Grant Number:	5R37CA222002-03 Interpret this number
Primary Investigator:	Wackowski, Olivia
Organization:	Rbhs-School Of Public Health
Project Title:	Perceptions and Impact of Modified Risk Tobacco Product Communication Messages
Fiscal Year:	2020

ABSTRACT Combustible cigarettes are the most deadly form of tobacco, but public misperceptions exist about the relative risk of lower harm products such as snus and e-cigarettes. As such, tobacco control professionals have advocated that smokers be better informed of these reduced risks given that this may facilitate switching to these reduced risk products from combustible cigarettes, and subsequent harm-reduction benefits (e.g., lower lung cancer risk). Tobacco companies are also beginning to apply to the FDA for permission to make reduced risk claims in their advertising, and this trend is likely to continue as the industry moves the market towards developing products with reduced risks relative to cigarettes. However, very little is known about how to communicate reduced risk (RR) tobacco messages, where they should be placed, how consumers might perceive them, and what their effects might be. Only a few studies have begun exploring the impact of RR messages presented as a benefit claim on smokeless tobacco or e-cigarette advertisements, or presented within a warning label that is required on ads. No studies have compared one approach versus the other, nor their potentially different impacts on important outcomes such as perceived message source, credibility, recall, risk perceptions, and use intentions. Similarly, little research exists on the impact of tobacco reduced risk information included in educational types of materials, such as fact sheets. In contrast to ads, health education materials may give consumers a fuller understanding of both the potential risks and risks relative to cigarettes, and could be used by health organizations or act as packaging inserts. As such, the overall goal of this study is to advance understanding of communication about reduced risk tobacco products. The specific aims are to: 1) develop tobacco reduced risk messages for short and long communication formats; 2) compare the impact of reduced risk messages presented as ad benefit claims versus within ad warning labels and 3) examine the impact of snus and e-cigarette educational fact sheets with reduced risk information. This project aims to address an important and timely research gap and produce high impact practical results that can immediately be used to guide industry regulations on tobacco risk communication and the development of tobacco educational materials that address relative tobacco product risks.




Longitudinal Association Between Harm Perceptions and Tobacco Behaviors Among Adults Who Smoke Cigarettes: Differential Associations Across Age Groups Using the PATH Study.
Authors: Weiger C.V. , Wackowski O.A. , Bover Manderski M.T. , Villanti A.C. , Chen-Sankey J. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2024-11-22 00:00:00.0; 26(12), p. 1684-1691.
PMID: 38908010
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Associations of educational and marketing messages with beliefs about nicotine and reduced nicotine cigarettes.
Authors: Mercincavage M. , Wackowski O.A. , Johnson A.C. , Young W.J. , Tan A.S.L. , Delnevo C.D. , Strasser A.A. , Villanti A.C. .
Source: Preventive Medicine, 2024 Aug; 185, p. 108056.
EPub date: 2024-06-27 00:00:00.0.
PMID: 38944058
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Noticing education campaigns or public health messages about vaping among youth in the United States, Canada and England from 2018 to 2022.
Authors: East K. , Taylor E. , Simonavičius E. , Nottage M. , Reid J.L. , Burkhalter R. , Brose L. , Wackowski O.A. , Liber A.C. , McNeill A. , et al. .
Source: Health Education Research, 2024-01-02 00:00:00.0; , .
EPub date: 2024-01-02 00:00:00.0.
PMID: 38165724
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Associations Between Noticing E-Cigarette Advertising Features and E-Cigarette Appeal and Switching Interest Among Young Adult Dual Users.
Authors: Chen-Sankey J. , Elhabashy M. , La Capria K. , Jeong M. , Klein E.G. , Villanti A.C. , Wackowski O.A. .
Source: Substance Use & Misuse, 2024; 59(12), p. 1758-1769.
EPub date: 2024-07-08 00:00:00.0.
PMID: 38978284
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Impact of IQOS modified risk messaging on physicians' product perceptions and recommendations.
Authors: Wackowski O.A. , Steinberg M.B. , Delnevo C.D. .
