The Appeal of Smokeless Tobacco Products Among Young Canadian Smokers: The Impact of Pictorial Health Warnings and Relative Risk Messages

Introduction:
This article investigates the perceptions and appeal of smokeless tobacco (ST) products among young adult Canadian smokers, as well as the impact of adding text and pictorial health warnings and a relative health risk message to the ST packages. The study is the first to examine perceptions of ST products among young adult Canadian smokers and the first published study to examine the impact of pictorial health warnings on ST products.

Key Points:

* The study consisted of a 2 x3 factorial "between-subjects" experiment in which four health warning labels (HWL) and a relative health risk (RHR) message were systematically varied.
* Participants were 611 Canadians aged 18-30 years who were current cigarette smokers.
* Product appeal and likelihood of future use were assessed, along with willingness to try ST for five different reasons and relative health risk beliefs.
* The presence of a RHR message had no effect on the appeal of the ST products, but those who saw a picture HWL on the ST products had lower odds of rating the products as appealing.
* Participants who saw a RHR message had higher odds of reporting correct beliefs about the health risk of ST compared with cigarettes, but those who saw a picture HWL had lower odds of reporting correct beliefs.
* About half of the respondents were willing to try at least one of the four STs for various reasons, and both the RHR message and the HWL had an effect on willingness to try ST.
* Pictorial HWL decreased willingness to try ST for four of the five reasons examined and had a consistent trend in decreasing willingness to try ST as the HWL severity was increased.

Main Message:
The study suggests that pictorial health warnings on ST products increase overall perceptions of risk and discourage use, but they also exacerbate the false belief that smokeless products are equally as harmful as conventional cigarettes. Therefore, greater efforts should be undertaken to promote more accurate perceptions of relative health risks between tobacco products.

Callery, W. E., D. Hammond, R. J. O’Connor, and G. T. Fong. “The Appeal of Smokeless Tobacco Products Among Young Canadian Smokers: The Impact of Pictorial Health Warnings and Relative Risk Messages.” Nicotine & Tobacco Research 13, no. 5 (May 1, 2011): 373–83. https://doi.org/10.1093/ntr/ntr013.