title: Reduced nicotine content cigarette advertising: How false beliefs and subjective ratings affect smoking behavior.
abstract: Tobacco advertising can create false beliefs about health harms that are reinforced by product design features. Reduced nicotine content (RNC) cigarettes may reduce harm, but research has not addressed advertising influences. This study examined RNC cigarette advertising effects on false harm beliefs, and how these beliefs - along with initial subjective ratings of RNC cigarettes - affect subsequent smoking behaviors. We further explored whether subjective ratings moderate associations between false beliefs and behavior.
  
  
  
  Seventy-seven daily, non-treatment-seeking smokers (66.2% male) participated in the first 15days of a randomized, controlled, open-label RNC cigarette trial. Participants viewed an RNC cigarette advertisement at baseline before completing a 5-day period of preferred brand cigarette use, followed by a 10-day period of RNC cigarette use (0.6mg nicotine yield). Participants provided pre- and post-advertisement beliefs, and subjective ratings and smoking behaviors for cigarettes smoked during laboratory visits.
  
  
  
  Viewing the advertisement increased beliefs that RNC cigarettes contain less nicotine and are healthier than regular cigarettes (p's<0.001 and 0.011), and decreased the belief that they are less likely to cause cancer (p=0.046). Neither false beliefs nor subjective ratings directly affected smoking behaviors. Significant interactions of strength and taste ratings with beliefs (p's<0.001), however, indicated that among smokers with less negative initial subjective ratings, greater false beliefs were associated with greater RNC cigarette consumption.
  
  
  
  Smokers may misconstrue RNC cigarettes as less harmful than regular cigarettes. These beliefs, in conjunction with favorable subjective ratings, may increase product use.
authors.affiliation: Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States. Electronic address: melmer@upenn.edu.
authors.forename: Melissa
authors.initials: M
authors.lastname: Mercincavage
authors.affiliation: Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States. Electronic address: msaddleson@gmail.com.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Saddleson
authors.affiliation: Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States. Electronic address: emily.gup@uphs.upenn.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: Gup
authors.affiliation: Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States. Electronic address: ahals@upenn.edu.
authors.forename: Angela
authors.initials: A
authors.lastname: Halstead
authors.affiliation: Department of Oncology, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007, United States. Electronic address: darren.mays@georgetown.edu.
authors.forename: Darren
authors.initials: D
authors.lastname: Mays
authors.affiliation: Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, Suite 4100, Philadelphia, PA 19104, United States. Electronic address: strasse3@mail.med.upenn.edu.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Strasser
mesh_terms: D000328:Adult; D003469:Culture; D008192:Deception; D000067088:Direct-to-Consumer Advertising; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009538:Nicotine / Q000032:analysis*; D012907:Smoking / Q000523:psychology*; D062789:Tobacco Products / Q000032:analysis*; D055815:Young Adult
chemical_list: D009538:Nicotine
keywords: False beliefs; Low nicotine; Reduced nicotine content; Smoking behaviors; Subjective ratings; Tobacco product advertising