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Public education about the relative harm of tobacco products: an intervention for tobacco control professionals
  1. Lois Biener1,
  2. Amy L Nyman1,
  3. Irina Stepanov2,
  4. Dorothy Hatsukami3
  1. 1Center for Survey Research, University of Massachusetts Boston, Boston, Massachusetts, USA
  2. 2Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
  3. 3Tobacco Research Programs, University of Minnesota, Minneapolis, Minnesota, USA
  1. Correspondence to Dr Lois Biener, Center for Survey Research, University of Massachusetts Boston, 100 Morrissey Blvd, Boston, MA 02125, USA; lois.biener{at}


Background In the USA, new regulations require the collection of information on tobacco constituents by brand and variety and publication of this information in a way not likely to be misconstrued by consumers. Understanding of such information becomes increasingly important as new tobacco products are marketed and modifications are made to reduce the toxicity of some products. This pilot study assessed the current knowledge of tobacco control professionals regarding the relative harmfulness of several tobacco products, and evaluated an online educational intervention aimed at improving understanding of variations in nicotine and tobacco-specific N-nitrosamines (TSNAs).

Methods Fifty-two tobacco control professionals participated in an online intervention which presented and discussed the results of constituent analyses of Camel Snus and Marlboro Snus compared to several conventional smokeless tobacco products. Comparisons with cigarettes were also discussed. Pre- and post-intervention questions assessed understanding of the concepts.

Results Pre-intervention responses demonstrated that 31% did not know that cigarettes are more harmful than smokeless tobacco, 67% did not know that smokeless products higher in nicotine are likely to be more effective substitutes for cigarettes, 52% did not know TSNAs are the major carcinogens in tobacco and 81% did not know new snus products tend to be lower in TSNAs than conventional spit tobacco. After intervention participation, knowledge increased on all points except one where pretest results were 100% correct.

Conclusions Public education campaigns are urgently needed for tobacco control professionals and consumers to increase awareness and understanding of the continuum of risk among tobacco products.

  • Harm Reduction
  • Non-cigarette tobacco products
  • Carcinogens
  • Nicotine

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