1
|
Becker E, McCaffrey S, Lewis J, Vansickel A, Larson E, Sarkar M. Characterization of Ad Libitum Use Behavior of On! Nicotine Pouches. Am J Health Behav 2023; 47:428-449. [PMID: 37596760 DOI: 10.5993/ajhb.47.3.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
Objectives: Actual use of nicotine pouch products is not well studied. The objectives of this study were to characterize on ® nicotine pouch (Test Products (TP)) use behavior, including association with cigarette and smokeless tobacco (ST) product use. Methods: Adults who smoke cigarettes (AS) and/or adults who use ST (ASTU) (N=1147) that were not planning to quit and had expressed interest in trying and using TP after a 5-day trial were offered ad libitum use of TPs (7 flavors at 5 nicotine levels) for 6 weeks. Results: Participants used a median of ~5-6 pouches/day of a variety of flavors and nicotine levels. In the final week of the study, 27% of AS and 71% of ASTU reported no use of cigarettes or ST respectively, while reporting continued use of TPs. Additionally, 39% of AS and 14% of ASTU reduced consumption of cigarettes or ST products respectively by 50%-99%, compared to reported use at screening. We found a statistically significant inverse relationship between TP flavor varieties and number of cigarettes/ST. Conclusions: These data suggest that TPs can be potential substitutes for cigarettes/ST products, and complete switching may offer harm reduction potential for AS and ASTU not interested in quitting.
Collapse
Affiliation(s)
| | | | | | | | - Elsa Larson
- Altria Client Services LLC, Richmond, VA, United States
| | | |
Collapse
|
2
|
Howard MC. Integrating the person-centered approach with the study of vaccine hesitancy: Applying latent profile analysis to identify vaccine hesitancy subpopulations and assess their relations with correlates and vaccination outcomes. Vaccine 2023:S0264-410X(23)00742-9. [PMID: 37357075 DOI: 10.1016/j.vaccine.2023.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 05/26/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
In scholarly and popular discussions of vaccine hesitancy, authors have repeatedly referred to different "types" of vaccine hesitant individuals; however, almost all modern research on vaccine hesitancy utilizes variable-centered approaches to identify the relation of variables rather than a person-centered approach to identify subpopulations, which suggests that a discrepancy exists between conceptual discussions and empirical research on vaccine hesitancy. For this reason, the current article conducts a latent profile analysis (LPA) on the dimensions of a well-supported vaccine hesitancy measure, which assess hesitancy towards vaccines in general. We also assess the relations of the resultant profiles (e.g., subpopulations) with relevant self-reported outcomes and correlates, wherein most of our outcomes are associated with COVID-19 and flu vaccines. Our LPA results support the existence of eight vaccine hesitancy profiles. The profile with the most unfavorable vaccination outcomes (e.g., willingness, receipt, and word-of-mouth) was associated with greater perceptions that vaccines cause health risks and unneeded when healthy; the profile with the most favorable vaccination outcomes was associated with low levels of all vaccine hesitancy dimensions. The other profiles produced a clear gradient between these two extremes. The profiles also differed regarding their standing on correlates, but the clearest difference was their relation with political orientation. Profiles with more unfavorable vaccination outcomes were associated with conservatism, whereas profiles with more favorable vaccinations outcomes were associated with liberalism. These results provide a new perspective for current understandings of vaccine hesitancy and open several avenues for future research.
Collapse
Affiliation(s)
- Matt C Howard
- The University of South Alabama, Mitchell College of Business, United States.
| |
Collapse
|
3
|
Zhou H, Hoe C, Zhang W, Yang X, Li M, Wu D. Are E-Cigarette and Tea Cigarette Gifting Behaviors Associated with Tobacco Use and Failed Quit Attempts in China? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15333. [PMID: 36430051 PMCID: PMC9696736 DOI: 10.3390/ijerph192215333] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/16/2022] [Accepted: 11/18/2022] [Indexed: 06/16/2023]
Abstract
This study aims to investigate e-cigarette and tea cigarette gifting in China and their influencing factors, as well as to explore whether they were associated with tobacco use and cessation. Using a multistage sampling design, 1512 household heads from Guangdong and Shaanxi provinces were recruited for the study and filled out an online questionnaire about smoking status, social participation, e-cigarette, and tea cigarette gifting. Results showed that more than 30% and nearly 3% of participants had been gifted tea cigarettes and e-cigarettes, respectively. Marital status, province of residence, smoking status, and social participation were associated with gifting behaviors. Logistic regressions showed that receiving e-cigarettes (OR = 3.43, p < 0.05) and tea cigarettes (OR = 1.70, p < 0.01) were related to tobacco use. Smokers who have received e-cigarettes (OR = 9.85, p < 0.01) and tea cigarettes (OR = 1.92, p < 0.05) were also less likely to quit smoking.
