Informing smokers on additives in cigarettes: a randomized trial

Abstract

Objective: To test the acceptability and impact of a booklet on chemical additives in cigarettes.

Methods: In 2005, 2152 current (59%), former (38%), and never (3%) smokers were enrolled on the Internet and randomly assigned to an intervention group which immediately received a 48-page booklet on cigarette additives by postal mail (n=1074), or to a control group (n=1078). Four weeks later, 1965 people (91%) answered an online follow-up questionnaire on knowledge on additives and motivation to quit smoking. Participants lived in France, Belgium, and Switzerland.

Results: Most participants in the intervention group agreed with: "What I learned in this booklet is outrageous" (74%) and "alarming" (71%). Most daily smokers agreed with: "This booklet makes me want to quit smoking" (52%). The booklet increased correct answers to affirmations such as: "Additives increase the impact of nicotine" (intervention: 83% "true", control: 61% "true", p<0.001) and: "Additives mask the smell and visibility of second-hand smoke" (74% versus 23%, p<0.001). The booklet had no impact on motivation to quit, smoking cessation rates and relapse rates.

Conclusions: The booklet was appreciated, caused vivid reactions and enhanced knowledge on additives. It had, however, no impact on smoking behavior, but this was not its primary objective.

Practice implications: More intensive education campaigns on cigarette additives are necessary and will be appreciated by the public.