Source: Tobacco Control, 2023-06-06 00:00:00.0; , .
EPub date: 2023-06-06 00:00:00.0.
PMID: 37280064
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Perceptions about levels of harmful chemicals in e-cigarettes relative to cigarettes, and associations with relative e-cigarette harm perceptions, e-cigarette use and interest.
Authors: Wackowski O.A. , Bover Manderski M.T. , Gratale S.K. , Weiger C.V. , O'Connor R.J. .
Source: Addiction (abingdon, England), 2023-05-23 00:00:00.0; , .
EPub date: 2023-05-23 00:00:00.0.
PMID: 37218410
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Awareness and beliefs about FDA e-cigarette regulation in the premarket application review era.
Authors: Weiger C. , Chen-Sankey J. , Jeong M. , Delnevo C. , Wackowski O. .
Source: Addictive Behaviors, 2023-05-09 00:00:00.0; 144, p. 107748.
EPub date: 2023-05-09 00:00:00.0.
PMID: 37182238
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Perceived Truthfulness of Reduced Lung Cancer Risk Advertising Claims Influences Consumers' Intention to try and to Purchase Snus.
Authors: Fix B.V. , Wackowski O.A. , Sharma A. , Diaz D. , Bansal-Travers M. , Cummings K.M. , Rees V.W. , Hatsukami D.K. , O'Connor R.J. .
Source: Tobacco Use Insights, 2023; 16, p. 1179173X231206042.
EPub date: 2023-10-13 00:00:00.0.
PMID: 37842177
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Longitudinal associations between receiving E-cigarette price promotions and subsequent E-cigarette use among U.S. Young adult cigarette smokers.
Authors: Elhabashy M. , Wackowski O.A. , Mercincavage M. , Cruz-Cano R. , Abadi M.H. , Ozga J.E. , Stanton C.A. , Chen-Sankey J. .
Source: Addictive Behaviors, 2022-11-14 00:00:00.0; 138, p. 107549.
EPub date: 2022-11-14 00:00:00.0.
PMID: 36410256
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Longitudinal associations between receiving E-cigarette price promotions and subsequent E-cigarette use among U.S. Young adult cigarette smokers.
Authors: Elhabashy M. , Wackowski O.A. , Mercincavage M. , Cruz-Cano R. , Abadi M.H. , Ozga J.E. , Stanton C.A. , Chen-Sankey J. .
Source: Addictive Behaviors, 2022-11-14 00:00:00.0; 138, p. 107549.
EPub date: 2022-11-14 00:00:00.0.
PMID: 36410256
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Tobacco Use, Dependence, and Age of Initiation among Youths with Cognitive Disability.
Authors: Casseus M. , Cooney J.M. , Wackowski O.A. .
Source: The Journal Of Pediatrics, 2022 08; 247, p. 102-108.e8.
EPub date: 2022-05-13 00:00:00.0.
PMID: 35569523
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Noticing people, discounts and non-tobacco flavours in e-cigarette ads may increase e-cigarette product appeal among non-tobacco-using young adults.
Authors: Chen-Sankey J. , Jeong M. , Wackowski O.A. , Unger J.B. , Niederdeppe J. , Bernat E. , Bansal-Travers M. , Moran M. , Kennedy R.D. , Broun A. , et al. .
Source: Tobacco Control, 2022-06-07 00:00:00.0; , .
EPub date: 2022-06-07 00:00:00.0.
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Exposure to negative news stories about vaping, and harm perceptions of vaping, among youth in England, Canada, and the US before and after the outbreak of E-cigarette or Vaping-Associated Lung Injury (EVALI).
Authors: East K. , Reid J.L. , Burkhalter R. , Wackowski O.A. , Thrasher J.F. , Tattan-Birch H. , Boudreau C. , Bansal-Travers M. , Liber A.C. , McNeill A. , et al. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2022-04-03 00:00:00.0; , .
EPub date: 2022-04-03 00:00:00.0.
