ArticleHarm reduction journal2011
Trends in beliefs about the harmfulness and use of stop-smoking medications and smokeless tobacco products among cigarettes smokers: Findings from the ITC four-country survey.
Article in Harm reduction journal, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
41 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- Comparative disease risks associated with cigarette smoking and use of moist smokeless tobacco and snus: an umbrella review of epidemiological evidence from the United States and Western Europe.BMC public health · 2025Pooled it
- Can the Public Be Educated About Constituents in Smokeless Tobacco? A Three-Wave Randomized Controlled Trial.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2021Trial
- The Impact of Smokeless Tobacco Risk Information on Smokers' Risk Perceptions and Use Intentions: A News Media Experiment.Health communication · 2019Trial
- Perceived Health Risks of Snus and Medicinal Nicotine Products.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2016Trial
- Public education about the relative harm of tobacco products: an intervention for tobacco control professionals.Tobacco control · 2014Trial
- Changing low income smokers' beliefs about tobacco dependence treatment.Substance use & misuse · 2014Trial
- The impact of product information and trials on demand for smokeless tobacco and cigarettes: evidence from experimental auctions.Preventive medicine · 2014Trial
- Estimating demand for alternatives to cigarettes with online purchase tasks.American journal of health behavior · 2014Trial
- Modeling the population health impact of accurate and inaccurate perceptions of harm from nicotine.Harm reduction journal · 2024Article
- Individual and Conjoint Factors Associated With Beliefs About the Harmfulness of Nicotine Replacement Therapies Relative to Combustible Cigarettes Among People Who Smoke: Findings From the 2020 ITC Four Country Smoking and Vaping Survey.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Article
- '95% less harmful'? Exploring reactions to quantitative modified risk claims for snus and e-cigarettes.Tobacco control · 2022Article
- Oral Nicotine Product Awareness and Use Among People Who Smoke and Vape in the U.S.American journal of preventive medicine · 2022Article
- Do Smokers' Perceptions of the Harmfulness of Nicotine Replacement Therapy and Nicotine Vaping Products as Compared to Cigarettes Influence Their Use as an Aid for Smoking Cessation? Findings from the ITC Four Country Smoking and Vaping Surveys.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2022Article
- Risk perception ofSSM - population health · 2022Article
- The effect of cigarette modified risk claims and brand on perceived risk, product appeal, and use intentions.PloS one · 2022Article
- 'I perceive it to be less harmful, I have no idea if it is or not:' a qualitative exploration of the harm perceptions of IQOS among adult users.Harm reduction journal · 2021Article
- Smoking cessation interventions in South Asian countries: protocol for scoping review.BMJ open · 2021Article
- Assessing likelihood of product use for snus with modified-risk information among adult current cigarette smokers, former tobacco users, and never tobacco users.Addictive behaviors reports · 2019Article
- Exposure to and perceptions of health warning labels on nicotine vaping products: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey.Addiction (Abingdon, England) · 2019Article
- Harm perceptions of e-cigarettes and other nicotine products in a UK sample.Addiction (Abingdon, England) · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
Abstract
backgroundEvidence shows that smokers are generally misinformed about the relative harmfulness of nicotine, and smokeless forms of nicotine delivery in relation to smoked tobacco. This study explores changing trends in the beliefs about the harmfulness and use of stop smoking medications and smokeless tobacco in adult smokers in four countries where public education and access to alternative forms of nicotine is varied (Canada, the US, the UK and Australia).
methodsData are from seven waves of the ITC-4 country study conducted between 2002 and 2009 with adult smokers from Canada, the US, the UK and Australia. For the purposes of this study, data were collected from 21,207 current smokers. Using generalised estimating equations to control for multiple response sets, multivariate models were tested to look for main effects of country, and trends across time, controlling for demographic variables.
resultsKnowledge remained low in all countries, although UK smokers tended to be better informed. There was a small but significant improvement across time in the UK, but mixed effects in the other three countries. At the final wave, between 37.5% (US) and 61.4% (UK) reported that NRT is a lot less harmful than cigarettes. In Canada and the US, where smokeless tobacco is marketed, only around one in six believed some smokeless tobacco products could be less harmful than cigarettes.
conclusionsMany smokers continue to be misinformed about the relative safety of nicotine and alternatives to smoked tobacco, especially in the US and Canada. Concerted efforts to educate UK smokers have probably improved their knowledge. Further research is required to assess whether misinformation deters smokers from appropriate use of alternative forms of nicotine.
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.