Collapse
Affiliation(s)
- Huan Zhou
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Connie Hoe
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Heidelberg Institute of Global Health, Heidelberg University, 69120 Heidelberg, Germany
| | - Weifang Zhang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou 310006, China
| | - Xiaozhao Yang
- Department of Sociology and Social Work, Sun Yat-sen University, Guangzhou 510275, China
| | - Mingyan Li
- Department of Sociology and Social Work, Sun Yat-sen University, Guangzhou 510275, China
| | - Dan Wu
- School of Psychology, Shenzhen Humanities & Social Sciences Key Research Bases of the Center for Mental Health, Shenzhen University, Shenzhen 518060, China
- Department of Psychology/Research Center for Quality of Life and Applied Psychology, Guangdong Medical University, Dongguan 523808, China
| |
Collapse
|
4
|
Wackowski OA, O'Connor RJ, Diaz D, Rashid M, Lewis MJ, Greene K. '95% less harmful'? Exploring reactions to quantitative modified risk claims for snus and e-cigarettes. Tob Control 2022; 31:730-736. [PMID: 33753549 PMCID: PMC8455704 DOI: 10.1136/tobaccocontrol-2020-056303] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/03/2021] [Accepted: 02/11/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Studies examining perceptions of 'modified risk tobacco product' (MRTP) messages for e-cigarettes and smokeless tobacco have indicated consumers want statistics and quantification of harm reduction. However, limited research exists on reactions to quantitative MRTP messages. DESIGN We conducted 12 focus groups in the USA in 2019-6 focused on e-cigarette messages and 6 on snus messages. Eight groups were with current smokers (ages 21-66) and four with young adult (ages 18-25) non-smokers (n=57). Participants discussed messages stating that use of snus and vaping products have been estimated by scientists to be about 90% and 95% less harmful than smoking cigarettes, respectively. RESULTS Several participants agreed the messages strongly communicated that the products are less harmful than cigarettes, were attention getting and could be 'convincing'. However, participants expressed scepticism about the source and accuracy of the stated figures, and some noted the claims could be misleading and attractive to young people. Comments also reflected some claim misunderstandings (eg, that e-cigarettes only pose a 5% chance of harm). Participants also agreed that stating e-cigarette risks 'are unlikely to exceed 5% of cigarette smoking harms' was confusing and less impactful than the '95% less harmful' wording. CONCLUSIONS Quantitative claims suggesting high levels of reduced risk when comparing e-cigarettes or smokeless tobacco/snus relative to cigarettes may be successful in gaining attention and being persuasive for some audiences, particularly, if from more credible sources. However, message developers, users and evaluators should be mindful of message limitations and aim to mitigate unintended consequences.
Collapse
Affiliation(s)
- Olivia A Wackowski
- Center for Tobacco Studies, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Richard J O'Connor
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Destiny Diaz
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Mariam Rashid
- Center for Tobacco Studies, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA
| | - M Jane Lewis
- Center for Tobacco Studies, Rutgers The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Kathryn Greene
- Department of Communication, Rutgers University, New Brunswick, New Jersey, USA
| |
Collapse
|
5
|
Andersen MB, Kjeld SG, Bast LS. Changes in Cigarette Smoking and Smokeless Tobacco Use During the Coronavirus Disease 2019 Lockdown Period Among Youth and Young Adults in Denmark. Nicotine Tob Res 2022; 25:298-308. [PMID: 36000931 PMCID: PMC9452126 DOI: 10.1093/ntr/ntac203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 08/01/2022] [Accepted: 08/23/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Cigarettes and smokeless tobacco (snus and nicotine pouches) are prevalent among youth and young adults in Denmark. Here, we examined the extent of changes in the use of cigarettes and smokeless tobacco during the first Coronavirus Disease 2019 (COVID-19) lockdown in March and April 2020 in Denmark as well as reasons for changed behavior. AIMS AND METHODS This study used data from a nationwide survey conducted among 15- to 29-year-olds from January to March 2021 including 13 530 respondents (response rate = 36.0%). Logistic regression analyses assessed the associations between sociodemographic characteristics and the odds of initiating or increasing as well as trying to stop or decreasing cigarette smoking and smokeless tobacco use. RESULTS The prevalence of cigarette smoking was 17.8% and 10.5% reported using smokeless tobacco. Around 40% of those currently smoking cigarettes reported smoke on par during the COVID-19 lockdown as before, 24.5% started to smoke or increased their smoking, and 27.4% tried to stop or smoked less. Approximately 37% used smokeless tobacco on the same level as, before the COVID-19 lockdown, 38.8% initiated or used more, and 14.1% tried to stop or used less. Females were more prone to initiate smokeless tobacco use and increase their level of smoking during the lockdown, and younger participants smoked less. More females compared with males changed their smoking behaviors because of their mood, and more younger participants did so because of fewer social gatherings. CONCLUSION Although most youths and young adults' tobacco behaviors remained the same during the COVID-19 lockdown, many also increased or decreased their behaviors-especially females and younger participants. IMPLICATIONS This study enables the possibility of detecting new tendencies in smoking and the use of smokeless tobacco among subgroups of the population during the COVID-19 lockdown. This knowledge is crucial for identifying which groups of youths are vulnerable to increasing their tobacco use in other pandemic situations and which groups call for special attention after the lockdown period. Future efforts may focus on vulnerable groups affected by the COVID-19 pandemic, such as females, and there is a need to monitor closely whether youth tobacco use changes as society becomes more normalized.
