Correcting Public Misperceptions about Very Low Nicotine Content Cigarettes - PROJECT SUMMARY/ABSTRACT
Tobacco use is the leading preventable cause of cancer and cancer deaths in the US. While most (69%)
smokers want to quit, only 6% succeed in doing so each year. For many smokers, the addictiveness of nicotine
makes quitting very difficult. To reduce cigarette smoking and resulting harms, FDA recently announced a
comprehensive approach to tobacco and nicotine regulation that includes moving toward a very low nicotine
content (VLNC) standard for cigarettes. Greatly reduced nicotine levels would facilitate smoking cessation.
However, smokers only benefit from a VLNC policy if they quit. The success of the policy may require
public understanding that, although these new cigarettes are less addictive, their high toxicity and
carcinogenicity are unchanged. Yet, in the first nationally representative survey of the perceived risk of VLNC
cigarettes, we found that 47% of adult smokers incorrectly thought smoking VLNC cigarettes would be less
likely to lead to cancer than smoking current cigarettes (the VLNC misperception).The VLNC misperception
was especially prevalent among smokers 55 and older. Additionally, we found that 24% of smokers said they
would be less likely to quit if a VLNC regulation is enacted. Thus, the VLNC misperception may undermine a
nicotine reduction policy. Although communication research suggests it is challenging to change people's
incorrect understanding, new communication techniques may help reduce the VLNC misperception.
In the proposed project, our overall goal is to reduce unintended consequences of a VLNC policy by
developing campaign messages that address public misperceptions. In Aim 1, we develop communication
campaign messages that test techniques to address the misperception that VLNC cigarettes are less
likely to cause cancer than current cigarettes. We begin by developing 24 potential campaign messages in
a factorial design, varying 4 key message characteristics. We review the messages with a panel of
communication experts and revise them as needed. We next conduct a discrete choice experiment to find the
6 most effective messages. Then we conduct focus groups with adult smokers to elicit evaluative discussion
about the 6 messages. Finally, we work with the expert panel to select 3 messages for use in Aim 2. In Aim 2,
we determine whether the vetted and refined campaign messages reduce the misperception. We
conduct an online experiment with a nationally-representative sample of 1,096 adult smokers to understand the
extent to which 3 campaign messages reduce the VLNC misperception and increase motivation to quit if a
VLNC regulation is enacted, and learn which messages do this most effectively.
The grant’s findings can inform communication campaigns about VLNC cigarettes. They also advance the
important science of correcting tobacco product misperceptions. This project will lead to an R01 proposal on
refining techniques to address VLNC misperceptions and conducting a repeated-exposure randomized
controlled trial delivered via smartphone to a recruited sample to test the impact of the campaign messages.
