Messages About Reduced Nicotine in Combusted Tobacco Products

Not Applicable

Completed

Conditions: Risk Behavior
Smoking Behaviors
Smoking
Smoking, Tobacco
Health Communication

Interventions: Behavioral: Reduced nicotine message exposure
Behavioral: Combined message exposure (reduced nicotine + modified risk)
Behavioral: Control message exposure
Behavioral: Modified risk message exposure

Registration Number: NCT05506046

Lead Sponsor: Georgia State University

Brief Summary: The investigators will conduct a message-exposure experiment with nationally representative samples of smokers, dual-users (cigarettes and e-cigarettes), and young adult non-smokers (aged 18-29).

Experimental messages will address the reduction of nicotine in cigarettes. Participants will also complete a follow-up survey after 2 weeks, measuring their recall of the messages and behaviors since message exposure.

Detailed Description: A national probability-based sample will be recruited to include 900 current exclusive smokers, 450 dual users, and 450 young adult (18-29) non-smokers, evenly split between men and women.

The study will be conducted using a self-administered, online questionnaire via proprietary, web-assisted interviewing software.

Participants are randomized to one of four conditions:

* reduced nicotine messages

* modified risk messages

* a combination of reduced nicotine message and modified risk message

* control messages with no cigarette-related content

Participants will take part in two sessions: in session 1 (estimated at about 15 min) participants will see the messages and report immediate outcomes including risk perceptions.

In session 2, which will take place 2 weeks after session 1, participants will complete a brief 5-minute survey measuring their recall of the messages and behaviors since message exposure.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 1901

Inclusion Criteria

Being 18 years old or older:
Belonging to one of three groups of participants; 900 current exclusive smokers, 450 dual users (cigarettes and e-cigarettes), and 450 young adult (18-29) non-smokers, evenly split between men and women.
Enrolled in existing nationally representative panel where recruitment is based

Exclusion Criteria

None.

Study & Design

Study Type: INTERVENTIONAL

Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Reduced Nicotine Messages	Reduced nicotine message exposure	Participants will receive messages with information about reduced nicotine cigarettes.
Combined Message -- Reduced Nicotine + Modified Risk Exposure	Combined message exposure (reduced nicotine + modified risk)	Participants will receive messages about reduced nicotine cigarettes and about e-cigarettes.
Control	Control message exposure	Participants will receive messages about bottled water which should have no impact on the outcomes of interest.
Modified Risk Messages	Modified risk message exposure	Participants will receive messages with information about e-cigarettes.

Primary Outcome Measures

Name	Time	Method
Perceived Health Risk of VLNCs (Absolute)	Immediately after exposure	Measured with a single item, assesses participant's perception of own risk of overall harm to health under conditions of smoking reduced nicotine cigarettes every day. Response options range from 1 (Not at all likely) to 5 (Extremely likely), with higher scores representing a better outcome. An additional option, "Don't know", is also provided.

Secondary Outcome Measures

Name	Time	Method
Perceived Addictiveness of VLNCs	Immediately after exposure	A single item measuring participants' perception of likelihood of developing addiction to reduced nicotine cigarettes under conditions of smoking them every day. Response options are from 1 (Not at all likely) to 5 (Extremely likely), with higher scores representing a worse outcome. An additional option, "Don't know", is also provided.
Perceived Message Effectiveness	Immediately after exposure	A three-item scale measuring to what extent participants think the messages they saw discourage them from wanting to smoke, make smoking seem unpleasant, and make them concerned about health risks of smoking. Response options: from 1 (Disagree) to 4 (Neither Disagree nor Agree) to 7 (Strongly Agree). Higher scores represent a better outcome. The final perceived message effectiveness score is the mean of the response to the three items.
Perceived Health Risk of VLNCs (Absolute) at Post-test	Two weeks after exposure	Measured with a single item, assesses participant's perception of own risk of overall harm to health under conditions of smoking reduced nicotine cigarettes every day. Response options range from 1 (Not at all likely) to 5 (Extremely likely), with higher scores representing a better outcome. An additional option, "Don't know", is also provided.
Interest in Trying Reduced Nicotine Cigarettes	Immediately after exposure	A single item measuring how interested a participant is in trying reduced nicotine cigarettes. Response options are from 1 (not at all) to 7 (extremely), with higher scores representing a worse outcome. An additional option, "Don't know", is also provided.
Intention to Switch From Cigarettes to Electronic Nicotine Products	Immediately after exposure	A single item measuring intention (during the next 6 months) to switch completely from cigarettes to electronic nicotine products. Response options are from 1 (not at all likely) to 7 (extremely likely), with higher scores representing a better outcome. An additional option, "Don't know", is also provided.
VLNC Comparative Risk Perceptions	Immediately after exposure	A single item measuring perceptions of comparative risk of smoking reduced nicotine cigarettes vs regular cigarettes. Response options are from 1 (Much less harmful) to 5 (Much more harmful), with higher scores representing a better outcome. An additional option, "Don't know", is also provided.
VLNC Policy Support	Immediately after exposure	A single item measuring support for the policy to reduce nicotine by 95% in all cigarettes. Response options are from 1 (Strongly Oppose) to 5 (Strongly Support), with higher scores representing a better outcome. An additional option, "Don't know", is also provided.
Smoking Behavior	Two weeks after exposure	Single item measuring the average number of cigarettes smoked per day in the past two weeks.