Collapse
Affiliation(s)
- Marie Borring Andersen
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark
| | - Simone G Kjeld
- Corresponding author: Simone G. Kjeld, MSc, National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark, E-mail:
| | - Lotus S Bast
- National Institute of Public Health, University of Southern Denmark, Studiestraede 6, 1455 Copenhagen K, Denmark
| |
Collapse
|
6
|
AlMoosawi S, Bajec M, Mainy N, Kallischnigg G, Zwisele B, Fischer K, Magnani P, Roulet S. Risk perception of IQOS™ and cigarettes: Temporal and cross-country comparisons. SSM Popul Health 2022; 18:101123. [PMID: 35669892 PMCID: PMC9162949 DOI: 10.1016/j.ssmph.2022.101123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/28/2022] [Accepted: 05/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Risk perception (RP) is central to smokers’ decision to switch to smoke-free tobacco and nicotine products (TNP). This study assessed temporal trends in the health RP of a novel heated tobacco product, IQOSTM, relative to cigarettes, among current IQOSTM users. Methods The analyses included repeated cross-sectional data from online surveys in Germany (2018–19), Italy (2018–19), and Japan (2016–17, 2017–18, and 2018–19) among a random sample of current adult IQOSTM users from local registers of IQOSTM users. The health RPs of cigarettes and IQOSTM were assessed using the ABOUT™–Perceived Risk instrument, and their difference was described as the relative RP of IQOSTM to cigarettes (RPCig:IQOSTM). Results After adjustment for covariates, the relative RPCig:IQOSTM was higher in 2018 than in 2019 (0.93; standard error, 0.33; P = 0.005). This was driven by an increase in the RP of IQOSTM over time in Italy (2018: 42.6 [95% CI, 41.6–43.5]; 2019: 44.4 [43.4–45.4]) and Japan (2017: 44.0 [43.1–44.9); 2018: 45.9 [45.2–46.7]; 2019: 48.6 [47.9–49.4]), while the RP of cigarettes remained stable. Conclusions The relative RP of IQOSTM decreased over time, driven by an increase in the RP of IQOSTM, in agreement with epidemiological studies indicating a temporal reduction in the relative RP of smoke-free TNPs. Continued surveillance of the RP of novel TNPs is warranted to inform effective TNP risk communication and ensure that adults smokers who would otherwise continue to smoke understand the relative risks of novel TNPs. Risk perception is central to smokers' decision to switch from cigarettes. Little is known of temporal changes in risk perception of novel tobacco products. Risk perception of heated tobacco increased in Italy and Japan. Difference in risk perception of heated tobacco relative to cigarettes declined.
Collapse
Affiliation(s)
- Suzana AlMoosawi
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
- Corresponding author.
| | - Martha Bajec
- Bajec Senseworks consulting, Hamilton, L9A 1L5, Ontario, Canada
| | - Nelly Mainy
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Gerd Kallischnigg
- ARGUS – Statistics and Information Systems in Environment and Public Health GmbH, Karl-Heinrich-Ulrichs-Straße 20a, DE-10785, Berlin, Germany
| | - Bertram Zwisele
- ARGUS – Statistics and Information Systems in Environment and Public Health GmbH, Karl-Heinrich-Ulrichs-Straße 20a, DE-10785, Berlin, Germany
| | - Karina Fischer
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Pierpaolo Magnani
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| | - Steve Roulet
- PMI R&D, Philip Morris Products S.A., Quai Jeanrenaud 5, CH-2000, Neuchâtel, Switzerland
| |
Collapse
|
7
|
Bhatt G, Goel S, Grover S, Kaur N, Singh S. A cross sectional study to assess tobacco use and its correlates among patients attending non-communicable disease clinics of a Northern Jurisdiction in India. J Family Med Prim Care 2021; 10:2915-2922. [PMID: 34660424 PMCID: PMC8483119 DOI: 10.4103/jfmpc.jfmpc_2471_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 02/21/2021] [Accepted: 04/09/2021] [Indexed: 12/01/2022] Open
Abstract
Background: Non-Communicable Diseases (NCDs) continue to rise unabated globally and the existing evidence has unequivocally established the relationship between tobacco use and NCDs. In 2010 the Government of India (GOI) introduced NCD clinics under the National Program for Prevention and Control of Cancer, Diabetes, Cardio Vascular Diseases and Stroke (NPCDCS) with the purpose of preventing and combating the NCD epidemic. This study was undertaken with an objective to comprehensively determine tobacco use and its correlates among patients attending these NCD clinics. Methods: A descriptive cross-sectional study was carried out among 1172 patients attending NCD clinics at district level, in Punjab, India between May to October 2018. Using systematic sampling every fourth patient was interviewed and equal numbers of visits were made to both the clinics. Results: Overall, the current tobacco use in any form was reported to be 10.2% among the study respondents. Majority of the tobacco users were males (23.3%), in 40–49 year age group, (18.7%), residing in urban area (15%), educated up to secondary school (18%) and non-government occupation bracket (27.4%) and hypertension disease category (41.6%). More SLT users had thought of quitting in past in comparison to smokers (46.6% vs 40%) and had higher quit attempts in past (42.5% vs 38.3%). In the binary logistic regression analysis, odds of tobacco use increased with increasing age, three times higher among participants who were employed (OR 3.75; CI 1.41-10.02),6 times higher in COPD disease category (OR 6.88; CI 2.1-20.59). Conclusion: Higher tobacco use among the NCD clinic attendees with increasing age predisposes them to develop grave complications. This calls for the need to administer intensive behaviour change interventions for tobacco cessation at the existing NCD clinics. This could further strengthen existing health systems and thereby improving health outcomes followed by achieving Sustainable Development Goals.
