Article Text

Download PDFPDF
Nicotine beliefs and perceptions of low nicotine labels and mitigating statements among people who do and do not smoke: a cross-sectional study from Aotearoa New Zealand
  1. Philip Gendall1,
  2. Lucy Popova2,
  3. James Thrasher3,
  4. Janet Hoek1
  1. 1Public Health, University of Otago Wellington, Wellington, New Zealand
  2. 2School of Public Health, Georgia State University, Atlanta, Georgia, USA
  3. 3Health Promotion, Education, and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA
  1. Correspondence to Professor Janet Hoek, Public Health, University of Otago, Wellington, New Zealand; janet.hoek{at}otago.ac.nz

Abstract

Background Aotearoa New Zealand proposed a new maximum nicotine content of 0.8 mg/g for smoked tobacco products, although the new government plans to repeal this legislation. Requiring ‘Very low nicotine’ (VLN) messages on cigarettes meeting this standard may reinforce misperceptions that they are less harmful than cigarettes currently sold.

Methods To explore knowledge of nicotine and very low nicotine cigarettes (VLNCs), and perceptions of cigarette packs featuring different low nicotine messages (eg, ‘Very low nicotine’) and mitigating statements (eg, ‘No cigarettes are safe’), we surveyed 354 people who smoked, 142 who formerly smoked, and 214 people who had never smoked regularly.

Results Around half of all respondents believed VLNCs were less harmful than regular cigarettes and around two-thirds incorrectly thought nicotine causes most of the related health problems resulting from smoking. Nearly a third thought VLNCs would be less harmful than regular cigarettes; 34% believed they would be just as harmful. Mitigating statements did not affect perceptions of people who smoked, although people who formerly, or who had never smoked regularly, perceived mitigating statements referring to poisons and cancer as significantly more likely than the VLN message to discourage smoking.

Conclusions Misunderstanding of VLNCs as less harmful than regular cigarettes is widespread; VLN messages may reinforce this misperception, which mitigating statements did not correct among people who smoke. As an alternative to VLN messages, policy makers could consider introducing VLNCs on a specified date and developing public information campaigns; these measures would avoid phase-in confusion and obviate the need for VLN messaging.

  • End game
  • Public policy
  • Packaging and Labelling
  • Nicotine

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

Statistics from Altmetric.com

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.

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

View Full Text

Footnotes

  • Contributors JH conceptualised the study; she developed the study protocol, with input from PG, LP and JT, and obtained ethical approval. PG led the questionnaire development with input from JH, LP and JT, oversaw the data collection and led the data analyses. PG and JH led the manuscript development and revisions; LP and JT provided feedback on earlier drafts of the original and revised manuscript. All authors have reviewed and approved the manuscript. PG is the guarantor.

  • Funding The research was funded by the Health Research Council of New Zealand (programme grant 19/641).

  • Competing interests There are no competing interests to declare.

  • 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.