Tobacco Harm Reduction Advertising in the Presence of a Government-Mandated Warning

Compelling research suggests that smokeless tobacco (SLT) products are safer than cigarettes, but awareness of this potential harm reduction alternative among consumers is low. Therefore, two between-subjects experimental studies explore the potential for allowing the marketing of SLT as a "reduced-risk" alternative to cigarette smoking. Specifically, this article addresses the issue of whether a harm reduction message with the simultaneous presence of the U.S. government-mandated warning would: (1) change intentions of smokers to use SLT products; or (2) attract those who would not otherwise use any tobacco. Results suggest that an advertiser making a harm reduction statement in the presence of the warning leads to limited changes in consumers' risk perceptions of SLT products or intentions to try the product. Exposure to the experimental ads did not make nonsmokers significantly more likely to try SLT products, but also did not make smokers indicate that they were likely to switch to SLT products. ********** Although increased awareness of the dangers associated with smoking has been successful in helping some consumers to quit smoking and preventing others from starting, millions of Americans continue to smoke. As such, viable options for smokers to reduce the harmful effects of smoking should be explored. Among the proposed options is increasing public awareness of the relative health risk of smokeless tobacco (SLT) in comparison to cigarettes (Britton and Edwards 2008; Kozlowski 2007). SLT may refer to a variety of oral tobacco products including tobacco in a pouch, moist snuff, lozenges or strips. However, for the purposes of this research, we examine SLT products low in nitrosamines, a known carcinogen (for a review, see Helliker 2007). A review of the extant literature indicates that a strong majority of scientific evidence suggests that SLT that is low in nitrosamines is considerably less harmful to users than cigarettes (Gartner et al. 2007; Lee 2007). However, research also suggests that a majority of the public is not aware of this difference in risk. Moreover, SLT marketers are currently not allowed to communicate harm reduction information in marketing communications. The underlying principle of harm reduction is that a product that has adverse health consequences is promoted as a substitute for one that has more severe adverse health consequences (Institute of Medicine 2001). Research suggests that a very substantial portion of the risk associated with smoking might be eliminated with SLT. Although the exact magnitude of reduction in risk gained from substituting use of SLT for cigarette smoking is not easily quantified and is the subject of disagreement, there appears to be a consensus among experts that SLT is considerably safer than cigarettes. Estimates from previous research range from 90% up to 99% reduction in risk (Levy et al. 2004; Rodu and Cole 2002). Specifically, switching to SLT reduces the risk of fatal heart and lung diseases because the tobacco is not incinerated. Hence, the primary question is no longer about whether SLT is considered by the scientific community to be of significantly less risk than cigarette smoking, but whether the population as a whole could benefit from information which communicates the relative risk of using SLT vs. smoking cigarettes. Studies suggest that Americans are not well informed about the relative risk of SLT and cigarettes (O'Connor et al. 2005). A key issue that has not been addressed in previous research is the potential ramifications of communicating the relative risks associated with SLT vs. cigarettes to consumers. The current regulatory environment does not allow for SLT marketers to communicate harm reduction information in the advertising and promotion of their products. However, the Family Smoking Prevention and Tobacco Act (S.982, H.R. 1256) provides for the possibility that such information could be communicated if several conditions are met. …