Collapse
Affiliation(s)
- Garima Bhatt
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Nirlep Kaur
- Department of Health and Family Welfare, State Tobacco Control Cell, Punjab, India
| | - Sandeep Singh
- Department of Health and Family Welfare, State NCD Control Cell, Punjab, India
| |
Collapse
|
8
|
Danielsson M, Tanner T, Patinen P, Birkhed D, Anttonen V, Lammi A, Siitonen S, Ollgren J, Pylkkänen L, Vasankari T. Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study. BMJ Open 2021; 11:e050502. [PMID: 34521671 PMCID: PMC8442068 DOI: 10.1136/bmjopen-2021-050502] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The health hazards of tobacco products depend on the level of exposure, but little is known about the characteristics of snus use. The aim of this study was to investigate the duration of daily exposure to snus among occasional and daily users and its associated predictive factors among young Finnish men. DESIGN Cross-sectional questionnaire study. SETTING Three out of 16 Finnish Defence Forces units. PARTICIPANTS 1280 young Finnish male conscripts starting their military service in 2016 chosen by simple random sampling. PRIMARY AND SECONDARY MEASURES The prevalence, duration of use and the amount of daily usage of snus and cigarettes were investigated. The attitudes towards perceived harmfulness of snus and the predictive factors affecting the total time of snus consumption were examined. RESULTS Almost a fifth (19.5%) of the conscripts reported daily snus use, and a further 16% reported occasional use. Daily snus use was associated with an earlier starting age, longer duration of use and higher daily exposure time compared with occasional use. On average, daily snus users consumed 10 portions and occasional users three portions per day (p<0.001). The daily total exposure time for daily users was 372 min (95% CI 344 to 401) and for occasional users 139 min (95% CI 106 to 171). Respondents with an upper secondary education had significantly less daily total exposure than those with basic comprehensive education (p=0.036). Perceptions of snus as a harmful substance resulted in a significantly lower duration of exposure. CONCLUSION Snus use was very common among young Finnish men. High snus exposure duration was associated with an earlier starting age, a longer history of use and a careless attitude to its health hazards. A higher education level was a protective factor for total exposure time. Studies of the long-term health effects and dependency profile of snus use are needed.
Collapse
Affiliation(s)
- Maria Danielsson
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
- Doctoral Programme in Population Health, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Tarja Tanner
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Pertti Patinen
- Center for Military Medicine, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Dowen Birkhed
- Former: Department of Cariology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Vuokko Anttonen
- Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland
- Medical Research Center, University Hospital and University of Oulu, Oulu, Finland
| | - Anelma Lammi
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
| | - Simo Siitonen
- The Defence Command, Finnish Defence Forces, Helsinki, Uusimaa, Finland
| | - Jukka Ollgren
- Department of Infectious Disease Surveillance and Control, Finnish Institute for Health and Welfare, Helsinki, Uusimaa, Finland
| | - Liisa Pylkkänen
- Finnish Medicines Agency Fimea, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Oncology, University of Turku, Turku, Varsinais-Suomi, Finland
| | - Tuula Vasankari
- Finnish Lung Health Association, Helsinki, Uusimaa, Finland
- Division of Medicine, Department of Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Varsinais-Suomi, Finland
| |
Collapse
|
9
|
O'Brien EK, Baig SA, Persoskie A. Absolute and Relative Smokeless Tobacco Product Risk Perceptions: Developing and Validating New Measures that are Up-to-Snuff. Nicotine Tob Res 2021; 24:265-269. [PMID: 34482405 DOI: 10.1093/ntr/ntab167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/17/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Tobacco risk perceptions impact behavior. Our 2018 systematic review of tobacco risk perception measures found no measures of smokeless tobacco (ST) risk perceptions with demonstrated validity and complete consistency with tobacco researcher recommendations (e.g. specifying use frequency). This study develops such measures to assess seven specific risk perceptions of market-leading ST products: absolute health and addiction risks, health and addiction risks relative to cigarettes, pregnancy health risks relative to cigarettes, health risks relative to nicotine replacement therapy, and health risks relative to tobacco cessation. METHODS AND RESULTS We fielded 64 items assessing risk perceptions associated with tobacco in an online survey experiment (N = 2754) that tested effects of exposing participants to a modified risk claim on a leading ST product. Through reliability and validity analyses, we reduced this to 35 items representing seven constructs. Exploratory factor analyses indicated single-factor solutions for all but two constructs: absolute health risk and health risk relative to cigarettes, which were each represented by two-factors (respiratory and oral risks). Participants perceived respiratory risks differently than oral risks: a modified risk claim reduced ST relative respiratory risk perceptions but increased ST perceived oral risks. CONCLUSIONS Absolute and relative risk perceptions were each represented by two factors that behaved differently, underscoring the utility of assessing respiratory and oral risk perceptions separately. These measures of seven risk perception constructs demonstrated some validity and can be used to assess perceptions of ST risk in future research, such as postmarket surveillance of tobacco products authorized for marketing by FDA. IMPLICATIONS This study develops and validates publicly available measures of seven smokeless tobacco risk perception constructs: absolute health and addiction risks, health and addiction risks relative to cigarettes, pregnancy health risks relative to cigarettes, health risks relative to nicotine replacement therapy, and health risks relative to tobacco cessation. This study suggests that for both absolute and relative risk perceptions, risks of respiratory and oral health effects should be assessed separately, because these risk perceptions may be impacted differently by modified risk claims, and are differentially related to smokeless tobacco beliefs, use intentions, and current use.
