands. Brand switching is a probable unintended consequence of communications that show differences in smoke chemicals between brands.</p></div

Participant characteristics.

<p>Participant characteristics.</p