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. 2023 Mar 1:244:109709.
doi: 10.1016/j.drugalcdep.2022.109709. Epub 2023 Jan 13.

Is perception reality? Associations among "light" cigarettes and number of cigarettes smoked per day

Roberta Freitas-Lemos  1 , Allison N Tegge  2 , Liqa N Athamneh  1 , Yu-Hua Yeh  1 , William H Craft  1 , Jeffrey S Stein  1 , Tracy T Smith  3 , Irina Stepanov  4 , Vaughan W Rees  5 , K Michael Cummings  3 , Richard J O'Connor  6 , Peter G Shields  7 , Dorothy K Hatsukami  8 , Warren K Bickel  9
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Is perception reality? Associations among "light" cigarettes and number of cigarettes smoked per day

Roberta Freitas-Lemos et al. Drug Alcohol Depend. .

Abstract

Introduction: Cigarette filter ventilation and light descriptors are associated with lowered perceptions of risk and smoking more cigarettes per day (CPD). This study examined the relationship between usual cigarette ventilation, perception, and CPD.

Methods: A crowdsourced sample (N = 995) of individuals who smoke higher-ventilated (=>20% ventilation) or lower-ventilated (=<10% ventilation) cigarettes identified their usual cigarette as "light" or "full flavor", and reported their average CPD.

Results: We found: 1) no association between ventilation status and perception of light versus full flavor (AUC=0.58), with the inaccurate perception being more prevalent in younger individuals (p = 0.041) and those who smoke L&M (73%, p < 0.001) and Camel (61%, p = 0.006) brands; and 2) perception, but not ventilation of usual cigarette, was significantly associated with CPD (p = 0.006), with individuals who perceived their cigarettes as light reporting an average of 13% more cigarettes per day (2.6 CPD), compared to those who perceived their cigarette as full flavor.

Conclusions: Perceptions of light versus full-flavor, but not ventilation status, predicted CPD. These findings may inform anti-smoking health communication strategies and smoking cessation interventions.

Implications: Tobacco control policies should eradicate the perception of cigarettes as light or full-flavored. Future research investigating the associations between cigarette filter ventilation and smoking behavior should consider the confounding effects that may lie in an individual's perceptions of their cigarettes.

Keywords: Cigarette descriptors; Filter ventilation; Full flavor cigarettes; Light cigarettes; Perceptions.

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Conflict of interest statement

Conflict of interest Although the following activities/relationships do not create a conflict of interest pertaining to this manuscript, in the interest of full disclosure, Dr. Bickel would like to report the following: W. K. Bickel is a principal of HealthSim, LLC; BEAM Diagnostics, Inc.; and Red 5 Group, LLC. In addition, he serves on the scientific advisory board for Sober Grid, Inc., and Ria Health, is a consultant for Alkermes, Inc., and works on a project supported by Indivior, Inc. Dr. Tegge would like to report work on a project supported by Indivior, Inc. Dr. Cummings and Dr. Rees serve as a paid expert witnesses in litigation against cigarette manufacturers. The other authors report no conflict of interest.

Figures

Figure 1.
Figure 1.
(A) ROC curve indicating the predictive performance of ventilation levels on perception of light or full flavor cigarettes. The diagonal line indicates the performance of a random classifier. (B) Proportion of individuals with inaccurate perception grouped by cigarette brand. The vertical dashed line indicates the studywide inaccurate perception rate. Error bars represent the standard error of the estimate.
See this image and copyright information in PMC

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