Collapse
Affiliation(s)
| | - Sabeeh A Baig
- Office of Science, Center for Tobacco Products, Food and Drug Administration (FDA), Silver Spring, MD, USA
| | | |
Collapse
|
10
|
Denlinger-Apte RL, Pacek LR, Ross JC, Bansal-Travers M, Donny EC, Hatsukami DK, Carroll DM. Risk Perceptions of Low Nicotine Cigarettes and Alternative Nicotine Products across Priority Smoking Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5311. [PMID: 34067652 PMCID: PMC8156883 DOI: 10.3390/ijerph18105311] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/07/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND As the U.S. Food and Drug Administration considers a low nicotine product standard for cigarettes, it is important to examine how people who smoke, especially individuals from priority populations disproportionately affected by smoking, perceive low nicotine content (LNC) cigarettes and their relative risk perceptions of alternative nicotine delivery system (ANDS) products, including e-cigarettes and snus, and medicinal nicotine. METHODS Data are from Wave 4 (2016-2017) of the adult Population Assessment of Tobacco Use and Health (PATH) Study. We examined respondents' absolute risk perceptions about nicotine, LNC cigarettes, ANDS products and medicinal nicotine; their relative risk perceptions of LNC cigarettes and ANDS products compared to conventional cigarettes; and their relative risk perceptions of medicinal nicotine compared to ANDS products. RESULTS The majority of respondents across priority smoking populations indicated snus, e-cigarettes, and LNC cigarettes were 'about the same' level of harmfulness or addictiveness as conventional cigarettes. The majority of respondents indicated e-cigarettes to be 'about the same' harmfulness as medicinal nicotine. CONCLUSIONS Our study indicates that adults who smoke cigarettes generally have misperceptions about the harms of nicotine and the relative risks of ANDS products and such misperceptions exist regardless of their racial/ethnic identity, sexual orientation, and gender identity.
Collapse
Affiliation(s)
- Rachel L. Denlinger-Apte
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; (R.L.D.-A.); (J.C.R.)
| | - Lauren R. Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA;
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA; (R.L.D.-A.); (J.C.R.)
| | - Maansi Bansal-Travers
- Roswell Park Comprehensive Cancer Center, Department of Health Behavior, Buffalo, NY 14263, USA;
| | - Eric C. Donny
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA;
| | - Dorothy K. Hatsukami
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN 55414, USA;
| | - Dana Mowls Carroll
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55414, USA
| |
Collapse
|
11
|
Wackowski OA, O’Connor RJ, Pearson JL. Smokers' Exposure to Perceived Modified Risk Claims for E-Cigarettes, Snus, and Smokeless Tobacco in the United States. Nicotine Tob Res 2021; 23:605-608. [PMID: 32812028 PMCID: PMC7885787 DOI: 10.1093/ntr/ntaa159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/13/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION Based on arguments for harm reduction and health benefits, tobacco companies in the United States can apply for regulatory authorization to make "modified risk tobacco product" (MRTP) marketing claims. The impact of future MRTP claims may depend on whether they are noticed, believed, and lead to smokers switching products. This study provides baseline data about smokers' exposure to perceived MRTP claims ahead of any MRTP authorizations. AIMS AND METHODS We analyzed measures from Wave 3 of the US-based Population Assessment of Tobacco and Health (PATH) study which asked smokers to indicate if they had seen any e-cigarettes, snus, or other smokeless tobacco (SLT) products that claim to be "less harmful" in the past 12 months, and their likelihood of using products with these claims in the next 30 days. RESULTS Significantly fewer smokers noted having seen snus (5.1%) or other SLT (5.6%) with "less harmful" claims compared with e-cigarettes (29.1%). For each product, the prevalence of MRTP claim exposure was higher among smokers who perceived the product to be less harmful than smoking, who currently used the product, and who had higher rates of tobacco advertising exposure at the point of sale. Among smokers who noticed products with "less harmful" claims, about one-quarter said they would use them in the future (24%-27%). CONCLUSIONS Ahead of any Food & Drug Administration (FDA) authorization for MRTP claims, some smokers already perceive exposure to "less harmful" claims for e-cigarettes, but few do for SLT. MRTP claims may motivate some smokers to use these products. IMPLICATIONS This study provides new baseline data about smokers' perceived exposure to MRTP claims in the United States ahead of any regulatory claim authorization. Using data from Wave 3 of the US PATH study, we found that some smokers already perceive exposure to "less harmful" claims for e-cigarettes (29%), but few do for SLT (5%-6%). Among smokers who noticed products with "less harmful" claims, about one-quarter said they would use them in the future (24%-27%), suggesting MRTP claims may motivate some smokers to use products described as "less harmful."