PMID: 35368062
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Over 1 year later: smokers' EVALI awareness, knowledge and perceived impact on e-cigarette interest.
Authors: Wackowski O.A. , Gratale S.K. , Jeong M. , Delnevo C.D. , Steinberg M.B. , O'Connor R.J. .
Source: Tobacco Control, 2022-02-28 00:00:00.0; , .
EPub date: 2022-02-28 00:00:00.0.
PMID: 35228318
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Over 1 year later: smokers' EVALI awareness, knowledge and perceived impact on e-cigarette interest.
Authors: Wackowski O.A. , Gratale S.K. , Jeong M. , Delnevo C.D. , Steinberg M.B. , O'Connor R.J. .
Source: Tobacco Control, 2022-02-28 00:00:00.0; , .
EPub date: 2022-02-28 00:00:00.0.
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Nicotine pouch product awareness, interest and ever use among US adults who smoke, 2021.
Authors: Hrywna M. , Gonsalves N.J. , Delnevo C.D. , Wackowski O.A. .
Source: Tobacco Control, 2022-02-25 00:00:00.0; , .
EPub date: 2022-02-25 00:00:00.0.
PMID: 35217596
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Novel nicotine concentration labels improve adolescents' and young adults' understanding of the nicotine strength of electronic nicotine delivery system products.
Authors: Morean M.E. , Wackowski O.A. , Eissenberg T. , Delnevo C.D. , Krishnan-Sarin S. , Gueorguieva R. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2022-02-05 00:00:00.0; , .
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Balancing Risks and Benefits of E-Cigarettes in the Real World.
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Source: American Journal Of Public Health, 2022 02; 112(2), p. e1-e2.
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Exploring the implications of modified risk claim placement in tobacco advertising.
Authors: Wackowski O.A. , Gratale S.K. , Rashid M.T. , Greene K. , O'Connor R.J. .
Source: Preventive Medicine Reports, 2021 Dec; 24, p. 101608.
EPub date: 2021-10-19 00:00:00.0.
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Content Analysis of E-cigarette News Articles Amidst the 2019 Vaping-Associated Lung Injury (EVALI) Outbreak in the U.S.
Authors: Jeong M. , Singh B. , Wackowski O.A. , Mukherjee R. , Steinberg M.B. , Delnevo C.D. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2021-10-08 00:00:00.0; , .
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Cigarette Relighting: A Series of Pilot Studies Investigating a Common Yet Understudied Smoking Behavior.
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Source: International Journal Of Environmental Research And Public Health, 2021-06-16 00:00:00.0; 18(12), .
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Adults who use e-cigarettes have difficulty understanding nicotine concentrations presented as mg/ml and percent nicotine.
Authors: Morean M.E. , Wackowski O.A. , Eissenberg T. , Delnevo C.D. , Krishnan-Sarin S. .
Source: Addictive Behaviors, 2021-04-27 00:00:00.0; 120, p. 106965.
EPub date: 2021-04-27 00:00:00.0.
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'95% less harmful'? Exploring reactions to quantitative modified risk claims for snus and e-cigarettes.
Authors: Wackowski O.A. , O'Connor R.J. , Diaz D. , Rashid M. , Lewis M.J. , Greene K. .
Source: Tobacco Control, 2021-03-22 00:00:00.0; , .
EPub date: 2021-03-22 00:00:00.0.
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Adolescents and young adults have difficulty understanding nicotine concentration labels on vaping products presented as mg/ml and percent nicotine.
Authors: Morean M.E. , Wackowski O.A. , Eissenberg T. , Delnevo C.D. , Krishnan-Sarin S. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2021-01-12 00:00:00.0; , .
EPub date: 2021-01-12 00:00:00.0.
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Examining market trends in smokeless tobacco sales in the United States: 2011-2019.
Authors: Delnevo C.D. , Hrywna M. , Miller Lo E.J. , Wackowski O.A. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2020-11-26 00:00:00.0; , .
EPub date: 2020-11-26 00:00:00.0.
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Inferences beyond a claim: a typology of potential halo effects related to modified risk tobacco product claims.
