Lucy Popova

Alternative Tobacco Product Use and Smoking Cessation: A National Study

OBJECTIVES We investigated the frequency of alternative tobacco product use (loose leaf, moist snuff, snus, dissolvables, electronic cigarettes [e-cigarettes]) among smokers and the association with quit attempts and intentions. METHODS A nationally representative probability-based cross-sectional survey of 1836 current or recently former adult smokers was completed in November 2011. Multivariate logistic regressions evaluated associations between alternative tobacco product use and smoking cessation behaviors. RESULTS Of the smokers, 38% had tried an alternative tobacco product, most frequently e-cigarettes. Alternative tobacco product use was associated with having made a quit attempt, and those intending to quit were significantly more likely to have tried and to currently use the products than were smokers with no intentions to quit. Use was not associated with successful quit attempts. Interest in future use of alternative tobacco products was low, except for e-cigarettes. CONCLUSIONS Alternative tobacco products are attractive to smokers who want to quit smoking, but these data did not indicate that alternative tobacco products promote cessation. Unsubstantiated overt and implied claims that alternative tobacco products aid smoking cessation should be prohibited.

A longitudinal analysis of electronic cigarette use and smoking cessation.

Although electronic cigarettes (e-cigarettes) are aggressively promoted as smoking cessation aids,1 studies of their effectiveness for cessation have been unconvincing.2, 3 One randomized trial comparing e-cigarettes with and without nicotine, and nicotine patch found no differences in 6-month quit rates.2 Population-based, longitudinal studies have also not shown associations between e-cigarette use and quitting.4, 5 A longitudinal, international study found that, although 85% of smokers who used e-cigarettes reported using them to quit, e-cigarette users did not quit more frequently than non-users (p=.516).4 Among US quitline callers, e-cigarette users were less likely to have quit at 7 months than non-users.5 We employed a longitudinal analysis of a national sample of current US smokers to determine whether e-cigarette use predicted successful quitting, or reduced cigarette consumption.

The Extended Parallel Process Model: Illuminating the Gaps in Research

This article examines constructs, propositions, and assumptions of the extended parallel process model (EPPM). Review of the EPPM literature reveals that its theoretical concepts are thoroughly developed, but the theory lacks consistency in operational definitions of some of its constructs. Out of the 12 propositions of the EPPM, a few have not been tested explicitly and not a single one received unequivocal empirical support. This article proposes alternative operationalization for some of the constructs and examines some assumptions of this theory, such as additive relationship between the constructs, the role of time and issue of thresholds, and disregard for the existing state of the audience. Finally, the role of the EPPM as a potential foundation for a general theory of negative emotional appeals is addressed.

Spatial presence and perceived reality as predictors of motion-based video game enjoyment

This study investigated the impact of new motion-based video game control systems on spatial presence, perceived reality, and enjoyment of video games. In two experiments, university students played video games on either new motion-based (Sonys Move, Microsofts Kinect, and Nintendos Wii), or standard video game systems (PS3 and XBOX 360 with gamepads). The results indicate that, in the context of golf, racing, and boxing games, the higher technological interactivity of motion-based systems (particularly Kinect) increases feelings of spatial presence, perceived reality, and enjoyment. Perceived reality predicted spatial presence; and spatial presence, in turn, was a significant predictor of enjoyment. Moving toward a more natural user interface (NUI) between the player and the game world can create a more immersive, realistic, and fun experience for the player. A new model for enjoyment of motion-based video games is proposed.

Testing Equivalence in Communication Research: Theory and Application

Although equivalence testing is preferred when a researchers goal is to support the null hypothesis (i.e., no substantial effect), equivalence tests are virtually unknown and unused in the communication field. This article provides the rationale for and theoretical background of equivalence testing and offers examples of equivalence tests for the independent and dependent groups t-test and tests of association using Pearsons coefficient or correlation. From a review of meta-analyses, we provide tables of commonly observed effect-sizes across subdisciplines and topic areas in communication and offer these as a guideline for choosing minimum substantial effects (Δ) in equivalence testing when no other information source is available. To facilitate the adoption of equivalence tests in future research, we provide easy-to-use custom dialogs for SPSS which greatly simplify their computation and application.

Nonsmokers’ responses to new warning labels on smokeless tobacco and electronic cigarettes: an experimental study

