Public education about the relative harm of tobacco products: an intervention for tobacco control professionals: Table 1

Abstract

Background In the United States, new regulations require the collection of information on tobacco constituents by brand and variety and publication of this information in a way not likely to be misconstrued by consumers. Understanding of such information becomes increasingly important as new tobacco products come onto the market and modifications are made to reduce the toxicity of some products. This pilot study assessed current knowledge of tobacco control professionals regarding relative harmfulness of several tobacco products, and evaluated an online educational intervention aimed at improving understanding of variations in nicotine and tobacco specific N-nitrosamines (TSNAs). Methods Fifty-two tobacco control professionals participated in an online intervention which presented and discussed the results of constituent analyses of Camel Snus and Marlboro Snus compared to several conventional smokeless tobacco. Comparisons to cigarettes were also discussed. Pre- and post-test questions assessed understanding of the concepts. Results Pretest responses demonstrated that 31% did not know that cigarettes are more harmful than smokeless tobacco; 50% or more did not know that smokeless products higher in nicotine are likely to be more effective substitutes for cigarettes; that TSNAs are the major carcinogens in tobacco and that the new snus products tend to be lower in TSNAs than conventional spit tobacco. After participating in the intervention, knowledge increased on all points except one on which pretest results showed 100% correct. Conclusions Public education campaigns are urgently needed for tobacco control professionals, and then for consumers to increase awareness and understanding of the continuum of risk among tobacco products.

US adult tobacco users' absolute harm perceptions of traditional and alternative tobacco products, information-seeking behaviors, and (mis)beliefs about chemicals in tobacco products

“…19 Proponents of harm reduction advocate for increased public education about the tobacco risk continuum, stating that individuals may be able to satisfy their nicotine cravings while using relatively less risky tobacco products. 20,21 …”

“My First Thought was Croutons”: Perceptions of Cigarettes and Cigarette Smoke Constituents Among Adult Smokers and Nonsmokers

“…[8][9][10][11] Carcinogenic constituents include benzene, 1,3-butadiene, formaldehyde, nicotine-derived nitrosamine ketone (NNK), and N-nitrosonornicotine (NNN). 6,[11][12][13] Acrolein and acetaldehyde are two of the most harmful constituents to respiratory health, and arsenic and hydrogen cyanide pose great risk to cardiovascular health. 13 In addition to direct health effects, constituents, particularly nicotine, may cause indirect harm to consumers by enabling tobacco product initiation, hindering cessation, or leading to higher intensity or frequency of tobacco use.…”

“…Similarly, the International Tobacco Control Four Country Survey (ITC-4) found that most smokers were aware that cigarette smoke contains carbon monoxide (65%-81%), but fewer (17%-58%) were aware that it contains arsenic. 11,12 Researchers in Australia found that smokers and nonsmokers in 15 group discussions had low awareness of cigarette and cigarette smoke constituents, and that most could only name two or three constituents, with carbon monoxide, carbon dioxide, and nicotine the most frequently mentioned. 32 In addition to a limited understanding of the public's understanding of cigarette smoke constituents in general, little is known about how people perceive individual constituents, which constituents would discourage smokers from wanting to smoke and nonsmokers from starting to smoke, and why those particular constituents elicit more discouragement than others.…”

Assessing Constituent Levels in Smokeless Tobacco Products: A New Approach to Engaging and Educating the Public

“…2,3,12 Borland et al 13 provided smokers with a fact sheet about the harmfulness of SLT and NRT relative to cigarettes; 1 week later, knowledge increased and smokers reported more interest in SLT (and to a lesser extent NRT), but misperceptions about the relative harm from SLT and NRT were still common. Biener, Bogen, and Connolly 2 found that adult smokers increased their perceptions of health risks associated with two brands of heated tobacco products (Eclipse and Advance) after receiving constituent information about them.…”

“…Biener, Bogen, and Connolly 2 found that adult smokers increased their perceptions of health risks associated with two brands of heated tobacco products (Eclipse and Advance) after receiving constituent information about them. Biener and colleagues 12 found that tobacco control professionals can improve their knowledge about TSNA and nicotine in tobacco products using health education materials. However, what is also needed are techniques that do not require extensive training and that provide the broader public with engaging formats that educate but do not confuse consumers about the constituents in a variety of brands and types of SLT products.…”