Can Exposure to Brief Messages Correct Misperceptions?

Primary outcomes

1. Change in Accuracy of Belief That Nicotine Causes Cancer

   Time frame: 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."

2. Change in Relative Harm Beliefs Regarding E-cigarettes

   Time frame: 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).

3. Change in Relative Harm Beliefs Regarding NRT

   Time frame: 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).

4. Change in Relative Harm Beliefs Regarding Very Low Nicotine Cigarettes

   Time frame: 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).

5. Change in Inferential Beliefs Regarding Smokeless Tobacco

   Time frame: 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).

6. Change in Inferential Beliefs Regarding Cigarillos

   Time frame: 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).

7. Change in Beliefs About Intention to Switch Products

   Time frame: 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."