Collapse
Affiliation(s)
- Olivia A Wackowski
- Rutgers Center for Tobacco Studies, Department of Health Behavior, Society and Policy, Rutgers School of Public Health, Rutgers University, New Brunswick, NJ
| | - Richard J O’Connor
- Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY
| | - Jennifer L Pearson
- Department of Health Administration and Policy, School of Community Health Sciences, University of Nevada, Reno, NV
| |
Collapse
|
12
|
Morgan JC, Cappella JN. Harm Perceptions and Beliefs about Potential Modified Risk Tobacco Products. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:E576. [PMID: 33445525 PMCID: PMC7827331 DOI: 10.3390/ijerph18020576] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 01/17/2023]
Abstract
Under US law, tobacco products may be authorized to claim lower exposure to chemicals, or lower risk of health harms. We sought to examine the harm perceptions and beliefs about potential modified risk tobacco products (MRTPs). We recruited 864 adult current and former smokers in August 2019. Participants read a paragraph describing the potential for the FDA to authorize MRTPs and a brief description of MRTPs. The most endorsed beliefs for each product were that they contained nicotine and that they were risky. Believing that e-cigarettes can help smokers quit smoking, that they tasted good, and looked cool were associated with greater odds of intending to try e-cigarettes after controlling for demographic and use factors. For snus, the beliefs that the product was not addictive and tasted good were associated with increased odds of intending to try snus. The beliefs that heated tobacco would taste good and would be a good quit aid was associated with increased odds of intentions to try heated tobacco products. Understanding what the public believes about products currently or potentially authorized to be marketed as modified risk tobacco products can inform communication efforts.
Collapse
Affiliation(s)
- Jennifer C. Morgan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA 19104, USA;
| | | |
Collapse
|
13
|
Wackowski OA, Jeong M. Comparison of a General and Conditional Measure of E-Cigarette Harm Perceptions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5151. [PMID: 32708854 PMCID: PMC7400449 DOI: 10.3390/ijerph17145151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/16/2022]
Abstract
Measures of tobacco product harm perceptions are important in research, given their association with tobacco use. Despite recommendations to use more specific harm and risk perception measures, limited research exists comparing different wordings. We present exploratory survey data comparing young adults' (ages 18-29) responses to a general e-cigarette harm perception measure ("How harmful, if at all, do you think vaping/using an e-cigarette is to a user's health?") with a more specific conditional measure, which personalized the behavior/harm ("imagine you vaped," "your health") and presented a specific use condition (exclusive daily vaping) and timeframe (10 years). Data were collected in January 2019 (n = 1006). Measures were highly correlated (r = 0.76, Cronbach's α = 0.86), and most (65%) provided consistent responses, although more participants rated e-cigarettes as very or extremely harmful using the conditional (51.6%) versus the general (43.9%) harm measure. However, significant differences in harm ratings were not observed among young adults who currently vaped. Correlations between each harm perception measure and measures of e-cigarette use intentions were similar. More specifically worded harm perception measures may result in somewhat higher e-cigarette harm ratings than general measures for some young adults. Additional research on best practices for measuring e-cigarette and other tobacco harm perceptions is warranted.
Collapse
Affiliation(s)
- Olivia A. Wackowski
- Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, New Brunswick, NJ 08901, USA;
| | | |
Collapse
|
14
|
Abstract
Purpose
This paper aims to overview the need for tobacco harm reduction, the consumer products that facilitate tobacco harm reduction and the barriers to its implementation. The worldwide endemic of tobacco smoking results in the death of over seven million smokers a year. Cigarette quit rates are very low, from 3%–12%, and relapse rates are high, from 75%–80% in the first six months and 30%–40% even after one year of abstinence. In addition, some smokers do not desire to quit. Cigarette substitution in tobacco harm reduction is one strategy that may reduce the burden of morbidity and mortality.
Design/methodology/approach
This review examines the displacement of smoking through substitution of non-combustible low-risk products such as snus, heated tobacco products and e-cigarettes.
Findings
Toxicological testing, population studies, clinical trials and randomized controlled trials demonstrate the potential reductions in exposures for smokers. Many barriers impede the implementation of product substitution in tobacco harm reduction. These products have been subjected to regulatory bans and heavy taxation and are rejected by smokers and society based on misperceptions about nicotine, sensational media headlines and unsubstantiated fears of youth addiction. These barriers will need to be addressed if tobacco harm reduction is to make the maximum impact on the tobacco endemic.
Originality/value
This review provides the rationale for tobacco harm reduction, evaluates the current products available and identifies the barriers to implementation.
