ArticleTobacco control2020
'The lesser devil you don't know': a qualitative study of smokers' responses to messages communicating comparative risk of electronic and combusted cigarettes.
Article in Tobacco control, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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
25 citing papers in PubMed, 27 citations in OpenAlex.
- Effects of a Modified Exposure Claim for an e-Cigarette on Claim Comprehension, Behavioral Intentions, and Risk Perceptions Among US Adult Tobacco Users and Nonusers: Randomized Experimental Study.JMIR formative research · 2026Trial
- Effects of modified risk tobacco product claims on consumer comprehension and risk perceptions of IQOS.Tobacco control · 2022Trial
- Communicating risk differences between electronic and combusted cigarettes: the role of the FDA-mandated addiction warning and a nicotine fact sheet.Tobacco control · 2020Trial
- Effects of a Nicotine Fact Sheet on Perceived Risk of Nicotine and E-Cigarettes and Intentions to Seek Information About and Use E-Cigarettes.International journal of environmental research and public health · 2019Trial
- Exploring the Underlying Beliefs Shaping Perceptions of E-cigarette Harm Among a Convenience Sample of Adults in the United States.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2026Article
- The Impact of Exposure to Food and Drug Administration E-cigarette Authorization Messages on Product Perceptions and Interest-An Experiment With Adults Who Smoke and Youth.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2024Article
- Warning Labels as a Public Health Intervention: Effects and Challenges for Tobacco, Cannabis, and Opioid Medications.Annual review of public health · 2024Review
- Perceptions about levels of harmful chemicals in e-cigarettes relative to cigarettes, and associations with relative e-cigarette harm perceptions, e-cigarette use and interest.Addiction (Abingdon, England) · 2023Article
- Perceived Truthfulness of Reduced Lung Cancer Risk Advertising Claims Influences Consumers' Intention to try and to Purchase Snus.Tobacco use insights · 2023Article
- '95% less harmful'? Exploring reactions to quantitative modified risk claims for snus and e-cigarettes.Tobacco control · 2022Article
- 'It brings light to what you really put into your body': a focus group study of reactions to messages about nicotine reduction in cigarettes.Tobacco control · 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
- Associations between perceived source credibility, e-cigarettes, and e-cigarette ad perceptions.Preventive medicine reports · 2022Article
- Adolescent risk perceptions of ENDS use: Room for change in tobacco education.Preventive medicine reports · 2022Article
- A Content Analysis of U.S. Adults' Open-Ended Responses to E-Cigarette Risk Messages.Health communication · 2022Article
- "When I Don't Have a Cigarette It's Helpful, but It Really Don't Satisfy:" Qualitative Study of Electronic Nicotine Delivery Systems (ENDS) Use among Low-Income Smokers.International journal of environmental research and public health · 2022Article
- Exploring the implications of modified risk claim placement in tobacco advertising.Preventive medicine reports · 2021Article
- Will E-Cigarette Modified Risk Messages with a Nicotine Warning Polarize Smokers' Beliefs about the Efficacy of Switching Completely to E-Cigarettes in Reducing Smoking-Related Risks?International journal of environmental research and public health · 2021Article
- Smokers' Exposure to Perceived Modified Risk Claims for E-Cigarettes, Snus, and Smokeless Tobacco in the United States.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2021Article
- Harm Perceptions and Beliefs about Potential Modified Risk Tobacco Products.International journal of environmental research and public health · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
introductionCommunicating to smokers that e-cigarettes deliver lower levels of harmful chemicals than combusted cigarettes is a challenging issue. This study qualitatively explored smokers' interpretations of messages communicating the risk of e-cigarettes relative to cigarettes (comparative risk messages).
methodWe developed 12 print comparative risk messages and evaluated them in 12 focus groups with 72 adult smokers (18+ years old) in Atlanta, Georgia.
resultsParticipants interpreted uncertainty about health effects of e-cigarettes as an indicator of significant unknown risks, which some believed to be potentially more severe than the known effects of cigarettes (such as cancer and heart disease). Also, participants were sceptical about the lower risk claims. Some participants misinterpreted what 'switching completely' or 'switching 100% of the time' means, perceiving switching from e-cigarettes to combusted cigarettes as comparable with the use of both products. When chemicals in e-cigarettes were mentioned (eg, nicotine or formaldehyde), participants viewed e-cigarettes as very harmful and had difficulty reconciling this belief with the reduced risk claim. Comparative risk messages emphasising smoking risks were perceived as effective. Participants also appreciated being given an option to switch if they cannot quit. Participants suggested the inclusion of more facts and statistics and a credible message source (eg, public health agencies) to increase message effectiveness.
conclusionComparative risk messages may be more acceptable to smokers if they show direct comparisons of the number of toxic chemicals in cigarettes and e-cigarettes, are attributed to a credible source(s), and emphasise smoking risks.
Indexed as
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.