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GSU Researcher Receives $6.9 Million in Grants to Develop and Test Tobacco Education Strategies

— April 29, 2024

Findings will help inform public health campaigns as FDA considers new regulations on very low nicotine and menthol cigarettes.

ATLANTA—With the Food and Drug Administration considering landmark regulations that would significantly limit the amount of nicotine and ban menthol in cigarettes, a Georgia State University researcher is proactively developing and testing targeted messages to improve public health.

Funded by a five-year, $3.9 million grant from the National Cancer Institute and the Food and Drug Administration’s Center for Tobacco Products, a team led by Associate Professor Lucy Popova in the GSU School of Public Health will develop and test messages that can accompany the policy of reducing nicotine in combusted cigarettes by 95% to minimally or non-addictive levels. Because smoking is more common among those with psychological distress and those with low socioeconomic status, this project will specifically focus on these groups.

In a separate five-year, $3 million project that was recently funded by the National Cancer Institute, Popova will develop and test messages that aim to reduce tobacco use among menthol cigarette smokers with low socioeconomic status.

“Regulations limiting the amount of nicotine in cigarettes and banning menthol would have a huge effect on public health,” Popova said. “To be most effective, these regulations need to be paired with effective messages that reach the people who need them the most.”

Very Low Nicotine Cigarettes: “Just as harmful, but easier to quit.”

Previous work by Popova and her colleagues has examined beliefs about very low nicotine cigarettes (VLNCs) using focus groups and experiments in which smokers were given several messages to identify those that generated the greatest perceived harmfulness and those that most strongly motivated them to try to quit. The researchers found that messages that were most effective emphasized that that although VLNCs have less nicotine, they still contain all of the other harmful chemicals found in traditional cigarettes—such as cadmium, lead and ammonia.

“A lot of people believe nicotine is the most harmful thing in cigarettes and that cigarettes with reduced nicotine are less harmful—and that’s not the case,” Popova said. “They’re just as harmful, but easier to quit.”

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Photo by Kristaps Solims on Unsplash

Popova’s new study will test messages in situations that more closely mimic a future in which VLNCs are widely available. Current smokers will be provided VLNCs with test messages delivered through leaflets inserted into cigarette packs. These participants also will view print and video ads during weekly visits. The control group will receive VLNCs but no messaging about their harms.

Communicating for Health Equity

Decades of public health campaigns—combined with steps such as raising tobacco taxes and enacting smoke free regulations—have helped dramatically reduce tobacco use in the United States. Despite this progress, nearly 30% of people without a college degree smoke, compared to 11% of people with a bachelor’s degree. Similarly, 36% of people with incomes below the poverty level smoke, compared to 21% of those at or above the poverty level. The Centers for Disease Control and Prevention notes that tobacco companies target low-income communities with advertising for menthol-flavored cigarettes and flavored cigars.

To close gaps that contribute to higher levels of death and disability among socioeconomically disadvantaged populations, Popova and her colleagues will develop messages with input from current smokers and then test their impact in a randomized trial with a nationally representative sample of people who smoke menthol cigarettes and flavored cigars.

Participants for studies in both projects will be recruited through several Atlanta-area organizations, many of which were identified by the community advisory board of the SURGE project that Popova launched in 2022.

Researchers have estimated that the enactment of a regulation to make cigarettes minimally addictive or non-addictive would save millions of American lives in the coming decades, while banning menthol in cigarettes and cigars would save 650,000 lives.

Popova’s co-investigators on the study at the Georgia State University School of Public Health are Claire Spears (Associate Professor) and Alexander Kirpich (Assistant Professor). In addition, Jim Thrasher (Professor, Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina) and Nicholas Giordano (Assistant Professor, Nell Hodgson Woodruff School of Nursing, Emory University) are co-investigators on the VLNC project. Jiaying Liu (Associate Professor, Department of Communication, University of California Santa Barbara) and Anna Kostygina (Principal Research Scientist, NORC at University of Chicago) are co-investigators on the health equity project.

Research reported in this news release was supported by the National Cancer Institute of the National Institutes of Health and Food and Drug administration under award number R01CA239308 and by the National Cancer Institute of the National Institutes of Health under award number R01CA289552. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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