Smokers’ and Young Adult Non-Smokers’ Perceptions and Perceived Impact of Snus and E-Cigarette Modified Risk Messages

Abstract

Although no tobacco products are safe, tobacco companies in the United States may request regulatory authorization to make certain “modified risk tobacco product” (MRTP) claims in their marketing. However, few qualitative studies have explored consumer perceptions and understanding of comparative risk messages and wordings. We examined consumer perceptions of statements indicating reduced risks and exposure to chemicals from snus and e-cigarettes relative to smoking. We conducted 12 focus groups with adult smokers (ages 21–66) and young adult (YA) non-smokers (ages 18–25) (n = 57) in the USA in 2019. Participants shared reactions to modified risk and exposure messages and message variations. Participants largely understood claims, including language about “switching completely.” However, participants expressed desire for more message specificity, evidence, risk reduction reasons, and statistics/quantitative information. Claim believability and acceptance was also limited by existing negative product beliefs and experiences, negative media reports, and skepticism about message source. YAs did not express product interest based on message exposure. Some YAs suggested the included “smoker” language made the messages less interesting/relevant. Given existing proposals for and use of MRTP messages, additional research on their wording, framing, delivery, and effects may help inform regulatory or organizational decisions about such messages, optimize potential benefits, and mitigate unintended consequences.

Content Analysis of E-cigarette News Articles Amidst the 2019 Vaping-Associated Lung Injury (EVALI) Outbreak in the United States

“… 14 In light of the EVALI outbreak, studies have begun describing the likely influence of the lung disease and EVALI-related news on risk perceptions. 8 , 18 , 19 For example, one qualitative study found that exposure to EVALI news was associated with reduced interest in e-cigarettes among young adult non-smokers (a potentially unintended positive effect) but was also associated with increased harm perceptions and reduced receptivity to switching to e-cigarettes among adult current smokers (a potentially negative unintended effect). 19 Population-level research has also suggested increases in perceptions that e-cigarettes are equally or more harmful than traditional cigarettes after EVALI, 8 even outside of the United States.…”

Nicotine Dependence and Stress Susceptibility in E-Cigarette Smokers: The Korea National Health and Nutrition Examination Survey 2013–2017

“…Thus, they wanted to stop smoking or at least to decrease the amount of combustible cigarette consumption, but they also wanted to continue smoking with less harmful product. This conflicting attitude of e-cigarette users explains why they are easily exploited by manufactures who claim e-cigarettes are MRTPs 17 . In addition, e-smokers were more susceptible to stress than non-smokers or smoker.…”

Exploring the implications of modified risk claim placement in tobacco advertising

“…Data are from 11 focus groups from a broader study on MRTP claim reactions ( Wackowski et al, 2020 , Wackowski et al, 2021 ). Six groups focused on snus messages and five on e-cigarette messages 1 .…”

“…Messages were informed by previous studies and MRTP applications. Details about those messages, procedures and findings are presented elsewhere ( Wackowski et al, 2020 , Wackowski et al, 2021 ). Briefly, although some smokers expressed interest in MRTP statements/products, participants also expressed considerable message skepticism.…”