Focus Group Study of Youth Reactions to Creative Advertising Concepts Designed to Prevent Youth Tobacco Use among Multicultural Youth

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Addendum D - Facts for Discussion(Final)

Focus Group Study of Youth Reactions to Creative Advertising Concepts Designed to Prevent Youth Tobacco Use among Multicultural Youth

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Focus Group Study of Youth Reactions to Creative Advertising Concepts Designed to Prevent Youth Tobacco Use among Multicultural Youth

Addendum D: Tobacco Facts for Discussion


A subset of CTP-approved facts will be chosen for Creative Development focus group Fact Discussion.


Fact for Discussion

Fact

Source

TFR ID

A. Even though cigars and cigarillos come in crazy flavors, they are still addictive, and contain toxic chemicals that can cause cancer.

B. Cigars and rillos come in all types of flavors, but they are still addictive, and can give you cancer.

Flavors like strawberry and grape can mask the harshness of cigars, cigarillos and little cigars, but don’t be fooled - the flavoring doesn’t make them less harmful. All of these products can lead to nicotine addiction and contain toxic, cancer-causing chemicals that can cause serious health problems.

U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: Preventing Tobacco Use among Youth and Young Adults. We Can Make the Next Generation Tobacco-Free (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.

Food and Drug Administration (FDA). Harmful and potentially harmful constituents in \tobacco products and tobacco smoke: established list.
Federal Register. 2012; 77(64). http://www.fda.gov/downloads/TobaccoProducts/GuidanceComplianceRegulatoryIInformation/UCM297981.pdf. Accessed August 18, 2014

TF0033


A. Cig smoke contains nasty chemicals like cadmium, which is found in batteries.

B. Cadmium is a toxic chemical found in batteries, as well as cigarette smoke.

Cadmium is a chemical [or, a toxic metal] found in batteries and cigarette smoke.


U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

TF0046


A. Cigarette smoke has formaldehyde in it. That’s what they use to put in dead bodies, fam.


B. A chemical called formaldehyde that’s used to preserve dead bodies is straight up found in cigs.

Formaldehyde is a chemical [or, a carcinogen] found in cigarette smoke. It is also used to embalm dead bodies.


U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

TF0047


A. Chemicals like ammonia that are added to tobacco may make it easier for you to get hooked on cigs.  


B. Chemicals like ammonia that are added to cigs may increase how addictive they are, keeping you stuck in that cycle.

Some chemicals added to tobacco, like ammonia, may increase the absorption of nicotine in the brain —increasing the addictiveness of the product.


U.S. Department of Health and Human Services (USDHHS). How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

Cancer Research UK. Source of the chemicals in cigarettes. http://www.cancerresearchuk.org/cancer-info/healthyliving/smokingandtobacco/whatsinacigarette/wheredothesechemicalscomefrom. 2009. Accessed August 18, 2014

TF0048


A. Cigs can straight wreck your immune system, and may leave you wide open to catching respiratory illnesses, like bronchitis and pneumonia.

B. Smoking knocks your immune system, which may leave you open to bronchitis and pneumonia.

Smoking can weaken your immune system and leave you more vulnerable to respiratory illnesses, like bronchitis and pneumonia.


U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Smoking: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.

U.S. Department of Health and Human Services (USDHHS).
The Health Consequences of Smoking: 50 Years of Progress. A Report of the Surgeon General (Fact Sheet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.

TF0073


A. Cig smoke has benzene in it, which is also found in crude oil, gasoline, and diesel exhaust. Straight wackness.


B. Cig smoke has benzene in it. That’s the same stuff found up in crude oil, gasoline, and diesel exhaust.

Benzene is a chemical found in crude oil, gasoline, diesel exhaust, and cigarette smoke.


