title: Perceived Health Risks of Snus and Medicinal Nicotine Products.
abstract: BACKGROUND
  Perceived health risk (PHR) of a tobacco product may influence both uptake and continued use. In this study, we examined PHRs of snus and medicinal nicotine using the PHR scale and the relationship of PHR responses to use of these products in smokers seeking an alternative to smoking.
  
  
  METHODS
  Smokers were randomly assigned to snus or to medicinal nicotine for a period of 12 weeks and asked to only use the assigned product. The PHR scale involves rating the extent of perceived risk of a product for different diseases and was given at baseline and weeks 4 and 12 during treatment. Relationships between PHR scale scores and study attrition, compliance with only using the product, and continued use of the product after treatment were determined.
  
  
  RESULTS
  Response to the PHR scale showed no significant differences between the snus and medicinal nicotine for perceived risks for lung cancer, emphysema, and bronchitis. However, significant differences were observed for other cancers, heart disease, stroke and risk for addiction, particularly after product use, with higher scores among those assigned to snus. Scores on the PHR scale were not related to any of the trial outcome variables.
  
  
  CONCLUSIONS
  Among smokers seeking an alternative to smoking in a clinic setting, PHR of a product changes after product use but may not be related to product use patterns.
  
  
  CONCLUSIONS
  PHRs of snus or medicinal nicotine in smokers assigned to these products become more accurate after product use. PHR does not appear to be associated with patterns of product use; rather satisfaction with a product is a better indicator as to whether a smoker is compliant with only using the product or continues to use the product.
authors.affiliation: Department of Psychiatry, Tobacco Research Programs, University of Minnesota, Minneapolis, MN; hatsu001@umn.edu.
authors.forename: Dorothy K
authors.initials: DK
authors.lastname: Hatsukami
authors.affiliation: Biostatistics and Bioinformatics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN;
authors.forename: R I
authors.initials: RI
authors.lastname: Vogel
authors.affiliation: Department of Psychology, Oregon Research Institute, Eugene, OR;
authors.forename: Herb H
authors.initials: HH
authors.lastname: Severson
authors.affiliation: Department of Psychiatry, Tobacco Research Programs, University of Minnesota, Minneapolis, MN;
authors.forename: Joni A
authors.initials: JA
authors.lastname: Jensen
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
mesh_terms: D000368:Aged; D016739:Behavior, Addictive / Q000188:drug therapy*; D001991:Bronchitis / Q000517:prevention & control; D004646:Emphysema / Q000517:prevention & control; D005260:Female; D040261:Harm Reduction; D006801:Humans; D008175:Lung Neoplasms / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000627:therapeutic use*; D010349:Patient Compliance / Q000706:statistics & numerical data; D010352:Patient Dropouts; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D016540:Smoking Cessation / Q000379:methods*; D000074606:Smoking Prevention; D061485:Tobacco Use Cessation Devices; D014029:Tobacco Use Disorder / Q000150:complications / Q000188:drug therapy*; D014030:Tobacco, Smokeless / Q000009:adverse effects*
chemical_list: D009538:Nicotine