Article Text

Download PDFPDF
PREP advertisement features affect smokers’ beliefs regarding potential harm
  1. A A Strasser1,
  2. K Z Tang1,
  3. M D Tuller1,
  4. J N Cappella2
  1. 1
    Transdisciplinary Tobacco Use Research Center, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, Pennsylvania, USA
  2. 2
    Annenberg School of Communications, University of Pennsylvania, 3620 Walnut Street, Philadelphia, Pennsylvania, USA
  1. Andrew A Strasser, PhD, Transdisciplinary Tobacco Use Research Center, University of Pennsylvania, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, USA; strasse3{at}


Background: The Institute of Medicine report on potential reduced exposure products (PREPs) recommends that advertising and labelling be regulated to prevent explicitly or implicitly false or misleading claims. Belief that a product is less harmful may increase use or prevent smoking cessation.

Objective: To determine the effect of altering advertisement features on smokers’ beliefs of the harm exposure from a PREP.

Methods: A Quest advertisement was digitally altered using computer software and presented to participants using web-based television recruitment contracted through a survey company. 500 current smokers completed demographic and smoking history questions, were randomised to view one of three advertisement conditions, then completed eight items assessing their beliefs of the harmfulness of the product. Advertisement conditions included the original, unaltered advertisement; a “red” condition where the cigarette packages were digitally altered to the colour red, implying increased harm potential; and a “no text” condition where all text was removed to reduce explicit product information. Polytomous logistic regression, using “incorrect,” “unsure” and “correct” as outcomes, and advertisement type and covariates as predictors, was used for analyses.

Results: Participants randomised to the “no text” advertisement were less likely to be incorrect in their beliefs that Quest cigarettes are lower in tar, less addictive, less likely to cause cancer, have fewer chemicals, are healthier and make smoking safer.

Conclusions: Smokers can form false beliefs about the harmfulness of PREP products based on how the PREPs are marketed. Careful examination must be undertaken to provide empirical evidence to better formulate regulatory principles of PREP advertising.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Funding: Center of Excellence in Cancer Communication Research (P50-101404; Hornik), Transdisciplinary Tobacco Use Research Center (P50-84718; Lerman) and National Cancer Institute (RO1-CA120594; Strasser).

  • Competing interests: None.