Benzene. U.S. National Library of Medicine. Updated 06 November, 2008. http://toxnet.nlm.nih.gov/cgi-bin/sis/search/a?dbs+hsdb:@term+@DOCNO+35

U.S. Department of Health and Human Services (USDHHS).
A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

TF0101


A. Menthols may be even more addictive than other cigs, leaving you out of control.

Menthols may be even more addictive and harder to quit than other cigarettes.


Hoffman AC, Simmons D. Menthol cigarette smoking and nicotine dependence. Tobacco Induced Diseases. 2011; 9(Suppl 1): S5: 1-5.

Hoffman AC, Miceli D. Menthol cigarettes and smoking cessation behavior.
Tobacco Induced Diseases. 2011; 9(Suppl 1): S6: 1-5.

TF0024


A. Check the facts. Cig smoke contains straight up poisonous gas called carbon monoxide that’s also found in car exhaust.

Carbon monoxide is a chemical [or, a poisonous gas] that is found in cigarette smoke and car exhaust.


U.S. Department of Health and Human Services (USDHHS). The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.

TF0043


A. There are over 7,000 chemicals in cigarette smoke that can ruin your freshness. Many of them are toxic, and more than 70 can cause cancer.


B. Cigs contain a grip of chemicals. We’re talking over 7,000, including more than 70 chemicals that can give you cancer.

Cigarette smoke contains 7,000+ chemicals, many of which are toxic, including more than 70 that can cause cancer.


U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

Hecht SS. Research opportunities related to establishing standards for tobacco products under the Family Smoking Prevention and Tobacco Control Act.
Nicotine & Tobacco Research. 2012; 14(1):18-28.

Hoffmann D, Hoffmann I, El Bayoumy K. The less harmful cigarette: a controversial issue. A tribute to Ernst L. Wynder.
Chemical Research in Toxicology. 2001; 14:767-790.

International Agency for Research on Cancer (IARC). Tobacco smoke and involuntary smoking. In:
IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 83. Lyon, France: International Agency for Research on Cancer; 2004.

International Agency for Research on Cancer (IARC). Some non-heterocyclic polycyclic aromatic hydrocarbons and some related exposures. In:
IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. Vol. 92. Lyon, France: International Agency for Research on Cancer; 2010.


TF0045


A. Tobacco smoke contains lead, which is a toxic metal that used to be in paint. Not fresh.  

B. They stopped putting lead in paint, but you can still find the toxic chemical in tobacco smoke.

Lead, a chemical [or, a toxic metal] once used in paint, is found in tobacco smoke.


U.S Department of Health and Human Services (USDHHS). A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

TF0049


A. For real, smoking can actually make your stress worse, not better.

B. Thinking smoking is a stress reliever is all hype. It can actually stress you out more.

Smoking not only doesn’t reduce stress, but can make the stress you already feel worse.

Parrott A. Does cigarette smoking cause stress? The American Psychologist. 1999; 54(10):817-820.

TF0056


A. Cigars can end your life too, with over 9,000 deaths a year in the US caused by cigar use.

B. Cigars cause around 9,000 deaths every year. Keep it real, bruh. There is no safe way to smoke tobacco.

Regular cigar smoking is responsible for approximately 9,000 premature deaths each year in the U.S.


Center for Tobacco Products (CTP). Statistics Sheet. Cleared May 15, 2015.

Nonnemaker J, Rostron B, Hall P, MacMonegle A, Apelberg B. Mortality and Economic Costs From Regular Cigar Use in the United States, 2010.
American Journal of Public Health. 2014; 104: e86-e91.

TF0204


A. Don’t get it twisted. Cigars dish out similar cancer-causing stuff as smoking cigs.

B. Cigarette or cigar; it doesn’t matter. Both contain similar cancer-causing substances.

Smoking cigars exposes users to similar types of harmful and cancer-causing substances as smoking cigarettes.


Chen J, Kettermann A, Rostron BL, Day HR. Biomarkers of exposure among U.S. cigar smokers: an analysis of 1999-2012 National Health and Nutrition Examination Survey (NHANES) data. Cancer Epidemiology, Biomarkers & Prevention. 2014; 23(12):2906-2915.

