Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California.
Center for Tobacco Control Research and Education, University of California San Francisco, San Francisco, California.
J Adolesc Health. 2023 Sep;73(3):445-451. doi: 10.1016/j.jadohealth.2023.04.025. Epub 2023 Jun 9.
United States Smokeless Tobacco Company LLC submitted a modified risk tobacco product application to the US Food and Drug Administration, proposing a claim that switching to Copenhagen snuff fine cut from cigarettes reduces lung cancer risk. This claim could affect adolescents' smokeless tobacco perceptions and its use.
Students (N = 592; mean age: 15.3 years; 46% male; 32% nonHispanic White; 8% smokeless tobacco ever-users) at seven California high schools were randomized within a survey to view a Copenhagen snuff image, either with or without the proposed reduced risk claim. Participants were then asked about the harm of smokeless tobacco and their willingness to try Copenhagen snuff if a friend offered. Postimage harm rating and willingness were compared between image groups overall, stratified by past 30-day tobacco use (87% of tobacco users were e-cigarette users), and adjusted for participant characteristics using multivariable regression.
Participants who viewed the claim were less likely to perceive smokeless tobacco to cause "a lot" of harm (56% vs. 64%; p = .03), including after statistical adjustment (risk ratio [RR]: 0.84; 95% confidence interval [CI]: 0.75, 0.94), and with a numerically stronger effect among tobacco users (RR: 0.65; 95% CI: 0.48, 0.86). The claim did not increase willingness overall (17% vs. 20%; p = .41) but did increase willingness among tobacco users (RR: 1.67; 95% CI: 1.05, 2.67).
Brief exposure to a reduced-risk claim decreased adolescents' smokeless tobacco harm perceptions and increased willingness to try among tobacco users. The Food and Drug Administration order permitting this claim could increase some adolescents' susceptibility to smokeless tobacco, particularly those already using other tobacco products like e-cigarettes.
美国无烟烟草公司向美国食品和药物管理局提交了一份改良风险烟草产品申请，提出了一项主张，即从香烟切换到哥本哈根鼻烟细切可以降低肺癌风险。这一主张可能会影响青少年对无烟烟草的看法及其使用。
在加利福尼亚州的七所高中内，学生（N=592；平均年龄：15.3 岁；46%为男性；32%为非西班牙裔白人；8%为曾使用无烟烟草者）在调查中被随机分为两组，分别观看带有或不带有拟议的降低风险主张的哥本哈根鼻烟图像。然后，参与者被问及无烟烟草的危害，以及如果朋友提供，他们尝试哥本哈根鼻烟的意愿。在总体上、按过去 30 天的烟草使用情况（87%的烟草使用者为电子烟使用者）进行分层，并使用多变量回归对参与者特征进行调整后，比较两组图像之间的事后图像危害评分和意愿。
观看主张的参与者认为无烟烟草造成“很多”危害的可能性较小（56%对 64%；p=0.03），包括在进行统计调整后（风险比[RR]：0.84；95%置信区间[CI]：0.75，0.94），且在烟草使用者中效果更为明显（RR：0.65；95% CI：0.48，0.86）。该主张并未总体上增加尝试意愿（17%对 20%；p=0.41），但确实增加了烟草使用者的尝试意愿（RR：1.67；95% CI：1.05，2.67）。
短暂接触降低风险的主张降低了青少年对无烟烟草的危害认知，并增加了烟草使用者尝试的意愿。美国食品和药物管理局允许这一主张的命令可能会增加一些青少年对无烟烟草的易感性，尤其是那些已经使用电子烟等其他烟草产品的青少年。