Collapse
|
15
|
Nilsen CV, Halkjelsvik T, Svartdal F. Health warning labels describing snus as less harmful than smoking: effects on perceptions of risk. Harm Reduct J 2020; 17:36. [PMID: 32503564 PMCID: PMC7275417 DOI: 10.1186/s12954-020-00380-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 05/22/2020] [Indexed: 11/10/2022] Open
Abstract
Background Using snus (Swedish moist snuff) is less harmful than smoking, but health warning labels (HWLs) on snus products do not reflect this relation. There are few studies on the effects of comparative risk information in snus warning labels. The purpose of this experiment is to examine whether risk perceptions differ after exposure to non-comparative vs. comparative risk information in snus warning labels. Methods A total of 254 Norwegians aged 19–69 were exposed to pictures of snus packages in one of four HWL conditions: non-comparative EU-based (“Snus is damaging to your health”), control (the text “Snus” only), general comparative risk (“Snus is less damaging to your health than smoking”), or percentage comparative risk (“Snus is 90% less damaging to your health than smoking”). Perceptions of risk from snus use and smoking were measured before (pre) and during (post) exposure to the HWL. Changes from pre to post in (1) perceptions of risk from snus use and (2) perceptions of risk differences from snus use versus smoking were tested in repeated measures ANOVAs with current snus and cigarette use as covariates. Results Both the perceived risks from snus use and its perceived risk difference to smoking decreased more in the control and the percentage HWL conditions than in the EU-based HWL condition. When comparing the general comparative risk and the EU-based HWL, a similar difference was found for the perceived risk difference, but not for the separate measure of snus risk. Both the snus risk and risk difference perception decreased more for the percentage than for the general relative risk HWL. Conclusions The non-comparative EU-based HWL claiming that “Snus is health damaging” maintains a high level of perceived risk from snus use, while no HWL and the suggested comparative HWLs adjust perceptions of risk in the direction of lower harm from snus use. An HWL describing snus as 90% less harmful than smoking was more effective than a general claim.
Collapse
Affiliation(s)
- Connie Villemo Nilsen
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway.
| | - Torleif Halkjelsvik
- Department of Alcohol, Tobacco and Drugs, Norwegian Institute of Public Health, P.O. Box 222 Skoeyen, 0213, Oslo, Norway.,Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, P.O. Box 222 Skoeyen, 0213, Oslo, Norway
| | - Frode Svartdal
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, 9037, Tromsø, Norway
| |
Collapse
|
16
|
Pillitteri JL, Shiffman S, Sembower MA, Polster MR, Curtin GM. Assessing comprehension and perceptions of modified-risk information for snus among adult current cigarette smokers, former tobacco users, and never tobacco users. Addict Behav Rep 2020; 11:100254. [PMID: 32467843 PMCID: PMC7244929 DOI: 10.1016/j.abrep.2020.100254] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/05/2020] [Accepted: 01/21/2020] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Snus, a low nitrosamine smokeless tobacco product, presents less risks to health than cigarettes. Effectively communicating such risk information could facilitate smokers switching completely to snus, thereby benefiting public health. METHODS This study assessed comprehension and perceptions of modified-risk information regarding snus. Adult cigarette smokers, former tobacco users, and never tobacco users (N = 3,922) from a US internet panel viewed an advertisement stating that smokers who switched completely to snus could greatly reduce risk of lung cancer, respiratory disease, heart disease, and oral cancer. Respondents answered questions regarding the modified-risk information and rated perceived risks of snus relative to cigarettes and other smokeless tobacco products. RESULTS Across the four diseases mentioned in the advertisement, most respondents (49.7%-68.6%, across tobacco user groups) understood that snus presents less risk than cigarettes but is not completely safe. Some indicated snus presents the same risk as cigarettes; this was highest for oral cancer (33.7%-42.02%) and lowest for lung cancer (15.4%-23.1%) and respiratory disease (15.6%-23.4%). Majorities understood snus is addictive (77.7%-87.9%), quitting all tobacco is the best option for smokers (83.6%-93.1%), and non-users of tobacco should not use snus (80.4%-87.8%). Only 2.1%-5.8% indicated smokers would receive a health benefit if they continued to smoke while using snus. CONCLUSIONS The modified-risk information, conveying that snus presents less risk than cigarettes but is not completely safe, was understood by majorities of respondents. Differential risk beliefs across diseases suggest responses were shaped not only by the modified-risk information, but also by intuitions and pre-existing beliefs about tobacco products.
Collapse
Affiliation(s)
- Janine L. Pillitteri
- PinneyAssociates, Inc., 201 North Craig Street, Suite 320, Pittsburgh, PA 15213, United States
| | - Saul Shiffman
- PinneyAssociates, Inc., 201 North Craig Street, Suite 320, Pittsburgh, PA 15213, United States
| | - Mark A. Sembower
- PinneyAssociates, Inc., 201 North Craig Street, Suite 320, Pittsburgh, PA 15213, United States
| | | | - Geoffrey M. Curtin
- RAI Services Company, 401 North Main Street, Winston-Salem, NC 27101, United States
| |
Collapse
|
17
|
Felicione NJ, Ozga-Hess JE, Ferguson SG, Dino G, Kuhn S, Haliwa I, Blank MD. Cigarette smokers' concurrent use of smokeless tobacco: dual use patterns and nicotine exposure. Tob Control 2020; 30:24-29. [PMID: 32051253 DOI: 10.1136/tobaccocontrol-2019-055345] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 11/25/2019] [Accepted: 12/10/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND The concurrent use of cigarettes with other tobacco products, such as smokeless tobacco (SLT), is increasingly common. Extant work with cigarette smokers who also use SLT is based heavily on retrospective reports and between-group comparisons. The purpose of this study was to assess prospectively the patterns of dual users' product use and nicotine exposure on days when cigarettes were smoked exclusively (single use) versus concurrently with SLT (dual use). DESIGN Forty-six dual cigarette-SLT users recorded their product use in real time via ecological momentary assessment for a 2-week longitudinal design. They responded to questions about situational factors (eg, location, mood) using this same diary, and collected saliva samples each night for later cotinine measurement. At the end of this 2-week period, users reported on their reasons for and beliefs about SLT use. RESULTS Cotinine levels were significantly higher on dual versus single use days (mean±SEM=374.48±41.08 ng/mL vs 300.17±28.13 ng/mL, respectively; p<0.01), and the number of cigarettes logged was higher on dual versus single use days (11.13±0.98 vs 9.13±1.11, respectively; p<0.01). Product use was distinguished by situational factors, with the strongest predictor being location of use. Moreover, the most common reason for initiating (56.52%) and continuing (67.39%) SLT use was to circumvent indoor smoking restrictions. CONCLUSIONS Results support the idea of product supplementation rather than replacement among this convenience sample of dual users. For smokers whose primary motivation for SLT use involves situations where they would otherwise be tobacco free, the potential benefits of clean indoor air laws may be diminished.
