Beliefs
Conditions
Brief summary
This study seeks to assess the efficacy of educational messages to correct misperceptions. A large proportion of the American population incorrectly believes that nicotine is the chemical responsible for causing cancer in tobacco products.1-3 This misconception may reduce the likelihood that established smokers who are unwilling or unable to quit tobacco product use completely will switch to less harmful non-combustible products. An online experiment will be used to test if corrective messages can reduce this misperception. The experiment will also test the effects of messages on beliefs about the relative harms of other tobacco products discussed in the message and accuracy of inferential beliefs. This will be accomplished by asking participants questions about two tobacco products that are not explicitly discussed in the messages. The experiment will test if the two components of narrative coherence, a concept identified in previous reviews of misperception correction as effective,4-6 is effective at reducing misperceptions about nicotine. Component 1 provides an explanation for why the new information is correct and component 2 provides an explanation for how the false information came to be believed. This study will use a factorial design to test the efficacy of the component of coherence individually as well as together. Hypotheses and Research Questions: RQ1: Will participants exposed to different corrective message conditions differ in increased accuracy of beliefs (a) that nicotine does not cause cancer, (b) regarding the relative risk of e-cigarettes compared to cigarettes, (c) regarding the relative risk of very low nicotine cigarettes (VLNC) compared to cigarettes and (d) regarding the relative risk of nicotine replacement therapy compared to cigarettes. H1: Participants exposed to the nicotine corrective message with both components of coherence will be significantly more likely to increase accuracy of beliefs regarding the relative harms of (a) smokeless tobacco compared to cigarettes and (b) cigarillos relative to cigarettes compared to those exposed to messages with just one component or no components of coherence. H2: Participants exposed to the nicotine corrective message with both components of coherence will be significantly more likely to increase their intention to switch completely to a noncombustible product compared to those exposed to messages with just one component or no components of coherence.
Interventions
BEHAVIORALCoherent corrective messages
Participants will be randomized to one of four message conditions: condition 1 will not contain either component of the coherence; condition 2 will contain one element of coherence (a causal explanation for why the corrective information is accurate); condition 3 will contain the other element of coherence (an explanation for why the misinformation came to be believed); condition 4 will include both elements of coherence.
Sponsors
Johns Hopkins Bloomberg School of Public Health
Study design
Allocation
RANDOMIZED
Intervention model
FACTORIAL
Primary purpose
OTHER
Masking
SINGLE (Subject)
Intervention model description
Participants will be randomized to view one of four messages. The message conditions are as follows: condition 1 will not contain either component of coherence; condition 2 will contain one element of coherence (a causal explanation for why the corrective information is accurate); condition 3 will contain the other element of coherence (an explanation for why the misinformation came to be believed); condition 4 will include both elements of coherence.
Eligibility
Sex/Gender
ALL
Age
21 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Are established smokers (have smoked at least 100 cigarettes in their lifetime and currently smoke some or all days) * Are 21 years of age or older (the legal age of tobacco purchase in the US) * Have not completed the cognitive interview during message pre-testing. * Rate their agreement with the following statement as at least 50 out of 100: To what extent do you agree with the following statement: The substance nicotine causes cancer. * Are registered with MTurk in the United States. * Have completed \>= 5,000 HIITs within the MTurk system * Have a HIIT approval rating of \>= 97%
Exclusion criteria
* Are not established smokers * Are younger than 21 years of age * Participated in cognitive interviews during message pre-testing * Are not registered with MTurk in the US * Have completed \< 5,000 HIITS * Have a HIIT approval rating of \<97% * Rate their agreement with the following statement as less than 50 out of 100: To what extent do you agree with the following statement: The substance nicotine causes cancer.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Accuracy of Belief That Nicotine Causes Cancer | Baseline and up to 5 minutes after receiving the corrective message | The extent to which participants agree or disagree with the following statement: The substance nicotine causes cancer. Response options are a continuous scale from 0 I do not agree at all to 100, I completely agree. |
