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Background: Public health officials have classified smoking as a risk factor for COVID-19 disease severity. Smokers generally have less trust in health experts than do nonsmokers, leading to reduced risk perceptions. This study addresses smokers' trust in information sources about COVID-19 and how trust is associated with perceived COVID-19 susceptibility and severity among smokers. Methods and findings: A nationally representative sample of 1,223 current smokers were surveyed between October and November 2020, indicating their level of trust in COVID-19 information sources, and their perceptions of risk from COVID-19. Multiple differences in trustworthiness emerged; smokers trusted their personal doctor for information about COVID-19 more than other information sources, while news media were generally distrusted. In addition, the FDA was trusted less than the NIH and CDC. Several "trust gaps" were observed, indicating disparities in levels of trust associated with gender, ethnicity, education, and political orientation, which had the strongest association with trust of all factors. Political orientation was also a significant predictor of COVID-19 risk perceptions, but there was no independent effect of political orientation when accounting for trust, which was predictive of all risk perception outcomes. Conclusions: Trusted sources, such as personal doctors, may most effectively convey COVID-19 information across political orientations and sociodemographic groups. News media may be ineffective at informing smokers due to their low credibility. The results suggest that trust may explain the apparent effect of political orientation on COVID-19 risk perceptions. Implications for researchers, communication professionals, and policy makers are discussed. [ABSTRACT FROM AUTHOR]

Introduction: In 2017, the US Food and Drug Administration (FDA) proposed lowering the amount of nicotine in combusted cigarettes to minimally addictive levels. If used, to encourage cessation and maximize the benefits of this action, the FDA needs to determine the most effective way to communicate to the public the practical impact of this nicotine tobacco product standard.Methods: Data were collected in 2018 from a nationally representative, online probability sample of 1198 adult smokers (aged ≥18 years old) in the United States. Smokers were randomly assigned one of five versions of the question regarding what they would most likely do if nicotine in cigarettes was reduced (nicotine levels were reduced by 95%; the government reduced nicotine levels by 95%; cigarettes were no longer addictive; cigarettes no longer relieved cravings; cigarettes were changed so that you would be able to quit more easily). Effects of framing on anticipated tobacco use intentions and perceived risk of very low nicotine cigarettes (VLNCs) were evaluated with multinomial logistic regressions.Results: Framing the nicotine tobacco product standard as cigarettes no longer relieved cravings resulted in the highest proportion of smokers reporting they intend to quit in response to this standard (43.9%), lowest proportions reporting anticipated intentions to continue using combusted tobacco products (45.3%), and lowest proportion believing that VLNCs are less harmful than regular cigarettes (26%).Conclusions: Different frames of nicotine reduction in cigarettes differentially affected smokers' anticipated tobacco use intentions and perceived risk of VLNCs. Presenting reduction as making cigarettes unable to relieve cravings might be particularly effective at motivating cessation. [ABSTRACT FROM AUTHOR]

Objectives: Publicity on incidents of electronic nicotine delivery systems (ENDS) exploding or catching fire may influence smokers' risk perceptions and decisions about using ENDS for quitting smoking. We examined combustible cigarette smokers' perceptions of the possibility of injury from exploding ENDS and the relationship of those perceptions to ENDS use, perceived risk relative to smoking, and perceived costs and benefits of ENDS use. Methods: We used data from the 2017 Tobacco Products and Risk Perceptions Survey of a national probability sample of US adults, conducted online in August and September 2017. The analytic sample consisted of 1181 current combustible cigarette smokers aware of ENDS. Results: Among combustible cigarette smokers aware of ENDS, a medium/high perceived risk of injury from exploding ENDS was associated with lower odds of current ENDS use (adjusted odds ratio [aOR] = 0.50; 95% confidence interval [CI], 0.30-0.86; P =.01), perceiving ENDS to be at least as harmful as cigarettes (aOR = 3.22; 95% CI, 2.11-4.93; P <.001), and feeling that the negatives of ENDS use outweighed the positives (aOR = 3.50; 95% CI, 2.00-6.14; P <.001). Conclusions: Product standards, improved product labeling, and education about how to properly use, charge, and store ENDS can help protect consumers from injury. Communication efforts should seek to fully inform combustible cigarette smokers about both the absolute health risks of ENDS, including risk of explosions, and their relative risks compared with those of cigarette smoking. [ABSTRACT FROM AUTHOR]

Objectives. Affect is an important dimension of risk perceptions, which are proximal determinants of little cigar and cigarillo (LCC) smoking. We examined the association among affect, risk perceptions, and current LCC use and susceptibility in a national probability sample of US young adults, aged 18-29. Methods. Structural equation models examined the effect of affect, via risk perceptions, on LCC current use and susceptibility for 772 young adults who took the 2015 Tobacco Products and Risk Perceptions Survey, which asked about affect for images related to LCCs and health risks of daily LCC use. Results. Positive affect toward LCCs was associated with lower perceived risks of daily LCC smoking (p < .001). Lower perceived risks were associated with higher probability of current LCC smoking (p = .008) among young adults who were aware of LCCs and with susceptibility to use among young adult never LCC users (p < .001). A direct effect of positive affect on current LCC use (p < .02) and susceptibility to use LCCs also was found. Conclusions. Future research should investigate how regulatory policy or enforcement actions can be used to regulate LCC components (eg, flavoring, advertising, etc) that influence affect and risk perceptions. [ABSTRACT FROM AUTHOR]

Introduction: Flavored little cigars, cigarillos, and filtered cigars (LCCs) are popular and pose unique health risks. This study explored risk perceptions of flavors in LCCs and the relationship between perceptions and use among U.S. adults.Methods: Data were from the 2015 Tobacco Products and Risk Perceptions Survey of a national probability sample of 6051 adults, conducted online, August-September, 2015. The analytic sample consisted of 5105 adults aware of LCCs and 2174 who had ever used any type of LCCs.Results: Just over half of adults reported flavors in LCCs as "very" or "somewhat" risky, while more than one-third of adults reported they did not know the risks of flavors in LCCs. Younger adults, males, and users of any LCCs were more likely than older adults, females and non-users, respectively, to perceive LCC flavors as less risky. Those who perceived LCC flavors as "not at all risky" or "a little risky" were roughly twice as likely to have ever used flavored LCCs compared to those who reported not knowing the risks (AOR = 2.07, 95% CI = 1.16 to 3.69 and AOR = 1.96, 95% CI = 1.26 to 3.06). Those who reported LCC flavors as "very risky" were also more likely to have ever used flavored LCCs than those who reported not knowing the risks (AOR = 1.50, 95% CI = 1.13 to 1.98).Conclusions: Though the proportion of adults assigning low risk to flavors in LCCs is small, these adults are more likely to use flavored LCCs. The association of use with risk perceptions of flavors in LCCs should be addressed in health risk campaigns.Implications: Flavored LCCs are popular, particularly among young adults. While understanding the impact of flavors is an FDA research priority, little is currently known about perceptions of risk associated with flavors in LCCs. This study explores the nature of risk perceptions of flavors in LCCs, and the relationship between perceptions and flavored LCC use. We conclude that perception of risk of flavors in LCCs is related to use of these products, particularly perception of less risk. Considering the relationship between use and risk perceptions would be helpful in constructing health risk messaging. [ABSTRACT FROM AUTHOR]