Scientific Standards for Studies on Modified Risk Tobacco Products (2012) / Chapter Skim
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5 Methods for Studying Risk Perception and Risk Communication
5 Methods for Studying Risk Perception and Risk Communication
Pages 191-220
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From page 191... ...
Careful attention is given regarding perceptions of dif ferent types of tobacco products, as well as how perceptions of tobacco 1 Family Smoking Prevention and Tobacco Control Act of 2009, Public Law 111-31, 123 Stat.
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BACKGROUND AND RATIONALE: IMPORTANCE OF RISK PERCEPTIONS Judgments about risk, otherwise known as risk perceptions, are viewed as a fundamental element of most theoretical models of health behavior and behavioral decision making, including social cognitive theory (Bandura, 2001) , the health belief model (Rosenstock, 1974)
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PERCEPTIONS OF TOBACCO-RELATED RISKS AND BENEFITS TO THE INDIVIDUAL A great number of studies have examined both smokers' and nonsmokers' perceptions of tobacco-related outcomes, including perceived short- and long-term health risks, social risks, risks of becoming addicted, risks from secondhand smoke, and cumulative risks. Findings on these tobacco-related perceptions as well as the important relationship between perceptions and tobacco use are reviewed next.
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From page 194... ...
. In addition to understanding the extent to which adolescent and adult smokers and nonsmokers perceive tobacco-related risks and whether these risk perceptions deter tobacco use, it is critical to learn the extent to which perceived tobacco-related benefits motivate individuals to use a tobacco product.
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. When inquired about the ease of quitting smoking, adolescents with smoking experience believed they will find it easier to quit and will be more likely to quit smoking compared to adolescents without smoking experience (Halpern-Felsher et al., 2004)
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Most of this research has examined perceptions of so called "light," "ultra light," and "lowtar" cigarettes. The studies show that adults have misperceptions about the health risks associated with smoking light and ultra light cigarettes; most adult smokers believe these cigarettes deliver less tar and nicotine, produce milder sensations, and result in less health consequences (Etter et al., 2003; Shiffman et al., 2001; Slovic, 2001)
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, "such perceptions are likely the result, in part, of the tobacco industry's marketing of light cigarettes as the healthier smoking choice, a safer alternative to cessation, and a first step toward quitting smoking altogether." More favorable perceptions of light, ultra light, and low-tar cigarettes are important to note, since many smokers have made the choice to smoke light cigarettes because they believe such cigarettes are less addictive or safer than regular cigarettes (Etter et al., 2003)
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From page 198... ...
. Thus, consumer perceptions of tobacco products applying for the modified risk claim should be explored separately for males and females in adolescent and adult samples.
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SCIENTIFIC STANDARDS FOR STUDIES ON RISK PERCEPTION AND RISK COMMUNICATION Study Questions to Address the Risk Perceptions of Modified Risk Tobacco Products With reference to each MRTP, it will be important to identify consumers' perceptions of disease risk, likelihood of addiction, likelihood of reducing or increasing others' exposure to potentially hazardous compounds (e.g., secondhand smoke) , and perceptions of risk compared to
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In addition, longitudinal postmarket studies should address whether differences in perceptions and/or intentions among different age, racial, socioeconomic status, or education groups predict later prod uct use, change in product use, or progression to dual use of MRTPs and traditional tobacco products. Research Designs This section outlines the committee's review of research designs for use in pre- and postmarket studies of consumer perceptions of MRTPs.
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Do the messages change intentions to use this MRTP or any other tobacco product? Once messages that communicate potential risks and benefits of use are developed using the focus groups, the effects of these messages on consumer perceptions should be tested.
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do participants plan to start using tobacco for the first time by using the MRTP, (2) do they intend to use it to help them quit smoking regular cigarettes or other traditionally available tobacco products, (3)
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Based on the scientific literature discussed earlier in this chapter, perceptions of MRTPs, including interpretation of marketing and health messages regarding particular MRTPs, and whether such perceptions influence changes in tobacco use, are likely to differ depending on whether or not consumers are current tobacco users, and whether or not current users desire to quit. Therefore, perceptions should be studied among people who have never used a tobacco product; people who have used any tobacco product in the past, but not currently; people who currently use a tobacco product and do not intend to quit; and people who currently use a tobacco product and do intend to quit, either with or without the use of NRT or other approved smoking cessation aids.
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From page 204... ...
, as well as the Nicotine Dependence Syndrome Scale, Minnesota Withdrawal Scale, and Shiffman-Jarvik Withdrawal Scale (American Psychiatric Association, 2000; Hughes and Hatsukami, 1986; Shiffman and Jarvik, 1976; Shiffman et al., 2004)
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From page 205... ...
Alternately, this type of smoker may believe he or she will never be able to quit using tobacco, and therefore view the MRTP as an option to continue using tobacco with less risk. Having experienced more than one failed attempt at smoking cessation may serve to solidify any beliefs smokers may have about their likelihood of success in the future, and affect their perceptions of the MRTP and their behavior accordingly.
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A sample size will be considered satisfactory based on a priori statistical power analyses to ensure that the sample adequately reflects the demographic characteristics of the population of interest. Study participants should not have any affiliation with the tobacco industry, the FDA, or any tobacco control agency.
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Previous research shows that conditional risk assess ments more closely reflect health risk behavior models and are stronger predictors of behavior than unconditional risk assessments, which do not place outcomes in a precise behavioral context (Halpern-Felsher et al., 2001; Ronis, 1992; Van Der Velde et al., 1996)
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From page 208... ...
This includes understanding their increased level of risk if they are not current tobacco users, or their presumed decreased level of risk if they are already tobacco users (this requires comparisons of risk between the MRTP and specific tobacco products that are currently on the market)
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Outcome Expectancies In addition to the methods for assessing risk perceptions outlined above, other factors that may relate to the likelihood of trying or adopting use of an MRTP should be considered. A number of research groups have examined outcome expectancies as predictors of both smoking uptake and relapse after cessation.
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From page 210... ...
. One study that exam ined expectancies in relation to modified tobacco products showed that positive expectancies predicted interest in trying both Quest and Eclipse, regardless of level of smoking experience (O'Connor et al., 2007)
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axes, either numeric or visualanalog. Validated clinical measures such as the Profile of Mood States or Positive and Negative Affect Schedule can also be employed to measure current feelings among participants (McNair et al., 1971; Watson et al., 1988)
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SOURCE: Wakefield et al., "Assessment of youth responses to anti-smoking ads: Description of a research protocol," Practice Ad Coding Scheme. Chicago: ImpacTeen, 2002.
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American Journal of Preventive Medicine 40(6)
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2011. The appeal of smoke less tobacco products among young Canadian smokers: The impact of pictorial health warnings and relative risk messages.
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2002. Risk involvement and risk perception among adolescents and young adults.
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2004. Tobacco industry research on smoking cessation.
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1974. The health belief model and preventive health behavior.
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1991. Adolescents' smoking behavior and risk perceptions.
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1994. Smoking outcome expectancies: Factor structure, predictive valid ity, and discriminant validity.
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