| Change in Relative Harm Beliefs Regarding E-cigarettes | Baseline and up to 5 minutes after receiving the corrective message | The next questions are about electronic cigarettes. You may also know them as e-cigarettes, vapes, vape pens, mods, or by brand names like Juul, Suorin, SMOK, Fin, NJOY, Blu, e-Go, or Vuse. Some look like cigarettes, and others look like small boxes, pens, or pipes. From now on, we will refer to these products as e-cigarettes. E-cigarettes heat up a liquid to aerosolize it so people can inhale it. Although some e-liquid does not contain nicotine, we are only interested in e-cigarettes that DO contain nicotine. Please answer the following questions about e-cigarettes that contain nicotine. Response options are, Much less harmful, Somewhat less harmful, Not less or more harmful, Somewhat more harmful, Much more harmful. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful). |
| Change in Relative Harm Beliefs Regarding NRT | Baseline and up to 5 minutes after receiving the corrective message | Participants will be shown a written description of NRT before answering questions about them: The next questions are about nicotine replacement therapy (NRT). NRT is a medicine that is available as skin patches, chewing gum, nasal and oral sprays, inhalers, lozenges and tablets and delivers nicotine to the body. Nicotine replacement therapy is approved to help people quit smoking. Participants will also see a picture of these products with the description. Response options are, Much less harmful, Somewhat less harmful, Not less or more harmful, Somewhat more harmful, Much more harmful. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful). |
| Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Baseline and up to 5 minutes after receiving the corrective message | Participants will be shown a written description of very low nicotine cigarettes before answering questions about them: The next questions are about very low nicotine cigarettes. A very low nicotine cigarette is a tobacco cigarette that is still smoked but has the vast majority (95% or more) of the nicotine removed from it. The average regular cigarettes typically contains 12-13 mg of nicotine. A very low nicotine cigarette could have less than 1 mg of nicotine in it. Very low nicotine cigarettes do not contain enough nicotine to maintain a physiological addiction to nicotine. Quest and Moonlight are brands of very low nicotine cigarettes. Participants will also see a picture of these products with the description. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful). |
| Change in Inferential Beliefs Regarding Smokeless Tobacco | Baseline and up to 5 minutes after receiving the corrective message | Participants will be shown a written description of smokeless tobacco before answering questions about them: The next questions are about smokeless tobacco. Smokeless tobacco like chewing, oral, or spit tobacco come as loose leaves, plugs, or twists of dried tobacco that may be flavored. It's chewed or placed between the cheek and gum or teeth. The user spits out (or swallows) the saliva that has soaked through the tobacco. Dissolvables are another type of product that dissolves in the mouth and can be sold as lozenges, strips, or sticks. Nicotine is absorbed through the mouth tissues. Participants will also see a picture of these products with the description. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful). |
| Change in Inferential Beliefs Regarding Cigarillos | Baseline and up to 5 minutes after receiving the corrective message | Participants will be shown a written description of smokeless tobacco before answering questions about them: The next questions are about cigarillos. Cigarillos look like small versions of traditional cigars, but can be bought in packages of one or two. Cigarillos smoke is often inhaled, unlike cigar smoke which is often held in the mouth and then released. Cigarillos are often flavored. Swisher Sweets, White Owl, and Dutch Masters are common cigarillo brands.. Participants will also see a picture of these products with the description. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful). |
| Change in Beliefs About Intention to Switch Products | Baseline and up to 5 minutes after receiving the corrective message | The extent to which participants agree or disagree with the following statement: I would consider completely switching to a tobacco product that is not lit on fire rather than continuing to smoke cigarettes. Response options are a continuous scale from 0 I do not agree at all to 100, I completely agree. |
Countries
United States
Participant flow
Recruitment details
Online recruitment began November 22, 2021 using Amazon Mechanical Turk. Funds to compensate participants were exhausted on November 23, 2021. An administrative delay in transferring funding created a delay in further recruitment, which was restarted on January 25, 2022 and was completed January 27, 2022.
