Communicating about Nicotine and Differential Risks of Tobacco Products

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ABSTRACT The US Food and Drug Administration’s (FDA) potentially groundbreaking plan to reduce tobacco-related death and disease by lowering nicotine in combusted cigarettes to minimally addictive levels has many challenges. The tobacco industry and its allies argue that it would lead to a skyrocketing black market and public and political backlash. Some caution that smokers would view reduced nicotine cigarettes as less harmful, which would deter quitting, similar to how “light” and “mild” descriptors caused many health-conscious smokers to continue smoking. To maximize the benefits of this potentially life-saving policy, it is necessary to develop effective ways to communicate about nicotine in various tobacco products and about the health risks of using products that have different levels of nicotine, such as combusted cigarettes and electronic nicotine delivery systems (ENDS). One promising communication strategy is to combine messages about reduced nicotine in combusted cigarettes with messages about lower risks of other nicotine-delivering products (i.e., “modified risk claims”). Our central hypothesis is that the two types of messages in combination have greater positive impact than either type alone. This might be due to modified risk messages being able to mitigate negative emotional reactions and reactance to reduced nicotine messages. Yet this communication strategy remains virtually unexplored. Research is sorely needed to examine these two types of messages as they present both sides of the FDA’s new comprehensive plan for nicotine and tobacco regulation. This project will provide that research by pursuing these specific aims: (1) Develop preliminary messages about reduced nicotine in combusted tobacco products using qualitative focus groups; (2) Quantify the relative importance of different types of information in communications about reduced nicotine using Discrete Choice Experiment; (3) Test the impact of messages about reduced nicotine in combusted tobacco products in the context of modified risk statements for novel tobacco products in a randomized clinical trial with a nationally representative sample of adult current exclusive smokers, dual users, and young adult (18-29) non-smokers. This project will use insights from communication and decision sciences to produce data that will contribute to the science that informs FDA regulatory actions around product review, product standards, and public education on nicotine and the differential risks of tobacco products.