The impact of cigarette package tar yield displays, tar warning statement, and plain packaging on low-tar cigarette misperceptions among South Koreans who smoke.

Introduction: This study examined whether different cigarette package features such as tar yield display, tar warning statement, and plain packaging affect beliefs about tar intake, smoothness, and safety of low-tar cigarettes among South Koreans who smoke.

Methods: An online randomized between-subjects experiment was carried out (n = 500) on a panel of South Koreans who smoke. Participants were exposed to either a mock cigarette package that 1) displayed tar yield; 2) did not display tar yield; 3) showed a tar warning statement; or 4) was plain packaged. Beliefs about tar intake, smoothness, and safety were measured post-exposure. Beliefs were compared across conditions, and mediation analysis was conducted.

Results: Participants exposed to the tar warning statement believed the mock cigarette would deliver lesser tar compared to those only exposed to the package that displayed tar yield. Those who viewed the cigarette package with no tar yield number were less likely to agree that the cigarette would be smoother compared to those who viewed the package with a visible tar yield number. The effect of viewing the tar warning statement on safety beliefs was fully mediated by tar intake beliefs. The effect of exposure to tar yield display on safety beliefs was fully mediated by smoothness beliefs.

Conclusion: Study results indicate that the current tar warning statement could increase misperceptions. Removing tar yield numbers may reduce smoothness beliefs about low-tar cigarettes. Health communication efforts should address beliefs about tar intake and smoothness when trying to correct low-tar cigarette misperceptions about safety.

Implications: Previous research has found that tar yield numbers displayed on the front of South Korean low-tar cigarette packages may mislead people to perceive lesser harm. However, studies have not yet examined whether other package elements such as the current tar warning statement or plain packaging could reduce misperceptions. Study results indicated that viewing the current tar warning statement backfires by increasing belief in lesser tar intake. Viewing tar yield numbers also led to increased perception that the cigarette will feel smoother. Plain packaging did not exert any effects on beliefs about tar intake, safety or smoothness. Findings can inform tobacco packaging policies and health communication efforts to reduce misperceptions about low-tar cigarettes.