Effects of FDA Authorized Smokeless Tobacco Claims Among US Adults Who Smoke Cigarettes

Single item measure asking participants how harmful they think daily use of the viewed smokeless tobacco product would be to their health compared to daily cigarette smoking, (1=a lot less harmful, 2=somewhat less harmful, 3=about the same, 4=somewhat more harmful, 5=a lot more harmful). Higher scores mean thinking the viewed smokeless tobacco product is more harmful than cigarettes.

Assessment of perceived risks of getting various smoking related diseases from using the viewed smokeless tobacco product versus from smoking cigarettes. Responses to 6 parallel questions (each asking about a different disease) were averaged together in this composite item. The question stated: "If you used only [General Snus/Copenhagen - inserted based on brand condition] or only cigarettes every day, which product would make it more likely that you would get": 1) lung cancer; 2) heart disease; 3) mouth cancer; 4) stroke; 5) chronic bronchitis; 6) emphysema. Response options to each were on a 5 point scale from (1=much more likely with General Snus/Copenhagen to 5=much more likely with cigarettes). Results presented here are based on the averages responses to the six items. Higher scores mean thinking risks are greater from smoking cigarettes than from using the viewed smokeless tobacco product.

Single item measure asking participants how likely or unlikely they think the viewed smokeless tobacco product would be to cause serious health problems during their lifetime, if they used it every day (from 1=not at all likely to 5=extremely likely). Higher scores mean greater likelihood of thinking the product is harmful to health.

Assessment of intentions to use the viewed smokeless tobacco products based on averaging responses to three parallel questions: "Thinking about the ads you saw for [General Snus or Copenhagen] products, how interested, in the next 6 months, would you be in: 1) Using or trying these products? 2) Using these products as a way to quit or cut down on your cigarette smoking? 3) Completely switching from cigarettes to these products? Response options to each were on a 5 point scale from (1=not at all interested to 5=extremely interested). Results presented here are based on the averaged responses to these three items. Higher scores mean greater interest in using the products.

Participants are asked to recall (yes/no) if the ads they viewed include any statement saying that using the product can lower risks of certain diseases.

A composite measure based on the average of 6 advertisement perceptions, asking participants to rate whether they agreed or disagreed that they ads they viewed: 1) included important information; 2) were understandable; 3) included believable information; 4) included credible information; 5) included information new to me; 6) make me want to learn more about those products. Response options were on a 6 point agreement scale from 1=strongly disagree to 6=strongly agree. Higher scores mean greater agreement that the ads were effective and persuasive.

A composite measure based on the average of 2 claim perception items, asking participants to rate whether they agreed or disagreed that the modified-risk claim in the ads they viewed was : 1) believable 2) credible. Participants responded to this while seeing the claim again on the survey screen. Response options were on a 7 point agreement scale from 1=strongly disagree to 7=strongly agree. Higher scores mean greater agreement that the claims were believable and credible.

A composite measure based on the average of 7 claim perception items, asking participants to rate whether they agreed or disagreed that the modified-risk claim in the ads they viewed was : 1) believable; 2) credible; 3) important; 4) new to me; 5) makes me think using this product could be less harmful to my health than smoking; 6) makes me more interested in trying this product; 7) would make me think seriously about completely switching to this product. Participants responded to this while seeing the claim again on the survey screen. Response options were on a 7 point agreement scale from 1=strongly disagree to 7=strongly agree. Higher scores mean greater agreement that participants thought the claim was persuasive/effective.

An item assessing participants' understanding of the need to completely switch to the smokeless tobacco product viewed in order to reduce risks. It said:

Please answer the next question based on your understanding of the ads you viewed earlier. Based on the ads, [General Snus OR Copenhagen, inserted based on condition] can reduce a smoker's health risks if you: (Select all that apply)

• Use only [General Snus/Copenhagen] and not smoke any cigarettes anymore
• Use [General Snus/Copenhagen] and smoke fewer cigarettes than before
• Use both products ([General Snus/Copenhagen] and cigarettes) about equally
• None of the above
• I don't know/not sure