Effects of claims and warnings on the risk perception of a novel heat-not-burn tobacco product

Abstract

A modified risk tobacco product (MRTP) is a legal designation in the United States for any tobacco product that is sold or distributed for use to reduce harm or the risk of tobacco-related disease associated with commercially marketed tobacco products such as cigarettes. Clear communication on the risks associated with these products is important to ensure that adult consumers understand these products features, benefits and risk profile. We report an analysis on three studies (1510, 1509, and 1534 participants, respectively), in which adult smokers and non-smokers were exposed to communication materials for a candidate MRTP, the Tobacco Heating System (THS). In the three studies, participants assessed risk perceptions of THS based on different combinations of THS communication materials (brochure or pack) and warnings (THS-tailored (PMI) or US Surgeon General’s warnings), along with benefit claims that were study-specific. Multiple linear regression analyses were conducted to assess the covariate-adjusted influence of communication-based factors on risk perception. In all three studies, the PMI warning produced higher levels of perceived risk (both for health and addiction) than the US Surgeon General’s warnings, and the brochure produced higher levels than the pack. Both adult former and never smokers perceived higher levels of health and addiction risks of THS than adult current smokers, a perception that was also influenced by race. Pooling of the results across the three studies showed a similar pattern of results and no effect of the claims on levels of perceived risk. These findings can help developing effective risk communications on MRTPs.