Collapse
Affiliation(s)
| | - Jenny E Ozga-Hess
- Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Stuart G Ferguson
- School of Medicine, University of Tasmania Faculty of Health, Hobart, Tasmania, Australia
| | - Geri Dino
- Social and Behavioral Sciences, West Virginia University School of Public Health, Morgantown, West Virginia, USA.,WV Prevention Research Center, West Virginia University School of Public Health, Morgantown, West Virginia, USA
| | - Summer Kuhn
- Health Sciences and Technology Academy, West Virginia University, Morgantown, West Virginia, USA
| | - Ilana Haliwa
- Psychology, West Virginia University, Morgantown, West Virginia, USA
| | - Melissa D Blank
- Psychology, West Virginia University, Morgantown, West Virginia, USA .,WV Prevention Research Center, West Virginia University School of Public Health, Morgantown, West Virginia, USA
| |
Collapse
|
18
|
Villanti AC, Naud S, West JC, Pearson JL, Wackowski OA, Hair E, Rath JM, Niaura RS. Latent Classes of Nicotine Beliefs Correlate with Perceived Susceptibility and Severity of Nicotine and Tobacco Products in US young adults. Nicotine Tob Res 2019; 21:S91-S100. [PMID: 31867640 PMCID: PMC6939776 DOI: 10.1093/ntr/ntz156] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 08/21/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pervasive misperceptions about nicotine may influence uptake of quit smoking aids and the impact of policies addressing nicotine as a tobacco product constituent. METHODS Latent class analyses were conducted using four items on nicotine beliefs asked of 4037 adults aged 18-40 in wave 9 (February-March 2016) of the Truth Initiative Young Adult Cohort Study. Confirmatory factor analyses identified three factors from 12 items: nicotine susceptibility (NSUS), nicotine severity (NSEV), and tobacco severity (TSEV). Analyses assessed correlations between latent classes, sociodemographics, and nicotine/tobacco factor scores. RESULTS A four-class model of nicotine beliefs was the best fit, with the largest class believing that nicotine plays a major part in smoking risks (class 1, n = 2070; 52%). Class 2 shared that belief but also responded "Don't know" to addiction questions (class 2, n = 382; 11%). Fewer belonged in class 3, who reported that nicotine plays a small part in health risks (n = 1277; 30%), and class 4, who perceived nicotine as not cancer causing (n = 308; 7%). Latent class membership was correlated with sociodemographics, peer smoking, and past 30-day tobacco use. Classes 1 and 2 had similar NSUS scores and classes 3 and 4 had similar NSEV and TSEV scores. DISCUSSION Differences in the perceptions of nicotine and tobacco-related harms can be partially explained by clustering of underlying nicotine beliefs. These classes of beliefs are correlated with sociodemographic predictors of smoking. These findings may help to identify specific beliefs or groups to be targeted by public education efforts on nicotine. IMPLICATIONS The current study supports that underlying nicotine beliefs are associated with perceived harms of specific nicotine and tobacco products (relative to cigarettes), with greater false beliefs about nicotine correlated with greater perceived susceptibility to nicotine addiction. Two important inferences emerge from this study: first, that education to address nicotine beliefs may also reframe perceptions of the harms of nicotine and tobacco products; and second, that this type of education may differentially impact perceptions of the harms of nicotine products (e.g., nicotine replacement therapy and e-cigarettes) and tobacco products (e.g., cigars, smokeless, and hookah).
Collapse
Affiliation(s)
- Andrea C Villanti
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
| | - Shelly Naud
- Department of Medical Biostatistics, University of Vermont, Burlington, VT
| | - Julia C West
- Vermont Center on Behavior and Health, Department of Psychiatry, University of Vermont, Burlington, VT
| | - Jennifer L Pearson
- Division of Social and Behavioral Sciences/Health Administration and Policy, School of Community Health Sciences, University of Nevada, Reno, Reno, NV
| | - Olivia A Wackowski
- Center for Tobacco Studies, Rutgers School of Public Health, State University of New Jersey, New Brunswick, NJ
| | | | | | - Raymond S Niaura
- Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY
| |
Collapse
|
19
|
McKelvey K, Halpern-Felsher B. From tobacco-endgame strategizing to Red Queen's race: The case of non-combustible tobacco products. Addict Behav 2019; 91:1-4. [PMID: 30642577 PMCID: PMC6541479 DOI: 10.1016/j.addbeh.2019.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Karma McKelvey
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Department of Pediatrics, Stanford University, 770 Welch Rd., Suite 100, Palo Alto, CA 94304, United States.
| |
Collapse
|