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Weiger C, Kennedy RD, Villanti AC, Cohen JE, Moran MB. A Descriptive Analysis of Beliefs About Nicotine and Switching to Noncombustibles Among Adults Who Smoke Cigarettes and Believe Nicotine Causes Cancer. Subst Use Misuse 2024:1-8. [PMID: 39172103 DOI: 10.1080/10826084.2024.2392534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/23/2024]
Abstract
Introduction: Many people who smoke cigarettes report believing that nicotine causes cancer, a misperception that may reduce interest in switching to noncombustible nicotine products. Quantitative survey questions do not capture how this population thinks about nicotine and switching to noncombustible products. Methods: This study used an online convenience sample of 193 US adults who smoke cigarettes and reported that nicotine causes cancer. Respondents were asked if they thought nicotine was harmful (and why or why not) and if they would consider switching to a noncombustible product (and why or why not). Inductive and deductive coding were used, and descriptive statistics are reported. Results: Descriptions of nicotine directly causing disease (61%) were more common than descriptions of nicotine causing addiction to a harmful product (8%). One-third expressly stated that nicotine causes cancer, and 21% that nicotine causes lung disease. Interest in switching was moderate (mean 47.4 out of 100). When asked about switching, 34% described enjoying their current smoking experience, 23% described a perceived health benefit, 16% described a health concern, and 11% worried that switching would not address nicotine addiction. Discussion: Adults who smoke commonly perceived nicotine as a direct cause of cigarette-related disease, and harm and addictiveness perceptions were often mentioned as reasons for interest or disinterest in switching to a noncombustible. Future studies could explore strategies for correcting nicotine misperception, stigma related to addiction, and common concerns related to health as well as user experience.
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Affiliation(s)
- Caitlin Weiger
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Ryan D Kennedy
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Andrea C Villanti
- Rutgers Institute for Nicotine & Tobacco Studies, Rutgers University, New Brunswick, New Jersey, USA
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Meghan B Moran
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Weiger C, Cohen JE, David Kennedy R, Moran MB. Testing messaging strategies to correct beliefs about nicotine and relative harm perceptions of non-cigarette tobacco products compared to cigarettes: A 2 × 2 factorial experiment of factsheets. Addict Behav 2024; 150:107915. [PMID: 38042048 DOI: 10.1016/j.addbeh.2023.107915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 12/04/2023]
Abstract
INTRODUCTION The misperception that nicotine is a major cause of cancer is common and may relate to inaccurate relative harm perceptions about tobacco products. To assess if messaging can correct these misperceptions, we tested factsheets that manipulated presences vs absence of (1) a causal alternative (i.e., combustion, not nicotine, causes disease) and/or (2) a reason for the misinformation (i.e., nicotine is the focus of many health messages). METHODS We used an online 2 × 2 factorial experiment of n = 193 adults who smoke and believe nicotine causes cancer to assess the effect of different message strategies on perceptions of tobacco products and switch intention. Pre-post differences and between-condition differences were assessed. RESULTS Strength of agreement with the statement that nicotine is a major cause of cancer decreased and switch intentions increased after message exposure. The proportion of participants with low relative harm perceptions increased for e-cigarettes and smokeless tobacco (p <.0001) and decreased for very low nicotine cigarettes compared to cigarettes. The message with both strategies decreased agreement that nicotine causes cancer more than the message with only the causal alternative. There was no significant effect of condition on relative harm beliefs or switch intentions. CONCLUSIONS Messages with both corrective strategies can reduce the belief that nicotine causes cancer to a greater extent than messaging that only contains a causal alternative. Belief accuracy increased after any message exposure, but these findings should be interpreted cautiously given the study design. Combined strategies should be further investigated in larger samples.
