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pdfAugust 10, 2012
Consumer Risk Perceptions of
Tobacco Products
Focus Group Summary Report
Contract No. HHSF223201110005B, Task 6
Prepared for
Conrad Choiniere
Center for Tobacco Products
DHHS, FDA/OMPT
9200 Corporate Blvd
Room 310N
Rockville, MD 20850
Prepared by
Sarah Ray
Katherine M. Kosa
Sheryl C. Cates
Carol Schmitt
Matthew C. Farrelly
RTI International
3040 Cornwallis Road
Research Triangle Park, NC 27709
RTI Project Number 0212926.006.001
RTI Project Number
0212926.006.001
Consumer Risk Perceptions of
Tobacco Products
Focus Group Summary Report
Contract No. HHSF223201110005B, Task 6
August 10, 2012
Prepared for
Conrad Choiniere
Center for Tobacco Products
DHHS, FDA/OMPT
9200 Corporate Blvd
Room 310N
Rockville, MD 20850
Prepared by
Sarah Ray
Katherine M. Kosa
Sheryl C. Cates
Carol Schmitt
Matthew C. Farrelly
RTI International
3040 Cornwallis Road
Research Triangle Park, NC 27709
_________________________________
RTI International is a trade name of Research Triangle Institute.
Contents
Section
Page
1.
Introduction
1-1
2.
Study Methods
2-1
2.1 Study Design ......................................................................................... 2-1
2.2 Study Materials...................................................................................... 2-2
2.3 Analysis ................................................................................................ 2-3
3.
Key Findings
3-1
3.1 Use of Tobacco Products ......................................................................... 3-1
3.1.1 Brands Used ................................................................................ 3-1
3.1.2 What Participants Like about Using Tobacco Products ........................ 3-2
3.2 Ranking Cigarette Brands in Terms of Harm to Health ................................. 3-3
3.2.1 Words/Phrases Describing Cigarette Brands ..................................... 3-3
3.2.2 Familiarity of Cigarette Brands Used in the Rankings ......................... 3-9
3.2.3 Summary of Rankings—Cigarettes .................................................. 3-9
3.3 Ranking Smokeless Tobacco Brands in Terms of Harm to Health ..................3-12
3.3.1 Familiarity of Smokeless Tobacco Brands Used in the Rankings ..........3-12
3.3.2 Summary of Rankings—Smokeless Tobacco ....................................3-12
3.4 Risk Perceptions of Different Types of Tobacco Products in Terms of Harm
to Health .............................................................................................3-15
3.4.1 Summary of Rankings—Cigarettes and Smokeless Products ...............3-15
3.4.2 Factors Influencing Risk Perceptions ...............................................3-16
3.4.3 Participants’ Comments on the Ranking Process ...............................3-16
3.4.4 Beliefs Regarding Manufacturers Marketing a Product as Less
Harmful .....................................................................................3-18
4.
Summary
4-1
4.1 Product Characteristics ........................................................................... 4-1
4.2 Product Packaging, Labeling, and Marketing ............................................... 4-2
4.3 Other Factors ........................................................................................ 4-2
Appendixes
A
Moderator Guide .................................................................................... A-1
B
Handouts .............................................................................................. B-1
iii
Tables
Number
Page
2-1.
Segmentation of Focus Group Participants ...................................................... 2-1
2-2.
Moderator Guide Summary ........................................................................... 2-3
3-1.
Words Used to Describe American Spirit ......................................................... 3-4
3-2.
Words Used to Describe Camel Blue ............................................................... 3-5
3-3.
Words Used to Describe Newport ................................................................... 3-6
3-4.
Words Used to Describe Marlboro Red ............................................................ 3-7
3-5.
Words Used to Describe Virginia Slims ............................................................ 3-7
3-6.
Words Used to Describe Basic ....................................................................... 3-8
3-7.
Words Used to Describe Black & Mild .............................................................. 3-8
iv
1. INTRODUCTION
The term “modified risk
tobacco product”
means any tobacco
product that is sold or
distributed for use to
reduce harm or the risk
of tobacco-related
disease associated with
commercially marketed
tobacco products.
~Section 911(b)(1) of
the Food, Drug, and
Cosmetic Act.
The Food and Drug Administration (FDA) has the authority to
regulate the manufacture, marketing, and distribution of tobacco
products to protect the public health. Section 911 of the Food,
Drug, and Cosmetic Act authorizes FDA to grant orders to
manufacturers to allow the marketing of products that may
reduce the harm or risk of tobacco-related disease associated
with commercially marketed tobacco products. FDA may allow
the marketing of these products, called modified-risk tobacco
products, if it is deemed appropriate for the promotion of public
health. To assess the potential impact that the marketing of
modified-risk tobacco products may have on the likelihood of
initiation and cessation of tobacco use, FDA requires information
regarding consumer perceptions of risk of tobacco products and of modified-risk tobacco
products.
FDA’s Center for Tobacco Products (CTP) contracted with RTI International to conduct
consumer focus groups to assess consumer perceptions of the relative risks of various
tobacco products. More specifically, these focus groups explored how consumers perceive
their own personal risks for serious illness from use of tobacco products. Collecting
information on the target audience’s perceptions will help inform the Agency’s efforts to
implement the provisions of the Tobacco Control Act related to modified-risk tobacco
products.
This report describes the study design and presents the findings from the first round of 16
focus groups. Section 2 describes the study procedures and materials, Section 3 presents
the key findings from the focus groups, and Section 4 summarizes the results of the focus
groups and factors to consider in the next round of focus groups.
1-1
2. STUDY METHODS
RTI International conducted 16 focus groups with consumers in four U.S. cities to assess
their perceptions of the relative risks of various commercially-available tobacco products.
