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. 2018 Nov;27(6):677-683.
doi: 10.1136/tobaccocontrol-2016-053579. Epub 2017 Jul 13.

Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment

Ramzi G Salloum  1 , Jordan J Louviere  2 , Kayla R Getz  1 , Farahnaz Islam  3 , Dien Anshari  3   4 , Yoojin Cho  3 , Richard J O'Connor  5 , David Hammond  6 , James F Thrasher  3
Affiliations

Evaluation of strategies to communicate harmful and potentially harmful constituent (HPHC) information through cigarette package inserts: a discrete choice experiment

Ramzi G Salloum et al. Tob Control. 2018 Nov.

Abstract

Background: The US Food and Drug Administration (FDA) has regulatory authority to use inserts to communicate with consumers about harmful and potentially harmful constituents (HPHCs) in tobacco products; however, little is known about the most effective manner for presenting HPHC information.

Methods: In a discrete choice experiment, participants evaluated eight choice sets, each of which showed two cigarette packages from four different brands and tar levels (high vs low), accompanied by an insert that included between-subject manipulations (ie, listing of HPHCs vs grouping by disease outcome and numeric values ascribed to HPHCs vs no numbers) and within-subject manipulations (ie, 1 of 4 warning topics; statement linking an HPHC with disease vs statement with no HPHC link). For each choice set, participants were asked: (1) which package is more harmful and (2) which motivates them to not smoke; each with a 'no difference' option. Alternative-specific logit models regressed choice on attribute levels.

Results: 1212 participants were recruited from an online consumer panel (725 18-29-year-old smokers and susceptible non-smokers and 487 30-64-year-old smokers). Participants were more likely to endorse high-tar products as more harmful than low-tar products, with a greater effect when numeric HPHC information was present. Compared with a simple warning statement, the statement linking HPHCs with disease encouraged quit motivation.

Conclusions: Numeric HPHC information on inserts appears to produce misunderstandings that some cigarettes are less harmful than others. Furthermore, brief narratives that link HPHCs to smoking-related disease may promote cessation versus communications that do not explicitly link HPHCs to disease.

Keywords: carcinogens; packaging and labelling; public policy.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1.
Figure 1.
Sample choice set
Figure 2.
Figure 2.
Relative Importance of Product Attributes on Key Outcomes
See this image and copyright information in PMC

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