Participants by arm
| Arm | Count |
|---|---|
| Nicotine Corrective Control A factual message about nicotine that does not contain a causal explanation for what actually causes tobacco-caused disease or an explanation for why the misperception that nicotine causes cancer may have come to be believed.
Coherent corrective messages: Participants will be randomized to one of four message conditions: condition 1 will not contain either component of the coherence; condition 2 will contain one element of coherence (a causal explanation for why the corrective information is accurate); condition 3 will contain the other element of coherence (an explanation for why the misinformation came to be believed); condition 4 will include both elements of coherence. | 42 |
| Nicotine Corrective With Causal Explanation A factual message about nicotine that contain a causal explanation for what actually causes tobacco-caused disease: tar and chemicals created in tobacco smoke when tobacco is lit on fire.
Coherent corrective messages: Participants will be randomized to one of four message conditions: condition 1 will not contain either component of the coherence; condition 2 will contain one element of coherence (a causal explanation for why the corrective information is accurate); condition 3 will contain the other element of coherence (an explanation for why the misinformation came to be believed); condition 4 will include both elements of coherence. | 53 |
| Nicotine Corrective With Reason for Misperception A factual message about nicotine that contains an explanation for why the misperception may have come to be believed: that health messaging often discuses nicotine and tobacco-caused disease at the same time and people incorrectly make the connection that nicotine causes cancer.
Coherent corrective messages: Participants will be randomized to one of four message conditions: condition 1 will not contain either component of the coherence; condition 2 will contain one element of coherence (a causal explanation for why the corrective information is accurate); condition 3 will contain the other element of coherence (an explanation for why the misinformation came to be believed); condition 4 will include both elements of coherence. | 56 |
| Nicotine Corrective With Both Components of Coherence A factual message about nicotine that contains both a causal explanation for what actually causes tobacco-caused disease and an explanation for why the misperception may have come to be believed.
Coherent corrective messages: Participants will be randomized to one of four message conditions: condition 1 will not contain either component of the coherence; condition 2 will contain one element of coherence (a causal explanation for why the corrective information is accurate); condition 3 will contain the other element of coherence (an explanation for why the misinformation came to be believed); condition 4 will include both elements of coherence. | 42 |
| Total | 193 |
Baseline characteristics
| Characteristic | Nicotine Corrective With Causal Explanation | Nicotine Corrective Control | Total | Nicotine Corrective With Both Components of Coherence | Nicotine Corrective With Reason for Misperception |
|---|---|---|---|---|---|
| Age, Continuous | 39 years | 39.5 years | 40 years | 40.5 years | 40 years |
| Cigarillo use Current use (past 30 days) | 10 Participants | 5 Participants | 31 Participants | 9 Participants | 7 Participants |
| Cigarillo use Ever use (not past 30 days) | 26 Participants | 19 Participants | 97 Participants | 24 Participants | 28 Participants |
| Cigarillo use Never use | 17 Participants | 18 Participants | 65 Participants | 9 Participants | 21 Participants |
| E-cigarette use Current use (past 30-day use) | 13 Participants | 12 Participants | 55 Participants | 11 Participants | 19 Participants |
| E-cigarette use Ever use (not past 30 days) | 32 Participants | 24 Participants | 109 Participants | 24 Participants | 29 Participants |
