Assessing the impact of messages about reduced nicotine cigar products among people who use little cigar and cigarillo: Insights from a discrete choice experiment.

Introduction: The U.S. Food and Drug Administration's (FDA) pursuit of a low nicotine standard for cigarettes raises concerns that a focus on cigarettes may encourage people to use other combusted tobacco products, undermining the policy's effectiveness. The FDA is considering expanding the policy to include cigar products, which will require effective messages for people who use those products.

Methods: In 2022, a discrete choice experiment was conducted with African American males and females and white males and females. Participants (n=1,722), aged 18-44 years and who had smoked little cigar and cigarillos (LCC) in the past 30 days, evaluated seven message attributes about reduced nicotine content (RNC) LCCs (presence or absence of information on source, chemicals, harm, nicotine, addiction, quitting efficacy, and enjoyment) across 20 choice sets. Participants assessed two of three outcomes: affect towards the policy, perceived harm of RNC LCCs, and motivation to quit smoking LCCs.

Results: Messages listing the FDA as the source were selected as eliciting more positive affect towards the policy, increasing perceived harm and motivation to quit smoking LCCs. Source was the most influential attribute for selecting messages in terms of positive affect towards the policy and motivation to quit. Chemicals and harm attributes had the most substantial effect on selecting messages as increasing perceived harm.

Conclusions: Citing the FDA as a source may improve the perceived effectiveness of RNC communications for people who use LCCs. Misperceptions about presumed lower harms of RNC products can be corrected with information about their harm and chemical properties.

Implications: Our findings among people who use LCCs suggest that source information shown as the FDA logo can increase message effectiveness while also influencing risk perceptions and motivation to quit smoking LCCs. To address misperceptions about RNC LCC harms, educational messages should particularly consider incorporating information about chemicals and harms.