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Effects of modified risk tobacco product claims on consumer comprehension and risk perceptions of IQOS
  1. Bo Yang1,
  2. Zachary B Massey2,
  3. Lucy Popova2
  1. 1Department of Communication, University of Arizona, Tucson, Arizona, USA
  2. 2School of Public Health, Georgia State University, Atlanta, Georgia, USA
  1. Correspondence to Dr Lucy Popova, School of Public Health, Georgia State University, Atlanta, GA 30302, USA; lpopova1{at}


Introduction Tobacco industry studies on consumers’ perceptions of modified risk claims (MRCs) often had important omissions (eg, no control group, not investigating whether consumers understand what ‘switching completely’ means). This study examined the effects of IQOS MRCs on risk perceptions and behavioural intentions.

Method Based on tobacco companies’ MRCs, we manipulated three MRC language features: explanation about ‘switching completely’ (absent vs present), number of diseases (single vs multiple) and language certainty (hypothetical vs certain). In an online experiment, we randomised 1523 US adult current smokers and 1391 young adult non-smokers to 1 of 9 conditions following a 2×2×2+1 control design. People reported their comprehension of ‘switching completely’, IQOS risk perceptions and behavioural intentions after message exposure.

Results More smokers exposed to MRCs that included an explanation about ‘switching completely’ (22.2%) (vs explanation absent (11.2%) and control (10.7%)) mentioned that ‘switching completely’ meant smoking 0 cigarettes. Compared with the control, several MRCs (eg, certain language) produced lower perceived risk of IQOS, including for diseases not mentioned in the MRCs. MRCs using certain and hypothetical language did not differ on any outcomes. MRCs highlighting reduced risk for a single disease and multiple diseases did not differ on any outcomes. MRCs did not influence behavioural intentions.

Conclusion The Food and Drug Administration should ensure that consumers understand what ‘switching completely’ means in an MRC and recognize that some language features may mislead consumers into believing that a product reduces the risk of diseases not mentioned in an MRC.

  • harm reduction
  • advertising and promotion
  • nicotine

Statistics from


  • Contributors BY and LP conceived the study and developed the study protocol. ZM created the message stimuli. BY analysed the data, wrote the first draft and submitted the manuscript. All authors contributed to writing, revision and approval of the final version.

  • Funding Research reported in this publication was supported by the National Cancer Institute of the National Institutes of Health and the Food and Drug Administration Centre for Tobacco Products (R00CA187460) and the National Institute on Drug Abuse of the National Institutes of Health and the Food and Drug Administration Centre for Tobacco Products (P50DA036128, R01DA047397).

  • Disclaimer The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Georgia State University IRB approved this study.

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

  • Data availability statement Data are available on reasonable request. Authors are willing to share the data on reasonable request.

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