Cleared by OS June 2015

A. Cigars can trash your freshness.


B. Smoking cigars puts you in danger of mad health risks.

Cigar smoking poses significant health risks to users.


Shanks TG, and Burns DM. Disease consequences of cigar smoking. Smoking and Tobacco Control, Monograph 9: Cigars–Health Effects and Trends. Bethesda, MD: National Cancer Institute; 1998; 4105-4160.

Baker F, Ainsworth SR, Dye JT, et al. Health risks associated with cigar smoking.
Journal of the American Medical Association. 2000; 284(6):735-740.

International Agency for Research on Cancer (IARC).
Tobacco Smoke and Involuntary Smoke. Lyon, France: World Health Organization, International Agency for Research on Cancer; 2004.

McCormack VA, Agudo A, Dahm CC, et al. Cigar and pipe smoking and cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC).
International Journal of Cancer. 2010; 127(10): 2402–2411.

Wyss A, Hashibe M, Chuang SC, et al. Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium 1122.
American Journal of Epidemiology. 2013; 178 (5):679-690.

Chang CM, Corey CG, Rostron BL, Apelberg BJ. Systematic review of cigar smoking and all-cause and smoking-related mortality.
Biomed Central Public Health. 2015; 15:390.

Cleared by OS June 2015

A. Smoking cigars can hit you with cancer in your lungs, mouth, pancreas, stomach, and bladder.

Cigar smoking causes cancers of the lung, oral cavity, esophagus, larynx, pancreas, stomach and bladder.


International Agency for Research on Cancer (IARC). Tobacco Smoke and Involuntary Smoke. Lyon, France: World Health Organization, International Agency for Research on Cancer; 2004.

Bertuccio P, La VC, Silverman DT, et al. Cigar and pipe smoking, smokeless tobacco use and pancreatic cancer: an analysis from the International Pancreatic Cancer Case- Control Consortium (PanC4).
Annals of Oncology. 2011; 22 (6):1420–1426.


Cleared by OS June 2015

A. E-cigs don’t play. Some e-cigs can hit you with the same amount of nicotine as cigarettes.


B. E-cigs are not what’s up. Some e-cigs can expose you to the same amount of nicotine as normal cigs.

E-cigarettes that contain nicotine can expose a user to similar amounts of nicotine as conventional cigarettes.


Vansickel AR, Eissenberg T. Electronic cigarettes: Effective nicotine delivery after acute administration. Nicotine & Tobacco Research. 2013; 15:267-270.

Hecht SS, Carmella SG, Kotandeniya D, et al. Evaluation of toxicant and carcinogen metabolites in the urine of e-cigarette users versus cigarette smokers.
Nicotine & Tobacco Research. 2015; 17(6):704-709.

Adriaens K, Van Gucht D, Declerck P, Baeyens F. Effectiveness of the electronic cigarette: an eight-week Flemish study with six-month follow-up on smoking reduction, craving and experienced benefits and complaints.
International Journal of Environmental Research and Public Health. 2014; 11:1220-1248.

Etter JF. Levels of saliva cotinine in electronic cigarette users.
Addiction. 2014; 109(5):825-829.

Cleared by OS June 2015

A. Think e-cigs are just water vapor? Na, fam. Some e-cigs can produce chemicals like formaldehyde, acrolein, and metal particles. Skip on that.

B. It’s more than just vapor. Some e-cigs can produce chemicals like formaldehyde, acrolein, and metal particles.

E-cigarettes do not produce just “water vapor”. Chemicals that have been identified in some aerosols include:
• volatile organic compounds (Cheng et al. 2014)
• polycyclic aromatic hydrocarbons (Cheng et al. 2014)
• flavoring substances
• metal particles (Williams et al. 2013)


Cheng T. Chemical evaluation of electronic cigarettes. Tobacco Control. 2014; 23:ii11–ii17.

