There is little awareness of the chemical components of cigarette smoke amongst US adults, even though many of them report having looked for relevant information. In a study published in the open access journal BMC Public Health, researchers from the University of North Carolina at Chapel Hill suggest that the Food and Drug Administration (FDA) expand its messaging activities so that information about these constituents reaches all segments of the US population, especially those most vulnerable to tobacco product use and its associated health risks.
Marcella Boynton, first author of the research paper, said: "The majority of the U.S. public wants easy access to information about chemicals in cigarettes and other tobacco products. Surprisingly, our results reveal that groups one might presume to be the least psychologically motivated to look for this information, young adults and smokers, were more likely to say that they had previously looked for this information."
More than a quarter of adults (27.5%) reported having looked for information on the different components of tobacco products and tobacco smoke, many of which are known to be poisonous or cause cancer. Out of these adults, 37.2% were young adults (18-25 years of age) and 34.3% were smokers. Out of non-smokers and older adults, 26% reported having looked for information on tobacco constituents. However, with the exception of nicotine, most respondents were largely unaware of which constituents are present in cigarette smoke. Over half of respondents (54.8%) indicated that they would like relevant information to be available on cigarette packs, and 28.7% would prefer to access that information online.
These results indicate that publication of tobacco constituent information is of interest to the public and could improve public health in the US where tobacco use is the leading cause of preventable death and disease, the researchers suggest.
Marcella Boynton said: "By making tobacco chemical information available to the public and tobacco industry practice more transparent, those seeking this information may be less likely to start smoking and more likely to quit because they will be better informed about the toxic chemicals present in tobacco products."
The research team conducted a nationally representative telephone survey among 5,014 US adults aged 18 years and over. To make sure that the sample adequately represented smokers, young adults and minority groups, the survey oversampled high smoking/low income areas and cell phone numbers, as well as groups known to have experienced mistreatment by government organizations in the past. Some of these groups, which include people living in poverty, people with lower education, and sexual minorities, are most affected by tobacco use and its associated health risks, according to the researchers.
The FDA was given the authority to regulate the tobacco industry with the passage of the 2009 Family Smoking Prevention and Tobacco Control Act. It expanded this authority to include additional tobacco products, such as e-cigarettes, hookahs and cigars in May 2016. Education campaigns intended to increase the public's awareness of potential health harms of tobacco products are part of the FDA's efforts to control tobacco products.
Given the FDA's role of communicating the harms of tobacco use, the researchers sought to understand how tobacco product users and non-users perceive the credibility of the FDA. Participants were asked if they had ever heard of the FDA and if they believed that the FDA could effectively regulate tobacco products. The vast majority of US adults surveyed (94.6%) reported having heard of the FDA, but awareness was lower amongst young adults, those with lower education, low numeracy and those living in poverty. The majority of both smokers (66.6%) and non-smokers (65.0%) believed that the FDA could effectively regulate tobacco products.
The study was limited by its focus on tobacco constituents for which the FDA has signaled that it will require manufacturers to provide information. Given the large number of chemicals in tobacco, future research into a wider range of constituents is needed to inform efforts to regulate tobacco use and communicate its risks, according to the researchers. This could benefit the majority of US smokers (over 80%) who reported an intention to quit in this study. Additional work is also needed to monitor public response to FDA communications and changing patterns of tobacco use.
Notes to editors:
1. Understanding how perceptions of tobacco constituents and the FDA relate to effective and credible tobacco risk messaging: A national phone survey of U.S. adults, 2014-2015, Marcella H. Boynton, Robert P. Agans, J. Michael Bowling, Noel T. Brewer, Erin L. Sutfin, Adam O. Goldstein, Seth M. Noar and Kurt M. Ribisl, BMC Public Health 2016, DOI: 10.1186/s12889-016-3151-5
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