JMIR Publications

ABSTRACT

Background:

Effective communication about the relative risks of cigarettes and e-cigarettes can help to increase switching away from cigarettes while minimizing unintended use.

Objective:

This study examined comprehension of a proposed modified exposure claim (MEC) about an e-cigarette (IQOS VEEV®; the Study Product, SP) and its effects of claim exposure on SP use intentions and risk perceptions among adult tobacco users and non-users.

Methods:

Adult smokers with no intention to quit smoking (S-NIQ, n = 606), adult smokers with intention to quit smoking (S-IQ, n = 600), adult e-cigarette users (ECU, n = 630), adult former smokers (FS, n = 619), adult tobacco and nicotine products (TNP) never-users aged 18-24 years (TNU18–24, n = 648), and adult TNP never-users aged 25 years and older (TNU25+, n = 749) participated in a randomized between-subjects online experimental study. Participants viewed a marketing brochure for the SP with (test condition) or without (control condition) an embedded MEC. Outcome measures included claim comprehension, intention to use (ITU) the SP regularly, and perceived health risk to self from using the SP or smoking cigarettes.

Results:

Most participants correctly understood the key elements of the claim: the SP produces lower levels of harmful chemicals compared to cigarettes (90.2%), and switching completely from cigarettes to the SP reduces exposure to harmful chemicals (92.4%). In both conditions, positive ITU for the SP was high among ECU (Control = 75.8% vs. Test = 79.0%), moderate among S-IQ (Control = 42.5%; Test = 55.5%) and S-NIQ (Control = 46.8%; Test = 54.1%), low among FS (Control = 9.2%; Test = 10.6%), and very low among TNU18–24 (Control = 0.9%; Test = 2.5%) and TNU25+ (Control = 1.3% vs. Test = 3.2%). All groups understood the SP posed a lower health risk compared to cigarettes. Claim exposure was associated with significantly lower risk perception of the SP relative to cigarettes.

Conclusions:

The tested MEC has the potential to benefit public health by simultaneously increasing already-high levels of SP use intention and reducing SP risk perceptions relative to cigarettes among adult tobacco users while generating low levels of use intention among tobacco non-users.