BackgroundGraphic warning labels are a tobacco control best practice that is mandated in the US for cigarettes under the 2009 Family Smoking Prevention and Tobacco Control Act. However, smokeless tobacco products are not required to carry graphic warning labels, and as of September 2014, electronic cigarettes in the US carry no warning labels and are aggressively marketed, including with “reduced harm” or “FDA Approved” messages.MethodsIn this online experiment, 483 US adult non-users of tobacco were randomized to view print advertisements for moist snuff, snus, and e-cigarettes with either warning labels (current warning label, graphic warning label) or “endorsements” (a “lower risk” label proposed by a tobacco company, an “FDA Approved” label) or control (tobacco advertisement with no label, advertisement for a non-tobacco consumer products). Main outcome measures included changes in perceived harm, positive attitudes towards, openness to using, and interest in a free sample of moist snuff, snus, and e-cigarettes.ResultsThe graphic warning label increased perceived harm of moist snuff and e-cigarettes. “Lower risk” and “FDA Approved” labels decreased perceived harm of moist snuff and snus respectively. Current warning label and graphic warning label significantly lowered positive attitudes towards e-cigarettes. In this sample of non-users of tobacco, 15% were interested in a free sample of alternative tobacco products (predominantly e-cigarettes). Proportion of participants interested in a free sample did not differ significantly across the conditions, but those interested in a free sample had significantly lower perceptions of harm of corresponding tobacco products.ConclusionsRegulatory agencies should not allow “lower risk” warning labels, which have similar effects to the “FDA Approved” label, which is prohibited, and should consider implementing graphic warning labels for smokeless tobacco products and e-cigarettes.

Perceptions of Relative Risk of Snus and Cigarettes Among US Smokers

In a survey of 1836 adult US smokers, when using a direct comparison measure, 22.1% reported snus was less harmful than were cigarettes. When asked indirectly (estimating the health risk of snus and cigarettes in 2 separate questions and comparing the answers to each other), 51.6% rated snus as less risky. The Food and Drug Administration should consider both direct and indirect measures when perceived risk data are presented as evidence for tobacco regulation.

Testing messages to reduce smokers’ openness to using novel smokeless tobacco products

Introduction Tobacco manufacturers’ aggressive promotion of new smokeless tobacco products such as snus warrants a timely and effective public health response. This study tested potential countermarketing messages to discourage current and former smokers from becoming dual users of smokeless tobacco and cigarettes. Methods In a pretest-post-test experiment, 1836 adult current and recently former smokers from a national sample were randomised to view one of six antismokeless tobacco ads followed by a snus ad, to view a control ad followed by a snus ad; or to view two control ads. Perceived effectiveness of ads and actual changes in attitudes and openness to snus were compared across groups using analyses of variance. Results Some ads that were perceived as most effective did not change attitudes or openness to trying snus, and conversely, some ads not perceived as effective changed attitudes and openness to snus. Ads portraying the negative health effects of smokeless tobacco were perceived as most effective, but ads with antitobacco industry themes significantly decreased favourable attitudes toward snus. Responses to ads were different for smokers who had ever used smokeless tobacco: for this group health effects and humorous/testimonial ads were effective. Conclusions Measures of perceived effectiveness of antitobacco ads need to be augmented with measures of actual effectiveness to assess countermarketing messages. Some of the developed ads, such as ads with anti-industry themes, were effective for the overall population of smokers whereas humorous/testimonial and health effects ads were particularly effective in changing attitudes of past users of smokeless tobacco.

Controller required? the impact of natural mapping on interactivity, realism, presence, and enjoyment in motion-based video games

In three experiments with U.S. undergraduates, effects of three levels of naturally mapped control interfaces were compared on a players sense of presence, interactivity, realism, and enjoyment in video games. The three levels of naturally mapped control interfaces were: kinesic natural mapping (using the players body as a game controller), incomplete tangible mapping (using a controller in a way similar to a real object), and realistic tangible mapping (using a controller or an object that directly relates to the real-life activity the game simulates). The results show that levels of interactivity, realism, spatial presence, and enjoyment were consistent across all conditions. However, when performing activities such as table tennis or lightsaber dueling with objects in-hand (incomplete tangible or realistic tangible conditions), perceived reality was a more important predictor of spatial presence. When performing the same activities with empty hands, interactivity emerged as the more important direct predictor of spatial presence. Control interface, therefore, matters greatly to the route by which cognitive processing of games takes place and how enjoyment is produced.

Scaring the Snus Out of Smokers: Testing Effects of Fear, Threat, and Efficacy on Smokers’ Acceptance of Novel Smokeless Tobacco Products

Novel smokeless tobacco products (such as snus) are aggressively promoted to smokers by the tobacco companies. The Extended Parallel Process Model (EPPM; Witte, 1992) was used to evaluate the current perceptions of threat, efficacy, attitudes, and behavioral intentions regarding snus in a nationally representative sample of 1,836 smokers. Participants were then exposed to messages designed to discourage smokers from trying snus. On average, smokers perceived health threat of snus as somewhat serious, but believed they can effectively avert this threat. Support was found for the EPPM’s proposition that when efficacy is high, greater perceived threat is associated with greater desired outcomes (less favorable attitudes toward snus and lower behavioral intentions to try snus in the future). No support was found for the proposition that when perceived efficacy is low, greater threat is associated with greater message rejection. Instead, message rejection was explained by fear felt while exposed to the anti-smokeless ads. This finding indicates the need to more clearly distinguish between cognitive (danger control) and affective (fear control) responses posited by the EPPM.