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Affiliation(s)
- Caitlin Weiger
- Rutgers Center for Tobacco Studies Fifth Floor, 303 George St. New, Brunswick, NJ 08901, United States; Institute for Global Tobacco Control Johns Hopkins Bloomberg School of Public Health Department of Health, Behavior & Society, 2213 McElderry St. Fourth Floor, Baltimore, MD 21205, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior & Society, 624 N Broadway Seventh Floor, Baltimore, MD 21205, United States.
| | - Joanna E Cohen
- Rutgers Center for Tobacco Studies Fifth Floor, 303 George St. New, Brunswick, NJ 08901, United States; Institute for Global Tobacco Control Johns Hopkins Bloomberg School of Public Health Department of Health, Behavior & Society, 2213 McElderry St. Fourth Floor, Baltimore, MD 21205, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior & Society, 624 N Broadway Seventh Floor, Baltimore, MD 21205, United States
| | - Ryan David Kennedy
- Rutgers Center for Tobacco Studies Fifth Floor, 303 George St. New, Brunswick, NJ 08901, United States; Institute for Global Tobacco Control Johns Hopkins Bloomberg School of Public Health Department of Health, Behavior & Society, 2213 McElderry St. Fourth Floor, Baltimore, MD 21205, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior & Society, 624 N Broadway Seventh Floor, Baltimore, MD 21205, United States
| | - Meghan B Moran
- Rutgers Center for Tobacco Studies Fifth Floor, 303 George St. New, Brunswick, NJ 08901, United States; Institute for Global Tobacco Control Johns Hopkins Bloomberg School of Public Health Department of Health, Behavior & Society, 2213 McElderry St. Fourth Floor, Baltimore, MD 21205, United States; Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior & Society, 624 N Broadway Seventh Floor, Baltimore, MD 21205, United States
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Plurphanswat N, Rodu B. Why can't smokers quit? Longitudinal study of smokers in the US using the Population Assessment of Tobacco and Health (PATH) waves 1 to 5. Addict Behav Rep 2023; 18:100517. [PMID: 37955038 PMCID: PMC10632605 DOI: 10.1016/j.abrep.2023.100517] [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: 05/24/2023] [Revised: 10/12/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023] Open
Abstract
Introduction Most adult cigarette smokers have tried unsuccessfully to quit. We followed participants in the Population Assessment of Tobacco and Health (PATH) study through five waves (2013-2019), comparing smoking, quit behaviors and other characteristics between persistent smokers and those who became and stayed former smokers. Methods The main analysis employed treatment effects to estimate mean differences in smoking and quitting behaviors among smoker groups. Logistic models were used to estimate predicted means based on continuing smokers' demographic characteristics to ensure that any differences in outcomes did not come from differences in demographic characteristics. Results Among smokers enrolled in PATH Wave 1, 68 % persisted in all subsequent waves. Compared with smokers who quit after Wave 1, persistent smokers had remarkably stable smoking behaviors, including significantly higher proportions of everyday smokers, consuming 10+ cigarettes per day, and smoking within 30 min of waking up. Persistent smokers were also less likely to try to quit completely, and experienced more negative symptoms from nicotine withdrawal. They also showed less interest in quitting and were less confident of being successful than smokers who quit by the next wave. Neither electronic nicotine delivery systems nor menthol played a role in continued smoking or quitting. Conclusions The characteristics and behaviors of persistent smokers in this study were stable over five waves of data collection during a six-year period, suggesting that these smokers need new cessation options.
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Affiliation(s)
| | - Brad Rodu
- Department of Medicine, School of Medicine, University of Louisville, Louisville, KY, Brown Cancer Center, University of Louisville, Louisville, KY 40202, USA
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Rubenstein D, Denlinger-Apte RL, Cornacchione Ross J, McClernon FJ. Adoption of E-Cigarettes Among Older Adults Who Smoke to Reduce Harm and Narrow Age-Related Disparities: An Application of the Health Belief Model. Nicotine Tob Res 2023; 25:1212-1214. [PMID: 36702774 PMCID: PMC10202631 DOI: 10.1093/ntr/ntad016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 12/19/2022] [Accepted: 01/24/2023] [Indexed: 01/28/2023]
Affiliation(s)
- Dana Rubenstein
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA
| | - Rachel L Denlinger-Apte
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Jennifer Cornacchione Ross
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - F Joseph McClernon
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA
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