Williams M, Villarreal A, Bozhilov K, Lin S, Talbot P. Metal and silicate particles including nanoparticles are present in electronic cigarette cartomizer fluid and aerosol.
PLoS One. 2013; 8(3):e57987


Cleared by OS June 2015

A. Some e-cigs can expose you to cancer-causing chemicals that can crack your freshness.


B. Some e-cigs can expose you to cancer-causing chemicals that are nothing to play with.

Known and suspected carcinogens such as formaldehyde and acetaldehyde, have been identified in some e-cigarette aerosols.

Goniewicz ML, Knysak J, Gawron M, et al. Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tobacco Control. 2014; 23(2):133-139.

Cheng T. Chemical evaluation of electronic cigarettes.
Tobacco Control. 2014; 23:ii11–ii17.

Cleared by OS June 2015

A. Some crazy bad things have happened to people while they were using e-cigs, like burns to the face from exploding e-cigs.

B. Some people have had wack experiences when using e-cigs, like face burns from exploding e-cigs.

Adverse experiences associated with e-cigarettes that have been reported to FDA include:
Pneumonia, congestive heart failure, disorientation, seizure, hypotension, possible aspiration pneumonia, second-degree burns to the face (product exploded in consumer’s mouth while driving and during routine use), chest pain and rapid heartbeat, possible infant death secondary to choking on e-cigarette cartridge.

Chen I. FDA summary of adverse events on electronic cigarettes. Nicotine & Tobacco Research. 2013; 15:615–616.


Cleared by OS June 2015

A. Smoking cigs can straight up wreck almost every part of your body with cancer.  


B. Real talk, smoking cigs can cause cancer almost anywhere in your body.

Smoking can cause cancer almost anywhere in your body.


U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: Preventing Tobacco Use among Youth and Young Adults. We Can Make the Next Generation Tobacco-Free (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.

U.S Department of Health and Human Services (USDHHS).
A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.


TF0075


A. Cig smoke has butane, which is a chemical found in fuel gas.


B. For reals though, the same stuff found in fuel gas, called butane, is also found in smoke from cigs.


Butane is a chemical found in fuel gas and cigarette smoke.


United States Securities and Exchange Commission (USSEC). Form 10-K.

U.S. Department of Health and Human Services (USDHHS).
The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006.

TF0102


A. Let’s get it right. Smoking don’t make you lose weight, fam.

Many young people believe that smoking can help them lose weight, but young people who smoke are not thinner than those who don’t.

U.S. Department of Health and Human Services (USDHHS). A Report of the Surgeon General: Preventing Tobacco Use among Youth and Young Adults. We Can Make the Next Generation Tobacco-Free (Consumer Booklet). Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2012.

TF0117


A. E-cigs come with that bad type of fire, because they can blow up and burn you.

B. For reals though, e-cigs have exploded on people causing serious burns.

E-cigarettes have exploded causing fires and burn injuries.


Downing M. Sherman man’s e-cigarette explodes while charging. KXII News 12. July 16, 2013. http://www.kxii.com. Accessed July 17, 2013.

Liebelson D, Suebsaeng A. Should you be worried about your e-cigarette exploding? Mother Jones. April 17, 2014. http://www.motherjones.com. Accessed September 14, 2014.

South Wales Argus. Valleys man's e-cigarette battery explodes. February 27, 2014. http://www.southwalesargus.com. Accessed March 28 2014.

Chen I. FDA summary of adverse events on electronic cigarettes.
Nicotine & Tobacco Research. 2013; 15:615–616.

Durmowicz EL, Rudy SF, Chen I-L. Electronic cigarettes: analysis of FDA adverse experience reports in non-users.
Tobacco Control. Published Online: 23 April 2015. (doi:10.1136/tobaccocontrol-2015-052235)

U.S. Fire Administration.
Electronic Cigarette Fires and Explosions. Washington, D.C.: U.S. Department of Homeland Security, Federal Emergency Management Agency. October 2014. https://www.usfa.fema.gov/downloads/pdf/publications/electronic_cigarettes.pdf. Accessed June 12, 2015.