Authors: Seidenberg A.B. , Popova L. , Ashley D.L. , Wackowski O.A. .
Source: Tobacco Control, 2020-10-12 00:00:00.0; , .
EPub date: 2020-10-12 00:00:00.0.
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Smokers' and Young Adult Non-Smokers' Perceptions and Perceived Impact of Snus and E-Cigarette Modified Risk Messages.
Authors: Wackowski O.A. , Rashid M. , Greene K.L. , Lewis M.J. , O'Connor R.J. .
Source: International Journal Of Environmental Research And Public Health, 2020-09-18 00:00:00.0; 17(18), .
EPub date: 2020-09-18 00:00:00.0.
PMID: 32961924
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Smokers' exposure to perceived modified risk claims for e-cigarettes, snus and smokeless tobacco in the United States.
Authors: Wackowski O.A. , O'Connor R.J. , Pearson J.L. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2020-08-19 00:00:00.0; , .
EPub date: 2020-08-19 00:00:00.0.
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Comparison of a General and Conditional Measure of E-Cigarette Harm Perceptions.
Authors: Wackowski O.A. , Jeong M. .
Source: International Journal Of Environmental Research And Public Health, 2020-07-17 00:00:00.0; 17(14), .
EPub date: 2020-07-17 00:00:00.0.
PMID: 32708854
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Content Analysis of Electronic Nicotine Delivery System Publications in Core Clinical Journals from 2012 to 2018.
Authors: Briganti M. , Wackowski O.A. , Delnevo C.D. , Brown L. , Hastings S.E. , Singh B. , Steinberg M.B. .
Source: International Journal Of Environmental Research And Public Health, 2020-03-25 00:00:00.0; 17(7), .
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From the Deeming Rule to JUUL-US News Coverage of Electronic Cigarettes, 2015-2018.
Authors: Wackowski O.A. , Sontag J.M. , Singh B. , King J. , Lewis M.J. , Steinberg M.B. , Delnevo C.D. .
Source: Nicotine & Tobacco Research : Official Journal Of The Society For Research On Nicotine And Tobacco, 2020-02-13 00:00:00.0; , .
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Baseline assessment of noticing e-cigarette health warnings among youth and young adults in the United States, Canada and England, and associations with harm perceptions, nicotine awareness and warning recall.
Authors: Sontag J.M. , Wackowski O.A. , Hammond D. .
Source: Preventive Medicine Reports, 2019 Dec; 16, p. 100966.
EPub date: 2019-08-06 00:00:00.0.
PMID: 31453077
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Characteristics of storefront tobacco advertisements and differences by product type: A content analysis of retailers in New York City, USA.
Authors: Giovenco D.P. , Spillane T.E. , Wong B.A. , Wackowski O.A. .
Source: Preventive Medicine, 2019 Jun; 123, p. 204-207.
EPub date: 2019-03-28 00:00:00.0.
PMID: 30930262
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Smokers' perceptions of risks and harm from snus relative to cigarettes: A latent profile analysis study.
Authors: Wackowski O.A. , Ray A.E. , Stapleton J.L. .
Source: Addictive Behaviors, 2019 Apr; 91, p. 171-174.
EPub date: 2018-11-14 00:00:00.0.
PMID: 30501991
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Youth and young adult exposure to and perceptions of news media coverage about e-cigarettes in the United States, Canada and England.
Authors: Wackowski O.A. , Sontag J.M. , Hammond D. .
Source: Preventive Medicine, 2019 Apr; 121, p. 7-10.
EPub date: 2019-02-04 00:00:00.0.
PMID: 30731093
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The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults' E-Cigarette Perceptions and Use Intentions.
Authors: Wackowski O.A. , Sontag J.M. , Hammond D. , O'Connor R.J. , Ohman-Strickland P.A. , Strasser A.A. , Villanti A.C. , Delnevo C.D. .
Source: International Journal Of Environmental Research And Public Health, 2019-01-10 00:00:00.0; 16(2), .
EPub date: 2019-01-10 00:00:00.0.
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