Skip to main content
An official website of the United States government
Grant Details

Grant Number: 2R01CA239308-04A1 Interpret this number
Primary Investigator: Popova, Lyudmila
Organization: Georgia State University
Project Title: Communicating About Nicotine and Differential Risks of Tobacco Products in Priority Populations
Fiscal Year: 2024


ABSTRACT Tobacco use continues to disproportionately harm priority populations, such as smokers with mental health conditions and people from low socioeconomic status (SES) groups. The US Food and Drug Administration (FDA) is moving forward with a groundbreaking plan to reduce tobacco-related death and disease by lowering nicotine in combusted cigarettes to minimally addictive levels. To maximize the effectiveness of this potentially life-saving policy, its implementation needs to be accompanied by messages that address misperceptions about very low nicotine cigarettes (VLNCs; e.g., that VLNCs are less harmful than regular cigarettes). Past randomized clinical trials (RCTs) with VLNCs found that they are less addictive than cigarettes, reduce the number of cigarettes smoked per day, and have similar beneficial effects among priority populations as in the general population. However, past RCTs with VLNCs did not include messages about the products or policy. Emerging studies have begun to investigate messages about VLNCs, but so far they did not examine the effects of messages on behavior and were all hypothetical, with messages unaccompanied by use of the actual product. We propose to take the next step and bring together two streams of research (RCTs of VLNCs and messages about VLNCs) that have remained disparate but need to be combined to more closely resemble reduced nicotine policy implementation in the real world. We will address three specific aims: (1) Develop targeted messages about reduced nicotine in combusted tobacco products for smokers with serious psychological distress (SPD) and socioeconomically disadvantaged smokers using qualitative focus groups. (2) Test the impact of messages about VLNCs on tobacco use behaviors in an RCT with smokers with SPD, low-SES, and smokers who are neither. After 1-week baseline using normal nicotine content cigarettes, participants will be randomized into treatment (VLNCs and messages) or control (VLNCs only) condition. Participants in the treatment condition will be exposed to messages as inserts (small printed leaflets) in cigarette packs and print and video ads during weekly in-person visits. All participants will use VLNCs for 4 weeks and complete daily logs and weekly in-person visits. (3) Assess experiences with VLNCs and messages among the RCT participants in focus groups following the completion of the RCT. The results will contribute to the science that informs FDA regulatory actions around product review, product standards, and public education on nicotine.


Messaging about very low nicotine cigarettes (VLNCs) to influence policy attitudes, harm perceptions and smoking motivations: a discrete choice experiment.
Authors: Reynolds R.M. , Popova L. , Ashley D.L. , Henderson K.C. , Ntansah C.A. , Yang B. , Hackworth E.E. , Hardin J. , Thrasher J. .
Source: Tobacco control, 2024-04-19; 33(3), p. 325-332.
EPub date: 2024-04-19.
PMID: 36171147
Related Citations

Reactions to Messages About a Nicotine Reduction Policy: A Focus Group Study Among People Who Use Little Cigars and Cigarillos.
Authors: Ntansah C.A. , Hackworth E.E. , Henderson K.C. , Reynolds R.M. , Yang B. , Ashley D.L. , Duong H.T. , Thrasher J.F. , Popova L. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2024-01-01; 26(1), p. 87-93.
PMID: 37596965
Related Citations

Effects of a Reduced Risk Claim on Adolescents' Smokeless Tobacco Perceptions and Willingness to Use.
Authors: Chaffee B.W. , Couch E.T. , Popova L. , Halpern-Felsher B. .
Source: The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 2023 Sep; 73(3), p. 445-451.
EPub date: 2023-06-09.
PMID: 37294249
Related Citations

Premium Cigar Festivals: A Potential Target for Marketing Restrictions.
Authors: Ozga J.E. , Smiley S.L. , Hart J.L. , Popova L. , Stanton C.A. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2023-07-28; 25(Suppl_1), p. S81-S83.
PMID: 37506236
Related Citations

"I Crave a Blunt, I Don't Crave a Cigarillo": A Focus Group Study on Perceptions of Nicotine and Addiction among US Adults Who Currently Smoke Little Cigars or Cigarillos.
Authors: Hackworth E.E. , Ntansah C.A. , Henderson K.C. , Pei D. , Reynolds R.M. , Duong H.T. , Yang B. , Ashley D.L. , Thrasher J.F. , Popova L. .
Source: International journal of environmental research and public health, 2023-03-14; 20(6), .
EPub date: 2023-03-14.
PMID: 36981995
Related Citations

'It brings light to what you really put into your body': a focus group study of reactions to messages about nicotine reduction in cigarettes.
Authors: Duong H.T. , Loud E.E. , Thrasher J.F. , Henderson K.C. , Ashley D.L. , Popova L. .
Source: Tobacco control, 2022 Sep; 31(5), p. 649-654.
EPub date: 2021-04-16.
PMID: 33863835
Related Citations

Perceptions of Nicotine Reduction Policy in the United States: A Qualitative Study.
Authors: Henderson K.C. , Loud E.E. , Duong H.T. , Reynolds R.M. , Yang B. , Ntansah C.A. , Ashley D.L. , Thrasher J.F. , Popova L. .
Source: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2022-08-06; 24(9), p. 1422-1429.
PMID: 35312014
Related Citations

Balancing Risks and Benefits of E-Cigarettes in the Real World.
Authors: Cohen J.E. , Krishnan-Sarin S. , Eissenberg T. , Gould T.J. , Berman M.L. , Bhatnagar A. , Barnett T.E. , Soule E. , Popova L. , Tan A.S.L. , et al. .
Source: American journal of public health, 2022 Feb; 112(2), p. e1-e2.
PMID: 35080942
Related Citations

Addicted to smoking or addicted to nicotine? A focus group study on perceptions of nicotine and addiction among US adult current smokers, former smokers, non-smokers and dual users of cigarettes and e-cigarettes.
Authors: Loud E.E. , Duong H.T. , Henderson K.C. , Reynolds R.M. , Ashley D.L. , Thrasher J.F. , Popova L. .
Source: Addiction (Abingdon, England), 2022 Feb; 117(2), p. 472-481.
EPub date: 2021-07-20.
PMID: 34227709
Related Citations

Which tobacco control policies do smokers support? Findings from the International Tobacco Control Four Country Smoking and Vaping Survey.
Authors: Smith T.T. , Nahhas G.J. , Borland R. , Cho Y.J. , Chung-Hall J. , Fairman R.T. , Fong G.T. , McNeill A. , Popova L. , Thrasher J.F. , et al. .
Source: Preventive medicine, 2021 Aug; 149, p. 106600.
EPub date: 2021-05-03.
PMID: 33957152
Related Citations

Back to Top