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  • Messaging about very low nicotine cigarettes (VLNCs) to influence policy attitudes, harm perceptions and smoking motivations: a discrete choice experiment

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Original research
Messaging about very low nicotine cigarettes (VLNCs) to influence policy attitudes, harm perceptions and smoking motivations: a discrete choice experiment
  1. Reed M Reynolds1,
  2. Lucy Popova2,
  3. David L Ashley2,
  4. Katherine C Henderson2,
  5. Charity A Ntansah3,
  6. Bo Yang4,
  7. Emily E Hackworth3,
  8. James Hardin5,
  9. James Thrasher3
  1. 1 Communication Department, University of Massachusetts Boston, Boston, Massachusetts, USA
  2. 2 School of Public Health, Georgia State University, Atlanta, Georgia, USA
  3. 3 Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
  4. 4 Department of Communication, University of Arizona, Tucson, Arizona, USA
  5. 5 Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
  1. Correspondence to Dr Reed M Reynolds, Communication Department, University of Massachusetts, Boston, MA 02125, USA; rreynolds25{at}gsu.edu

Abstract

Background To reduce smoking and the harms it causes, countries, including the USA, are considering policies to reduce nicotine in combustible tobacco to minimally addictive levels. Effective messages about very low nicotine cigarettes (VLNCs) and this policy are crucial in combating misperceptions threatening the policy’s effectiveness.

Data and methods A discrete choice experiment assessed messages about VLNCs. Participants were 590 adults who smoked exclusively, 379 adults who both smoked and used e-cigarettes, 443 adults who formerly smoked and 351 young adults who never smoked (total n=1763). Seven message attributes were varied systematically (source, harm, chemicals, nicotine, satisfaction, addictiveness and quitting efficacy). Outcomes were selection of messages that generated the most positive attitude towards reduced nicotine policy, the greatest perceived harmfulness of VLNCs, and most strongly motivated quitting and initiating behaviour for VLNCs.

Results Information about specific harms and chemicals of VLNCs had the largest effects on selection of messages as eliciting more negative attitudes towards VLNCs policy, increasing perceived VLNC harmfulness, increasing motivation to quit VLNCs and decreasing motivation to try VLNCs. Messages with information about quitting efficacy were selected as more motivating to quit among those who smoke, but also more motivating to try VLNCs among those who do not smoke.

Conclusion Harm and chemical information can be prioritised to ensure VLNCs are not misperceived as less harmful than regular cigarettes. Messages about increased quitting efficacy and reduced addictiveness associated with VLNCs may backfire if presented to those who do not smoke.

  • nicotine
  • cessation
  • public policy
  • public opinion

Data availability statement

Data are available on reasonable request.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/tc-2022-057577

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • Contributors RMR accepts full responsibility for the work and the conduct of the study, had access to the data, and controlled the decision to publish. Study concept and design: LP and JT. Acquisition, analysis or interpretation of the data: RMR, LP, JT and JWH. Drafting of the manuscript: all authors. Critical revision of the manuscript for important intellectual content: all authors. Statistical analysis: RMR, JT and JH. Obtained funding: LP and JT.

    • Funding This research was supported by the National Cancer Institute of the National Institutes of Health and the Food and Drug Administration Centre for Tobacco Products (R01CA239308).

    • Competing interests No, there are no competing interests.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.