[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-438515-105":59,"doc-detail-438515-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","independent-and-combined-effects-of-very-low-nicotine-cigarette-messages-and-e-cigarette-messages-randomised-clinical-trial","Independent and combined effects of very low nicotine cigarette messages and e-cigarette messages - randomised clinical trial","","USA considers reducing nicotine in cigarettes to non-addictive levels while promoting alternative nicotine delivery products such as e-cigarettes, yet effective communication is needed to prevent misperceptions that very low nicotine cigarettes (VLNCs) are less harmful than regular cigarettes. A four-group randomised clinical trial tested separate and combined message strategies against a control condition. Outcomes focused on perceived absolute harm of VLNCs and switching intentions, showing VLNC-focused messages improved harm perceptions without gains from adding e-cigarette content.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":40,"@type":76,"position":81},"https://docshare.wps.com/document/research-report/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/independent-and-combined-effects-of-very-low-nicotine-cigarette-messages-and-e-cigarette-messages-randomised-clinical-trial/438515/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/independent-and-combined-effects-of-very-low-nicotine-cigarette-messages-and-e-cigarette-messages-randomised-clinical-trial/438515.png","ImageObject",300,407,{"name":92,"@type":93},"Jiven","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-01","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":81},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What communication problem does the study address?","Question",{"text":112,"@type":113},"It addresses the need for effective messaging to reduce misperceptions that very low nicotine cigarettes are less harmful than regular cigarettes, especially when paired with promotion of alternative nicotine delivery products such as e-cigarettes.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the randomised clinical trial designed?",{"text":117,"@type":113},"In 2022–2023, a four-group randomised clinical trial used a national probability sample from an online panel and assigned participants to one of three message conditions or a control message.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings on harm perceptions and message effectiveness?",{"text":121,"@type":113},"VLNC messages increased perceived harm of VLNCs compared with e-cigarette and control conditions, and combined messaging further increased harm versus the e-cigarette condition. Adding e-cigarette messages did not enhance desired outcomes beyond VLNC messaging alone.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},438515,1790807744,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":39,"category_name":40,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":81,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":46,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":31},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","Author Manuscript Author Manuscript Author Manuscript Author Manuscript  \n\n| | HHS Public Access\u003Cbr>Author manuscript\u003Cbr>Tob Control. Author manuscript; available in PMC 2025 October 25. |\n| --- | --- |\n\nPublished in final edited form as:  \nTob Control. ; 34(e1): e48–e56 . doi:10.1136/tc-2023-058556 .  \nIndependent and combined effects of very low nicotine cigarette messages and e-cigarette messages: a randomised clinical trial  \nDi Pei 1 , Reed M Reynolds2 , Charity A Ntansah3 , Emily E Hackworth3 , Katherine C Henderson 1 , Bo Yang4 , Hue Trong Duong5 , David L Ashley6 , James F Thrasher3 , Lucy Popova 1  \n1School of Public Health, Georgia State University, Atlanta, Georgia, USA  \n2Communication Department, University of Massachusetts, Boston, Massachusetts, USA  \n3 Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA  \n4 Department of Communication, University of Arizona, Tucson, Arizona, USA  \n5 Department of Communication, Georgia State University, Atlanta, Georgia, USA  \n6TRSConsulting56 LLC, Lilburn, Georgia, USA  \nAbstract  \nBackground: USA is considering reducing nicotine in cigarettes to non-addictive levels, coupled with promoting alternative nicotine delivery products (eg, e-cigarettes) . However, effective communication is needed to reduce misperceptions about very low nicotine cigarettes (VLNCs) being less harmful than regular cigarettes.  \nOpen access This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: [https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/) .  \nCorrespondence to Dr Lucy Popova, Georgia State University, Atlanta, USA; [lpopova1@gsu.edu](lpopova1@gsu.edu).  \nContributors DP conducted formal analysis, drafted the initial manuscript and reviewed and revised the manuscript. RMR contributed to data collection and manuscript reviewing and editing. CAN, EEH, KCH, BY, HTD and DLA contributed to the conceptualisation and design of the study, as well as manuscript reviewing and editing. JFT and LP, as principal investigators, led the conceptualisation and design of the study, as well as manuscript reviewing and editing. All authors approved the final manuscript as submitted. Competing interests DLA has received funds for work done for the World Health Organization Tobacco Free Initiative, as a Special Government Employee of the U.S. Food and Drug Administration, as a consultant for Pfizer, as an employee of Cherokee National Operational Systems and as an independent contractor for MK Consulting.  \nPatient consent for publication Not applicable.  \nEthics approval This study involves human participants but Georgia State University Institutional Review Board (reference number: H22639) exempted this study. Participants gave informed consent to participate in the study before taking part.  \nProvenance and peer review Not commissioned; externally peer reviewed.  \nSupplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising f","cbCaicPKpZ6xG8QK","https://ap.wps.com/l/cbCaicPKpZ6xG8QK","pdf",855165,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What communication problem does the study address?\",\"answer\":\"It addresses the need for effective messaging to reduce misperceptions that very low nicotine cigarettes are less harmful than regular cigarettes, especially when paired with promotion of alternative nicotine delivery products such as e-cigarettes.\"},{\"question\":\"How was the randomised clinical trial designed?\",\"answer\":\"In 2022–2023, a four-group randomised clinical trial used a national probability sample from an online panel and assigned participants to one of three message conditions or a control message.\"},{\"question\":\"What were the main findings on harm perceptions and message effectiveness?\",\"answer\":\"VLNC messages increased perceived harm of VLNCs compared with e-cigarette and control conditions, and combined messaging further increased harm versus the e-cigarette condition. Adding e-cigarette messages did not enhance desired outcomes beyond VLNC messaging alone.\"}]","Independent and combined effects of very low nicotine cigarette messages and e-cigarette messages - randomised clinical trial | PDF",1790685559]