This pilot study tested the effect of a brief nicotine education messaging exposure on beliefs about nicotine, nicotine-replacement therapy (NRT), and e-cigarettes. Participants ages 18 and older were recruited via Amazon Mechanical Turk to complete a 20-min online survey in April/May 2020 to assess relationships between opioid use, smoking, and other behaviors. Participants with past-month extra-medical opioid use completed questions on background characteristics and literacy and then were randomized in a 2:1 ratio of two conditions: nicotine education (n = 362) or no message control (n = 181). Beliefs about nicotine, NRT, and e-cigarettes were asked of all participants; this occurred after message exposure for the nicotine education condition. Bivariate and multivariable analyses examined differences in beliefs by study condition. Brief nicotine messaging increased the probability of a correct response to "Nicotine is a cause of cancer" (false, 63% vs. 36%) and reduced the probability of a don't know response (9% vs. 17%) compared to the no message control condition. Nicotine education also reduced false beliefs about harms of long-term NRT use compared to cigarettes ( p < .05). In adjusted models, participants in the nicotine education group had lower mean false beliefs about nicotine ( p < .001) and to a lesser extent NRT ( p = .053) compared with the control group; there was no difference in mean false beliefs about e-cigarettes ( p = .547) between groups. A brief education intervention produced similar changes in nicotine beliefs in adults with past-month extra-medical opioid use as in a general adult sample. Findings support the potential for impact of nicotine public education messaging in vulnerable populations. Public Health SignificanceThe present study explored whether a brief nicotine messaging intervention corrects misperceptions of nicotine, nicotine-replacement therapy, or e-cigarettes for persons with past-month extra-medical opioid use. Findings show that a 1 min exposure to messages similar to what might be seen on warning labels or in media campaigns may improve understanding of nicotine and NRT, but not e-cigarettes.
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