title: US Smokers' Beliefs, Experiences and Perceptions of Different Cigarette Variants Before and After the FSPTCA Ban on Misleading Descriptors Such as "Light," "Mild," or "Low".
abstract: In December 2008, the Federal Trade Commission (FTC) took action that prompted the removal of nicotine and tar listings from cigarette packs and ads. As of June 2010, the US Family Smoking Prevention and Tobacco Control Act prohibited the use of explicit or implicit descriptors on tobacco packaging or in advertising that convey messages of reduced risk or exposure, specifically including terms like "light," "mild," and "low" and similar descriptors. This study evaluates the effect of these two policy changes on smokers' beliefs, experiences and perceptions of different cigarettes.
  
  
  
  Using generalized estimating equations models, this study analyzed survey data collected between 2002 and 2013 by the International Tobacco Control Policy Evaluation Study regarding US smokers' beliefs, experiences, and perceptions of different cigarettes.
  
  
  
  Between 2002 and 2013, smoker misperceptions about "light" cigarettes being less harmful did not change significantly and remained substantial, especially among those who reported using lower-strength cigarettes. After the two policy changes, reported reliance on pack colors, color terms, and other product descriptors like "smooth" to determine cigarette strength style trended upward.
  
  
  
  Policies implemented to reduce smoker misperceptions that some cigarettes are safer than others appear to have had little impact. Because of pack colors, color terms, descriptors such as "smooth," cigarette taste or feel, and possibly other characteristics, millions of smokers continue to believe, inaccurately, that they can reduce their harms and risks by smoking one cigarette brand or sub-brand instead of another, which may be delaying or reducing smoking cessation.
  
  
  
  What this study adds: This study confirms that US policies to reduce smoker misperceptions that some cigarettes are less harmful than others have not been successful. Following the removal of light/low descriptors and tar and nicotine numbers from cigarette packs and ads, pack colors, color words, other descriptors (eg, smooth), and sensory experiences of smoother or lighter taste have helped smokers to continue to identify their preferred cigarette brand styles and otherwise distinguish between which brands and styles they consider "lighter" or lower in tar and, mistakenly, less harmful than others. These findings provide additional evidence to support new enforcement or regulatory action to stop cigarettes and their packaging from misleading smokers about relative risk, which may be reducing or delaying quit attempts.
authors.affiliation: Nigel Gray Fellowship Group, Cancer Council Victoria , Melbourne , Australia.
authors.forename: Hua-Hie
authors.initials: HH
authors.lastname: Yong
authors.affiliation: Nigel Gray Fellowship Group, Cancer Council Victoria , Melbourne , Australia.
authors.forename: Ron
authors.initials: R
authors.lastname: Borland
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina , Charleston, SC.
authors.forename: K Michael
authors.initials: KM
authors.lastname: Cummings
authors.affiliation: O'Neill Institute for National and Global Health Law, Georgetown University Law Center , Washington, DC.
authors.forename: Eric N
authors.initials: EN
authors.lastname: Lindblom
authors.affiliation: Nigel Gray Fellowship Group, Cancer Council Victoria , Melbourne , Australia.
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute , Buffalo, NY.
authors.forename: Maansi
authors.initials: M
authors.lastname: Bansal-Travers
authors.affiliation: Department of Health Behavior, Roswell Park Cancer Institute , Buffalo, NY.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Connor
authors.affiliation: Social and Epidemiological Research, Centre for Addiction and Mental Health, London, ON, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|School of Health Studies, Western University, London, ON, Canada.
authors.forename: Tara
authors.initials: T
authors.lastname: Elton-Marshall
authors.affiliation: Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina , Columbia, SC.
authors.forename: James F
authors.initials: JF
authors.lastname: Thrasher
authors.affiliation: School of Public Health and Health Systems, University of Waterloo , Waterloo, ON , Canada.
authors.forename: David
authors.initials: D
authors.lastname: Hammond
authors.affiliation: Department of Statistics and Actuarial Science, University of Waterloo , Waterloo, ON , Canada.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Thompson
authors.affiliation: Institute of Psychiatry, King's College London , London , UK.
authors.forename: Timea R
authors.initials: TR
authors.lastname: Partos
mesh_terms: D000293:Adolescent; D000328:Adult; D000329:Advertising; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011356:Product Labeling / Q000331:legislation & jurisprudence*; D040242:Risk Reduction Behavior; D012907:Smoking / Q000523:psychology*; D016540:Smoking Cessation; D000074606:Smoking Prevention; D055697:Taste Perception; D009626:Terminology as Topic; D062789:Tobacco Products; D014481:United States; D055815:Young Adult