Article Text

Download PDFPDF
Interviews with smokers about smokeless tobacco products, risk messages and news articles
  1. Olivia A Wackowski,
  2. M Jane Lewis,
  3. Cristine D Delnevo
  1. Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, New Jersey, USA
  1. Correspondence to Dr Olivia A Wackowski, Department of Health Education & Behavioral Science, Center for Tobacco Studies, Rutgers School of Public Health, 335 George Street, Suite 2100, New Brunswick, NJ 08903, USA; wackowol{at}


Background Smokeless tobacco (SLT) products and their communication have been topics of discussion in harm reduction debates, but little is known about smokers’ perceptions of existing SLT risk messages. This study aimed to explore smokers’ perceptions of SLT and snus products and news stories with different risk messages about them.

Methods We conducted interviews with 30 smokers assigned to read 1 of 3 constructed news stories about SLT and snus with different messages about their risks relative to cigarettes: (1) a ‘favourable’ version (describing SLT/snus as a ‘safer’ smoking alternative); (2) a ‘cautious’ version (describing SLT/snus as having various risks); and (3) a ‘mixed’ version (both stating SLT risks and potential reduced-risk benefits).

Results Smokers felt somewhat more informed about snus after article reading and largely found quoted sources to be credible. Though some exposed to favourable SLT/snus messages appeared to modify their beliefs about the products’ acceptability and risks, many were left unchanged given pre-existing SLT risk perceptions influenced by prior SLT warnings, observed effects in known users, and concerns about SLT's mode of use. Willingness to use/not use snus in the future was also influenced by non-risk-related factors (eg, preference for smoking rituals). Many referenced e-cigarettes as being safer and more attractive smoking alternatives.

Conclusions Exposure to reduced-risk SLT information may have some impact on smokers’ SLT perceptions and interest, but this might be limited by a variety of negative SLT beliefs and growth of other smoking alternatives. Future research should explore SLT risk message effects with larger samples and different study designs.

  • Harm Reduction
  • Media
  • Non-cigarette tobacco products

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.


  • Twitter Follow Cristine Delnevo at @lozzola

  • Contributors OAW conceived and obtained funding for the study, led data collection and analysis, and drafted the manuscript. MJL and CDD assisted in obtaining study funding, developing the stimulus articles and critically reviewed the manuscript for important intellectual content. MJL also assisted in reviewing coded transcripts for agreement in themes. All authors approved the final version of the manuscript.

  • Funding This work was supported by a grant from the National Cancer Institute and the FDA Center for Tobacco Products (R03CA175901). OAW was the study principal investigator.

  • Competing interests None declared.

  • Ethics approval The Institutional Review Board for the Rutgers Biomedical and Health Sciences School approved this study under exempt review.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The stimulus news articles used in this study are available from the authors on request.