Abstract

Objective: Proposed regulation may establish nicotine standards in cigarettes to sub-addictive levels. In this study, we explore the association between nicotine perceptions and responses to a reduced nicotine policy scenario among current smokers. Methods: Data from a nationally representative sample of 18-54-year-old current tobacco users were collected in March-April 2018 (N = 1746). Current smokers (N = 854) were asked about nicotine-related health beliefs and nicotine addiction. Time to first cigarette (TTFC) was used to examine nicotine dependence. Adjusted and weighted logistic regression models examined these nicotine-related factors in association to support for a proposed government policy and related behavioral intentions. Results: Although 63% of survey participants accurately identified nicotine alone as the addiction cause, 49% incorrectly indicated that cancer and 56% indicated that increased health risk caused by cigarette smoking comes from nicotine. Smokers showed high support (72%) for a proposed low-nicotine policy. Greater misperception about nicotine harm was associated with greater odds (aOR = 1.66, p < .05) of policy support. Shorter TTFC was associated with greater intent to smoke low-nicotine cigarettes but was not associated with policy support. Conclusion: Evidence could inform health message development to address knowledge and misperceptions around nicotine when garnering public support for a low-nicotine policy.

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