title: Do smokers in Europe think all cigarettes are equally harmful?
abstract: BACKGROUND
  Despite the ban on misleading descriptors such as light or mild cigarettes in Europe, there are still widespread misperceptions of the relative harmfulness of different brands of cigarettes among smokers. This study examined the extent to which smokers in three European countries believed that some cigarette brands are less harmful and why, using data from the International Tobacco Control (ITC) Europe surveys.
  
  
  METHODS
  Cross-sectional analyses were completed among nationally representative samples of 4,956 current smokers (aged ≥ 18) from Germany (n = 1,515), France (n = 1,735) and the United Kingdom (n = 1,706) conducted between September 2006 and November 2007. Logistic regression models examined whether outcomes, including beliefs that some cigarettes could be less harmful than others, varied by socio-demographic and country of residence.
  
  
  RESULTS
  Around a quarter of smokers in the UK and France, and a third in Germany believed some cigarettes are less harmful than others. Overall, of smokers who falsely believed that some cigarettes are less harmful, 86.3% thought that tar/nicotine yields, 48.7% taste, and 40.4% terms on packs such as 'smooth' or 'ultra' indicated less harmful brands. About a fifth of smokers across all countries chose their brand based on health reasons, and a similar proportion gave tar yields as a reason for choosing brands.
  
  
  CONCLUSIONS
  Our research suggests that the current European Tobacco Products Directive is inadequate in eliminating misperceptions about the relative risk of brand descriptors on cigarettes. There is therefore an urgent need to protect smokers in Europe from these misperceptions via stronger measures such as plain packaging regulations.
authors.affiliation: Centre for Tobacco Control Research, Institute for Social Marketing, University of Stirling, UK. a.k.brown@stir.ac.uk
authors.forename: Abraham
authors.initials: A
authors.lastname: Brown
authors.forename: Ann
authors.initials: A
authors.lastname: McNeill
authors.forename: Ute
authors.initials: U
authors.lastname: Mons
authors.forename: Romain
authors.initials: R
authors.lastname: Guignard
mesh_terms: D000293:Adolescent; D000328:Adult; D003430:Cross-Sectional Studies; D003625:Data Collection; D005060:Europe; D005260:Female; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D040541:Marketing; D008875:Middle Aged; D011356:Product Labeling / Q000331:legislation & jurisprudence*; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology*; D013638:Tars / Q000032:analysis*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D013638:Tars