Abstract: E-cigarettes and Adult Smokers: A Test of Messages Communicating Relative Risk

◆ Sherri Jean Katz, University of Minnesota
◆ Elisia Cohen, University of Minnesota
◆ Dorothy Hatsukami, University of Minnesota


E-cigarettes have been called a reduced harm product that can potentially ease the public health burden of tobacco if existing cigarette smokers transition completely.[1,2] This plan, however, relies upon smokers actually transitioning, and prior research has highlighted that a growing percentage of adult smokers believe e-cigarettes are as harmful as combustible cigarettes.[3] The purpose of this study is to determine whether (H1) adult smokers who view a relative risk message will have lower risk perceptions than participants who do not view a relative risk message. Additionally, drawing upon the theoretical concept of a “smoking cue,”[4] or visual imagery related to smoking use, we tested (RQ1) the influence of including a “vaping cue.”

Participants and Design. An online (AMTurk, U.S. smokers) experiment (n = 317) tested the influence of a relative risk message about e-cigarettes (3 message conditions: vaping cue/ no vaping cue/no message) on risk perceptions. In total, 10 participants were excluded from analysis for timing issues, and one for failing an attention check. Most of the remaining 306 adult smokers had tried an e-cigarette (ever-use=272,past30days=140). Other demographic information is: female=171,cacausian=261,M(age)=39.35, SD(age)=11.22.

Stimulus Materials. The relative risk message featured: a toxic-indicator, showing cigarettes in red at the top, no tobacco use in green at the bottom, and e-cigarettes in yellow-green toward the bottom; 2. a reduced exposure statement; and 3. a testimonial and photo of a former-smoker (gender-matched to participant). The version with a vaping cue had misty vapor behind the “toxic-indicator,” while the other had just a black background.

Measures. A risk perception scale was developed by averaging the responses to two questions: how risky are electronic cigarettes and compared to traditional cigarettes, is using electronic cigarettes everyday risky for one’s health, (1) not risky at all to (4) very risky (M = 2.35, SD = .72, alpha = .89, loads on one component).

As predicted by H1, there was a main effect for message condition on the risk perception scale, F (2, 303) = 3.39, p = .035. In response to RQ1, participants who viewed the relative risk message with the vaping cue (M = 2.24, SD = .68) had lower risk perceptions than those who did not view a relative risk message (M = 2.50, SD = .80), p = .028. Participants who viewed the relative risk message without the vaping cue reported risk perceptions in the middle (M = 2.33, SD = .66).

Results indicate that a relative risk message can be effective in reducing the risk perceptions of e-cigarettes among adult smokers. In the case of this study, the image that included a vaping cue yielded the significant findings. A possible explanation is that the solid black background in the no vaping cue condition looked more serious than the vaping cue. Future research is needed to determine whether these messages might yield unintended effects among youth, whether relative risk messages are effective following the 2019 vaping-related lung injuries, and whether e-cigarettes remain a viable path of tobacco control following the 2019 lung injuries.