Tobacco Center of Regulatory Science, School of Public Health, Georgia State University, Atlanta, Georgia, USA.
Tob Control. 2019 Jul;28(4):440-448. doi: 10.1136/tobaccocontrol-2018-054404. Epub 2018 Aug 13.
Health agencies are grappling with communicating risks of electronic cigarettes (e-cigarettes) compared with combusted cigarettes. This study examined smokers' responses to two types of comparative risk messages with one type incorporating more negative antismoking elements in the design.
In an online experiment, 1400 US adult (18+ years) current smokers and recent quitters were randomised to view one of three comparative risk messages about e-cigarettes (CR messages), one of three comparative risk messages that included more negative antismoking elements in the design (CR- messages) or a control message. Selection of outcomes was guided by the antismoking message impact framework. Multivariate analyses of covariance and logistic regression models analysed effects of messages on message evaluations, e-cigarette-related and cigarette-related beliefs and behavioural intentions.
Both CR and CR- messages decreased smokers' intentions to smoke cigarettes, increased intentions to switch to e-cigarettes completely and increased perceptions that e-cigarettes are less harmful than combusted cigarettes. Neither message type increased dual use intentions relative to exclusive e-cigarettes use or smoking cessation. CR messages decreased perceived absolute risks of e-cigarettes and self-exempting beliefs about smoking, whereas CR- versus CR messages produced higher self-efficacy to quit smoking.
Comparative risk communication might encourage smokers to switch to lower-harm tobacco products. Comparative risk messages with more negative antismoking elements in the design might be particularly effective, because they led to higher self-efficacy to quit smoking. Regulatory agencies may consider using comparative risk messages with more negative antismoking elements to educate the public about lower risk of e-cigarettes.
健康机构正在努力沟通电子烟（电子烟）与可燃香烟相比的风险。本研究考察了吸烟者对两种类型的比较风险信息的反应，其中一种类型在设计中纳入了更多负面的反吸烟元素。
在一项在线实验中，1400 名美国成年（18 岁及以上）当前吸烟者和最近戒烟者被随机分配观看三种电子烟比较风险信息（CR 信息）中的一种，三种比较风险信息中的一种在设计中纳入了更多负面的反吸烟元素（CR-信息）或控制信息。选择结果的依据是反吸烟信息影响框架。多变量协方差分析和逻辑回归模型分析了信息对信息评价、电子烟相关和香烟相关信念以及行为意图的影响。
CR 和 CR-信息都降低了吸烟者吸烟的意愿，增加了完全改用电子烟的意愿，并增加了电子烟比可燃香烟危害小的看法。两种信息类型都没有增加相对于专用于电子烟使用或戒烟的双重使用意图。CR 信息降低了对电子烟的绝对风险的感知和对吸烟的自我豁免信念，而 CR-信息与 CR 信息相比，戒烟的自我效能更高。
比较风险沟通可能会鼓励吸烟者转向危害较小的烟草产品。设计中具有更多负面反吸烟元素的比较风险信息可能更有效，因为它们导致戒烟的自我效能更高。监管机构可能会考虑使用具有更多负面反吸烟元素的比较风险信息来教育公众电子烟的风险较低。
