Effective Formats for Communicating Risks from Cigarette Smoke Chemicals

Abstract

Objective The US government requires the public display of information about toxic chemicals in cigarettes and smoke by brand in a way that is understandable and not misleading. We sought to identify risk communication formats that meet these goals. Methods We conducted 3 online experiments with US adult convenience samples (total N = 1866). Participants viewed a webpage displaying information about chemicals in the smoke of a cigarette brand. Experiment 1 varied the chemicals listed and format for their health effects. Experiments 2 and 3 varied the format of chemical quantities and presence/absence of a visual risk indicator. Outcomes were understandable (increasing knowledge) and not misleading (not reinforcing misperceptions). Results Information about chemicals and health effects increased knowledge of these topics by ~30% (p < .001) compared to no information. Quantity format and use of a risk indicator generally did not affect knowledge. The proportion of participants misled ranged from 0% to 92%, depending on measure. Findings indicated 52% would use a website to search for safer cigarettes. Risk communication formats did little to reduce being misled. Conclusions Some risk communication formats successfully increased knowledge of chemicals and health effects. However, the formats did little to reduce the proportion of people misled.

The effect of cigarillo packaging elements on young adult perceptions of product flavor, taste, smell, and appeal

“…Cigarillo packs were branded with a fictitious name, “Brentfield”, a brand successfully used in prior research [ 34 , 35 ] to minimize the influence of brand loyalty and pre-existing brand perceptions. Cigarillo packs were manipulated on five elements, generating 180 pack images: 1) flavor descriptor (none, Sweet, Grape, Wine, Tropical); 2) pack color (no color, pink, purple); 3) pack type (box 5-pack, foil 2-pack); 4) branding (no branding, branded); 5) warning (no warning, text-only, pictorial) ( Fig 1 ).…”

Communicating about chemicals in cigarette smoke: impact on knowledge and misunderstanding

“…In phase one, the survey assessed knowledge of harmful chemicals (both familiar and unfamiliar) in cigarette smoke,11 knowledge of health effects, perceived likelihood of harm27 and perceived severity of harm among all people and misunderstanding among participants who viewed a website. The survey assessed knowledge of five harmful chemicals in cigarette smoke (acrylonitrile, ammonia, isoprene, lead, 1-aminoaphthalene) and five health effects caused by smoking (cancer of the pancreas, blood clots, erectile dysfunction, lung damage, addiction).…”

“…We coded correct responses as 1 and incorrect or don’t know responses as 0; we then averaged the variables to create chemicals and health effects knowledge scores that ranged from 0% to 100%. The survey assessed misunderstanding for participants exposed to a website with items concerning beliefs that the fictitious brand is ‘safer to smoke’, has ‘fewer harmful chemicals,’ is ‘much more harmful’ or ‘much less harmful’ than other cigarettes 11. We designated responses of ‘somewhat agree’ or ‘strongly agree’ as a misunderstanding (scored as 1; otherwise 0) and then averaged the variables to create a misunderstanding score that ranged from 0% to 100%.…”

“…Long lists of unfamiliar chemicals and their quantities are likely to confuse the public 5 7–9. Worse, presenting numerical information on chemical levels, as previously done with tar and nicotine yield and harmful or potentially harmful chemicals, may be counterproductive, giving the false impression that products with lower quantities are substantially safer 8 10–12. Additionally, the chemical information must also be widely accessible to the public to have an impact, including to vulnerable populations who may struggle to make sense of and apply health information (eg, low health literacy) or numbers (eg, low numeracy) 13 14.…”

“…Additionally, the chemical information must also be widely accessible to the public to have an impact, including to vulnerable populations who may struggle to make sense of and apply health information (eg, low health literacy) or numbers (eg, low numeracy) 13 14. Empirical data on how best to implement constituent disclosures so that they increase knowledge and do not mislead the public, especially vulnerable populations, is critical 11 15…”