Cleared by OS June 2015


A. There’s nothing fresh about hookah. A single 1-hour hookah sesh is as much smoke as 100-200 cigarettes.

Waterpipe or hookah smoking delivers the addictive drug nicotine and contains many of the same toxic chemicals that are in cigarette smoke. In fact, research shows that waterpipe smokers may absorb even more of the toxic chemicals found in cigarette smoke because of the length of the smoking session and the frequency of puffing when smoking waterpipes. A typical 1- hour hookah session involves inhaling 100–200 times the volume of smoke from a single cigarette. Waterpipe smokers are at risk for the same kinds of diseases caused by cigarette smoking.

Hookahs are water pipes that are used to smoke specially made tobacco that comes in different flavors, such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon…. Hookah is also called narghile, argileh, shisha, hubble-bubble, and goza…While many hookah smokers may think this practice is less harmful than smoking cigarettes, hookah smoking has many of the same health risks as cigarette smoking... Because of the way a hookah is used, smokers may absorb more of the toxic substances also found in cigarette smoke than cigarette smokers do. An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs. The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml inhaled when smoking a cigarette (CDC 2013).”


TF0034

A. Hookah contains many of the same toxic chemicals that are in cigarette smoke


Waterpipe or hookah smoking delivers the addictive drug nicotine and contains many of the same toxic chemicals that are in cigarette smoke. In fact, research shows that waterpipe smokers may absorb even more of the toxic chemicals found in cigarette smoke because of the length of the smoking session and the frequency of puffing when smoking waterpipes. A typical 1- hour hookah session involves inhaling 100–200 times the volume of smoke from a single cigarette. Waterpipe smokers are at risk for the same kinds of diseases caused by cigarette smoking.

Hookahs are water pipes that are used to smoke specially made tobacco that comes in different flavors, such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon…. Hookah is also called narghile, argileh, shisha, hubble-bubble, and goza…While many hookah smokers may think this practice is less harmful than smoking cigarettes, hookah smoking has many of the same health risks as cigarette smoking... Because of the way a hookah is used, smokers may absorb more of the toxic substances also found in cigarette smoke than cigarette smokers do. An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs. The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml inhaled when smoking a cigarette (CDC 2013).”


TF0034

A. Hookah puts you at risk for the same kinds of diseases as smoking cigarettes.


Waterpipe or hookah smoking delivers the addictive drug nicotine and contains many of the same toxic chemicals that are in cigarette smoke. In fact, research shows that waterpipe smokers may absorb even more of the toxic chemicals found in cigarette smoke because of the length of the smoking session and the frequency of puffing when smoking waterpipes. A typical 1- hour hookah session involves inhaling 100–200 times the volume of smoke from a single cigarette. Waterpipe smokers are at risk for the same kinds of diseases caused by cigarette smoking.

Hookahs are water pipes that are used to smoke specially made tobacco that comes in different flavors, such as apple, mint, cherry, chocolate, coconut, licorice, cappuccino, and watermelon…. Hookah is also called narghile, argileh, shisha, hubble-bubble, and goza…While many hookah smokers may think this practice is less harmful than smoking cigarettes, hookah smoking has many of the same health risks as cigarette smoking... Because of the way a hookah is used, smokers may absorb more of the toxic substances also found in cigarette smoke than cigarette smokers do. An hour-long hookah smoking session involves 200 puffs, while smoking an average cigarette involves 20 puffs. The amount of smoke inhaled during a typical hookah session is about 90,000 milliliters (ml), compared with 500–600 ml inhaled when smoking a cigarette (CDC 2013).”


TF0034





Addendum D: Tobacco Facts for Discussion Page 7 of 7


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