Understanding Adult and Youth Perceptions of Newly-Deemed Tobacco Products to Inform Public Health Communication

Theoretical Background and research questions/hypothesis: In 2016, with the Final Deeming Rule, the Food and Drug Administration’s Center for Tobacco Products extended its regulatory authority to include e-cigarettes, hookah, cigars, cigarillos, and other tobacco products. Several of these products are new to the market and research has shown that the use of alternative tobacco products like these is rising. Therefore, this study aimed to explore youth and adults’ knowledge and perceptions of these newly-deemed products. Specifically, using Theory of Planned Behavior and Theory of Reasoned Action as a framework, this study investigated knowledge, attitudes, and beliefs (KABs) about these newly-deemed products in order to better understand how to effectively influence motivations, intentions and use through health communication efforts.

Methods:  This study involved qualitative interviews with 23 people, in four cities across the U.S. (New York, Boston, Atlanta, and St. Louis). Interviews were conducted in March 2017. Criteria for participants included that they be 13 to 54 years of age and collectively represent various genders, races/ethnicities, and sexual orientations. Additionally, participants were screened in if 1) they were susceptible to/using tobacco, to ensure that participants represented the groups most at risk for using the newly-deemed products; and 2) they had misconceptions about some or all of the newly-deemed products, to allow for exploration of what and why misperceptions exist. Participants were asked a series of questions about four of the newly-deemed tobacco products (e-cigarettes, hookah, cigars, cigarillos) to assess KABs of these products. Interviews were recorded and transcribed. Interviews were analyzed using qualitative analysis software.

Results:  Results of this study reveal what people know and do not know about the newly-deemed tobacco products; what they think about them and people who use them; and how they compare to combustible cigarettes. Themes that emerged suggest that many people 1) do not believe these are tobacco products; 2) do not think they are addictive; and 3) do not think they are a significant health risk to adults or children.

Conclusions:  Results of this study can help inform the development of effective health communication messages about the dangers of newly-deemed tobacco products via media campaigns. Effective public education about these products can change KABs about their use and, ultimately, reduce tobacco intentions and behaviors.

Implications for research and/or practice:  This study is one of the first to explore the public’s perceptions and gaps in knowledge surrounding the newly-deemed tobacco products since the Final Deeming Rule was announced. The study’s results can shape directions for future health communications research and contribute to counterrmarketing efforts which have lagged behind the proliferation of pro-tobacco marketing and advertising of these products. More broadly, these findings add to the growing literature that examines use, risks, and public perceptions of newly-deemed tobacco products.