| E-cigarette use Never use | 8 Participants | 6 Participants | 29 Participants | 7 Participants | 8 Participants |
| Nicotine replacement therapy use Current use (past 30 days) | 4 Participants | 8 Participants | 24 Participants | 6 Participants | 6 Participants |
| Nicotine replacement therapy use Ever use (not past 30 days) | 20 Participants | 16 Participants | 74 Participants | 15 Participants | 23 Participants |
| Nicotine replacement therapy use Never use | 29 Participants | 18 Participants | 95 Participants | 21 Participants | 27 Participants |
| Race/Ethnicity, Customized Ethnic/racial minority | 7 Participants | 9 Participants | 37 Participants | 9 Participants | 12 Participants |
| Race/Ethnicity, Customized Non-Hispanic White | 46 Participants | 33 Participants | 156 Participants | 33 Participants | 44 Participants |
| Self-reported very low nicotine cigarette use Current use (past 30 days) | 1 Participants | 3 Participants | 8 Participants | 2 Participants | 2 Participants |
| Self-reported very low nicotine cigarette use Ever use (not past 30 days) | 7 Participants | 5 Participants | 28 Participants | 7 Participants | 9 Participants |
| Self-reported very low nicotine cigarette use Never use | 45 Participants | 34 Participants | 157 Participants | 33 Participants | 45 Participants |
| Sex: Female, Male Female | 22 Participants | 27 Participants | 95 Participants | 16 Participants | 30 Participants |
| Sex: Female, Male Male | 31 Participants | 15 Participants | 98 Participants | 26 Participants | 26 Participants |
| Smokeless tobacco use Current use (past 30 days) | 2 Participants | 3 Participants | 9 Participants | 3 Participants | 1 Participants |
| Smokeless tobacco use Ever use (not past 30 days) | 25 Participants | 13 Participants | 75 Participants | 17 Participants | 20 Participants |
| Smokeless tobacco use Never use | 26 Participants | 26 Participants | 109 Participants | 22 Participants | 35 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 42 | 0 / 53 | 0 / 56 | 0 / 42 |
| other Total, other adverse events | 0 / 42 | 0 / 53 | 0 / 56 | 0 / 42 |
| serious Total, serious adverse events | 0 / 42 | 0 / 53 | 0 / 56 | 0 / 42 |
Outcome results
Primary
Change in Accuracy of Belief That Nicotine Causes Cancer
The extent to which participants agree or disagree with the following statement: The substance nicotine causes cancer. Response options are a continuous scale from 0 I do not agree at all to 100, I completely agree.
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nicotine Corrective Control | Change in Accuracy of Belief That Nicotine Causes Cancer | 52.6 units on a scale | Standard Deviation 31.9 |
| Nicotine Corrective With Causal Explanation | Change in Accuracy of Belief That Nicotine Causes Cancer | 54.0 units on a scale | Standard Deviation 35.3 |
| Nicotine Corrective With Reason for Misperception | Change in Accuracy of Belief That Nicotine Causes Cancer | 39.2 units on a scale | Standard Deviation 34.1 |
| Nicotine Corrective With Both Components of Coherence | Change in Accuracy of Belief That Nicotine Causes Cancer | 36.1 units on a scale | Standard Deviation 35.4 |
p-value: 0.09595% CI: [-1.87, 33.3]ANCOVA
Comparison: Sidak's adjusted p-value contrasting marginal linear predictions for the Nicotine corrective with causal explanation and Nicotine corrective with both components of coherencep-value: 0.02295% CI: [2.02, 35.33]ANCOVA
Comparison: Sidak's adjusted p-value contrasting marginal linear predictions for the Nicotine corrective with reason for misperception and Nicotine corrective with both components of coherencep-value: 0.93195% CI: [-12.76, 20.15]ANCOVA
Primary
Change in Beliefs About Intention to Switch Products
The extent to which participants agree or disagree with the following statement: I would consider completely switching to a tobacco product that is not lit on fire rather than continuing to smoke cigarettes. Response options are a continuous scale from 0 I do not agree at all to 100, I completely agree.
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Nicotine Corrective Control | Change in Beliefs About Intention to Switch Products | 60.6 units on a scale | Standard Deviation 30.3 |
| Nicotine Corrective With Causal Explanation | Change in Beliefs About Intention to Switch Products | 53.5 units on a scale | Standard Deviation 36.4 |
| Nicotine Corrective With Reason for Misperception | Change in Beliefs About Intention to Switch Products | 56.4 units on a scale | Standard Deviation 34.3 |
| Nicotine Corrective With Both Components of Coherence | Change in Beliefs About Intention to Switch Products | 57.9 units on a scale | Standard Deviation 34.4 |
Comparison: ANCOVA adjusted for baseline consideration of switchingp-value: 0.96595% CI: [-9.25, 13.19]ANCOVA
Comparison: ANCOVA adjusted for baseline consideration of switchingp-value: 0.97995% CI: [-9.13, 12.27]ANCOVA
Comparison: ANCOVA adjusted for baseline consideration of switchingp-value: 0.7395% CI: [-6.46, 14.59]ANCOVA
Primary
Change in Inferential Beliefs Regarding Cigarillos
Participants will be shown a written description of smokeless tobacco before answering questions about them: The next questions are about cigarillos. Cigarillos look like small versions of traditional cigars, but can be bought in packages of one or two. Cigarillos smoke is often inhaled, unlike cigar smoke which is often held in the mouth and then released. Cigarillos are often flavored. Swisher Sweets, White Owl, and Dutch Masters are common cigarillo brands.. Participants will also see a picture of these products with the description. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful).
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nicotine Corrective Control | Change in Inferential Beliefs Regarding Cigarillos | Low relative harm perception | 6 Participants |
| Nicotine Corrective Control | Change in Inferential Beliefs Regarding Cigarillos | Missing | 3 Participants |
| Nicotine Corrective Control | Change in Inferential Beliefs Regarding Cigarillos | High relative harm perception | 33 Participants |
| Nicotine Corrective With Causal Explanation | Change in Inferential Beliefs Regarding Cigarillos | Low relative harm perception | 5 Participants |
| Nicotine Corrective With Causal Explanation | Change in Inferential Beliefs Regarding Cigarillos | Missing | 4 Participants |
| Nicotine Corrective With Causal Explanation | Change in Inferential Beliefs Regarding Cigarillos | High relative harm perception | 44 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Inferential Beliefs Regarding Cigarillos | High relative harm perception | 49 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Inferential Beliefs Regarding Cigarillos | Low relative harm perception | 6 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Inferential Beliefs Regarding Cigarillos | Missing | 1 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Inferential Beliefs Regarding Cigarillos | Low relative harm perception | 6 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Inferential Beliefs Regarding Cigarillos | Missing | 1 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Inferential Beliefs Regarding Cigarillos | High relative harm perception | 35 Participants |
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on cigarillo relative harm beliefsp-value: 0.92595% CI: [0.31, 3.62]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on cigarillo relative harm beliefsp-value: 0.52595% CI: [0.19, 2.35]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on cigarillo relative harm beliefsp-value: 0.58695% CI: [0.21, 2.4]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on cigarillo relative harm beliefs controlling for smokeless tobacco usep-value: 0.88395% CI: [0.31, 3.9]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on cigarillo relative harm beliefs controlling for smokeless tobacco usep-value: 0.53495% CI: [0.18, 2.41]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on cigarillo relative harm beliefs controlling for smokeless tobacco usep-value: 0.66195% CI: [0.22, 2.62]Regression, Logistic
Primary
Change in Inferential Beliefs Regarding Smokeless Tobacco
Participants will be shown a written description of smokeless tobacco before answering questions about them: The next questions are about smokeless tobacco. Smokeless tobacco like chewing, oral, or spit tobacco come as loose leaves, plugs, or twists of dried tobacco that may be flavored. It's chewed or placed between the cheek and gum or teeth. The user spits out (or swallows) the saliva that has soaked through the tobacco. Dissolvables are another type of product that dissolves in the mouth and can be sold as lozenges, strips, or sticks. Nicotine is absorbed through the mouth tissues. Participants will also see a picture of these products with the description. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful).
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nicotine Corrective Control | Change in Inferential Beliefs Regarding Smokeless Tobacco | Low relative harm perception | 17 Participants |
| Nicotine Corrective Control | Change in Inferential Beliefs Regarding Smokeless Tobacco | Missing | 3 Participants |
| Nicotine Corrective Control | Change in Inferential Beliefs Regarding Smokeless Tobacco | High relative harm perception | 22 Participants |
| Nicotine Corrective With Causal Explanation | Change in Inferential Beliefs Regarding Smokeless Tobacco | Low relative harm perception | 32 Participants |
| Nicotine Corrective With Causal Explanation | Change in Inferential Beliefs Regarding Smokeless Tobacco | Missing | 1 Participants |
| Nicotine Corrective With Causal Explanation | Change in Inferential Beliefs Regarding Smokeless Tobacco | High relative harm perception | 20 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Inferential Beliefs Regarding Smokeless Tobacco | High relative harm perception | 31 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Inferential Beliefs Regarding Smokeless Tobacco | Low relative harm perception | 22 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Inferential Beliefs Regarding Smokeless Tobacco | Missing | 3 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Inferential Beliefs Regarding Smokeless Tobacco | Low relative harm perception | 26 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Inferential Beliefs Regarding Smokeless Tobacco | Missing | 1 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Inferential Beliefs Regarding Smokeless Tobacco | High relative harm perception | 15 Participants |
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on smokeless tobacco relative harm beliefsp-value: 0.07795% CI: [0.18, 1.09]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on smokeless tobacco relative harm beliefsp-value: 0.85395% CI: [0.4, 2.15]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on smokeless tobacco relative harm beliefsp-value: 0.03795% CI: [0.18, 0.95]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on smokeless relative harm beliefs controlling for baseline beliefs and smokeless tobacco usep-value: 0.34995% CI: [0.21, 1.75]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on smokeless relative harm beliefs controlling for baseline beliefs and smokeless tobacco usep-value: 0.46495% CI: [0.54, 3.93]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on smokeless relative harm beliefs controlling for baseline beliefs and smokeless tobacco usep-value: 0.18795% CI: [0.18, 1.4]Regression, Logistic
Primary
Change in Relative Harm Beliefs Regarding E-cigarettes
The next questions are about electronic cigarettes. You may also know them as e-cigarettes, vapes, vape pens, mods, or by brand names like Juul, Suorin, SMOK, Fin, NJOY, Blu, e-Go, or Vuse. Some look like cigarettes, and others look like small boxes, pens, or pipes. From now on, we will refer to these products as e-cigarettes. E-cigarettes heat up a liquid to aerosolize it so people can inhale it. Although some e-liquid does not contain nicotine, we are only interested in e-cigarettes that DO contain nicotine. Please answer the following questions about e-cigarettes that contain nicotine. Response options are, Much less harmful, Somewhat less harmful, Not less or more harmful, Somewhat more harmful, Much more harmful. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful).
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding E-cigarettes | Low relative harm perception | 34 Participants |
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding E-cigarettes | Missing | 2 Participants |
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding E-cigarettes | High relative harm perception | 6 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding E-cigarettes | Low relative harm perception | 43 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding E-cigarettes | Missing | 1 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding E-cigarettes | High relative harm perception | 9 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding E-cigarettes | High relative harm perception | 16 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding E-cigarettes | Low relative harm perception | 38 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding E-cigarettes | Missing | 2 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding E-cigarettes | Low relative harm perception | 31 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding E-cigarettes | Missing | 1 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding E-cigarettes | High relative harm perception | 10 Participants |
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on e-cigarette relative harm beliefsp-value: 0.40295% CI: [0.56, 4.24]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on e-cigarette relative harm beliefsp-value: 0.29295% CI: [0.59, 5.62]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on e-cigarette relative harm beliefsp-value: 0.57195% CI: [0.3, 1.93]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on e-cigarette relative harm beliefs controlling for baseline beliefs and e-cigarette usep-value: 0.34995% CI: [0.47, 8.26]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on e-cigarette relative harm beliefs controlling for baseline beliefs and e-cigarette usep-value: 0.35595% CI: [0.53, 5.81]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on e-cigarette relative harm beliefs controlling for baseline beliefs and e-cigarette usep-value: 0.59195% CI: [0.24, 2.25]Regression, Logistic
Primary
Change in Relative Harm Beliefs Regarding NRT
Participants will be shown a written description of NRT before answering questions about them: The next questions are about nicotine replacement therapy (NRT). NRT is a medicine that is available as skin patches, chewing gum, nasal and oral sprays, inhalers, lozenges and tablets and delivers nicotine to the body. Nicotine replacement therapy is approved to help people quit smoking. Participants will also see a picture of these products with the description. Response options are, Much less harmful, Somewhat less harmful, Not less or more harmful, Somewhat more harmful, Much more harmful. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful).
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding NRT | Low relative harm perception | 39 Participants |
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding NRT | High relative harm perception | 2 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding NRT | High relative harm perception | 5 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding NRT | Low relative harm perception | 47 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding NRT | Low relative harm perception | 50 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding NRT | High relative harm perception | 3 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding NRT | Low relative harm perception | 40 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding NRT | High relative harm perception | 2 Participants |
p-value: 0.9895% CI: [0.13, 7.27]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on NRT relative harm beliefsp-value: 0.38295% CI: [0.09, 2.56]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on NRT relative harm beliefsp-value: 0.84695% CI: [0.13, 5.23]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on NRT relative harm beliefs controlling for NRT usep-value: 0.9995% CI: [0.13, 7.74]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on NRT relative harm beliefs controlling for NRT usep-value: 0.45895% CI: [0.09, 3.01]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on NRT relative harm beliefs controlling for NRT usep-value: 0.75495% CI: [0.12, 4.76]Regression, Logistic
Primary
Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes
Participants will be shown a written description of very low nicotine cigarettes before answering questions about them: The next questions are about very low nicotine cigarettes. A very low nicotine cigarette is a tobacco cigarette that is still smoked but has the vast majority (95% or more) of the nicotine removed from it. The average regular cigarettes typically contains 12-13 mg of nicotine. A very low nicotine cigarette could have less than 1 mg of nicotine in it. Very low nicotine cigarettes do not contain enough nicotine to maintain a physiological addiction to nicotine. Quest and Moonlight are brands of very low nicotine cigarettes. Participants will also see a picture of these products with the description. Response options were dichotomized to low relative harm perceptions (much less harmful, somewhat less harmful) and high relative harm perceptions (much more harmful, somewhat more harmful, not less or more harmful).
Time frame: Baseline and up to 5 minutes after receiving the corrective message
| Arm | Measure | Category | Value (COUNT_OF_PARTICIPANTS) |
|---|---|---|---|
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Low relative harm perception | 28 Participants |
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Missing | 1 Participants |
| Nicotine Corrective Control | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | High relative harm perception | 13 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Low relative harm perception | 30 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Missing | 0 Participants |
| Nicotine Corrective With Causal Explanation | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | High relative harm perception | 23 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | High relative harm perception | 29 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Low relative harm perception | 25 Participants |
| Nicotine Corrective With Reason for Misperception | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Missing | 2 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Low relative harm perception | 23 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | Missing | 1 Participants |
| Nicotine Corrective With Both Components of Coherence | Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes | High relative harm perception | 18 Participants |
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on VLNC relative harm beliefsp-value: 0.25695% CI: [0.68, 4.15]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on VLNC relative harm beliefsp-value: 0.96195% CI: [0.45, 2.32]Regression, Logistic
Comparison: Unadjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on VLNC relative harm beliefsp-value: 0.34595% CI: [0.3, 1.53]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective control compared to the Nicotine corrective with both components of coherence (reference group)) on VLNC relative harm beliefs controlling for baseline beliefs and VLNC usep-value: 0.3695% CI: [0.6, 4.04]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with causal explanation compared to the Nicotine corrective with both components of coherence (reference group)) on VLNC relative harm beliefs controlling for baseline beliefs and VLNC usep-value: 0.76595% CI: [0.48, 2.7]Regression, Logistic
Comparison: Adjusted logistic regression showing the effect of condition (Nicotine corrective with reason for misperception compared to the Nicotine corrective with both components of coherence (reference group)) on VLNC relative harm beliefs controlling for baseline beliefs and VLNC usep-value: 0.25295% CI: [0.25, 1.43]Regression, Logistic