This section describes the procedures and materials used to conduct the focus groups.
2.1
Study Design
From April to June 2012, RTI conducted 16 focus groups in four locations: Bethesda,
Maryland; Raleigh, North Carolina; Atlanta, Georgia; and Indianapolis, Indiana. RTI worked
with the Center for Tobacco Products (CTP) to develop the methodology and focus group
segmentation, including age groups, smoking behaviors, and other characteristics.
Table 2-1 shows the subpopulation and location for each focus group.
Table 2-1.
Segmentation of Focus Group Participants
Bethesda
Female, aged 18 to
24
Light users and
chippersa
Raleigh
Male, aged 18 to 24
b
Current users, light
users, and chippers
Atlanta
Indianapolis
Female, age 35+
Male, age 25+
Current users
Current users
Smokeless usersc
College students only
Male, age 18+
Female, aged 25 to 34
Male, aged 18 to 24
Female, aged 18 to 24
Recent former users
and quittersd
Current users
Light users and chippers
Current users
Female, age 35+
Female, aged 18 to 24
Female, aged 25–34
Female, age 18+
Current users
Current users, light
users, or chippers
Current users
Recent former users
and quitters
College students only
African Americans only
Male, aged 18 to 24
Male, age 25+
Male, aged 25 to 34
Male, age 35+
Current users
Current users
Current users
Current users
English-speaking
Hispanics only
African Americans only
a
Smokes, on average, fewer than 10 cigarettes, cigarillos, or little cigars per day, every day, or
smoked, on average, fewer than 10 cigarettes, cigarillos, or little cigars per day less than 20 days in
the past 30 days.
b
Smokes, on average, 10 or more cigarettes, cigarillos, or little cigars per day, every day, or smoked,
on average, 10 or more cigarettes, cigarillos, or little cigars per day at least 20 days in the past 30
days.
c
The original design specified males who only use smokeless tobacco products (e.g., chewing tobacco,
snuff, or dip). Due to a low-incidence rate, we were unable to recruit a full group of smokeless-only
users. Some participants also smoked cigarettes or other tobacco products.
d
Stopped smoking cigarettes, cigarillos, or little cigars less than 2 years ago but more than 6 months
ago.
2-1
Consumer Risk Perceptions of Tobacco Products
RTI subcontracted with local market research companies in each of the focus group
locations to recruit participants and provide the facilities for hosting the focus group
discussions. Using convenience sampling, the market research companies recruited from
their databases participants who met the requirements for inclusion in the specific
subpopulations. To be eligible to participate, respondents had to be able to read,
understand, and speak English.
Additionally, individuals were ineligible for participation if
they or a household member ever lobbied on behalf of the tobacco industry or personally
represented or worked on behalf of a tobacco company in connection with a tobacco
lawsuit;
they or a household member worked for any of the following entities in the past 5 years:
tobacco or cigarette company; public health or community organization involved in
communicating the dangers of smoking or the benefits of quitting; marketing,
advertising, or public relations agency or department;
they or a household member worked for any of the following government agencies in the
past 5 years: Food and Drug Administration (FDA), National Institutes of Health (NIH),
Centers for Disease Control and Prevention (CDC), Substance Abuse and Mental Health
Services Administration (SAMHSA), or Centers for Medicare & Medicaid Services (CMS);
or
they participated in any paid market research in the past 6 months.
Each focus group included between 6 and 11 participants, for a total of 142 participants.
Upon arrival to the focus group facility, participants read and signed an informed consent
form (approved by FDA’s and RTI’s Institutional Review Boards) and were rescreened to
confirm eligibility. Experienced moderators conducted the focus group discussions, while
trained staff members took notes during the discussions. Each focus group discussion lasted
1 hour. Participants received a monetary incentive of $50 for participating in the focus
group discussion.
2.2
Study Materials
RTI worked with CTP to develop a moderator guide to discuss consumer use and
perceptions of tobacco products. Table 2-2 summarizes the topics in the moderator guide,
and Appendix A provides a copy of the moderator guide.
During each focus group, participants were presented with two sets of tobacco products: the
first set included various brands of cigarettes, and the second set included various types
and brands of smokeless tobacco products. Participants were asked to rank the products
from each set from “least harmful to your health” to “most harmful to your health,” using
prepared worksheets (see Appendix B for copies of the handouts). The specific brands of
2-2
Section 2 — Study Methods
Table 2-2.
Moderator Guide Summary
Section
Purpose
Introduction
Moderator described the purpose of the discussion and how the group
would be conducted; participants introduced themselves.
Use of Tobacco Products
Participants who were current users described their use of tobacco
products and reasons for use. Former users described what type of
tobacco products they used to use and when they quit.
Ranking of Tobacco Products
Participants were presented with a variety of tobacco products and
asked to perform two exercises to rank products from “least harmful
to your health” to “most harmful to your health.”
Discussion on Ranking
Participants completed another ranking exercise using the four
products deemed by each group as least and most harmful and then
discussed their risk perceptions regarding the products presented to
them.
Conclusion
Participants shared any final comments.
tobacco products used during the discussions are described in Section 3. The order in which
the products were listed varied across focus group sessions. Each group was shown
cigarettes that varied in strength (regular, light, ultra light), shape/length (slim vs. regular),
flavor (menthol vs. non-menthol), claims (natural vs. no claim), price (discount vs.
premium), and familiarity (regional vs. national) and smokeless tobacco products that
varied in strength, flavor, cut, and price.
2.3
Analysis
The focus groups were professionally video- and audio-recorded by the local market
research companies and video-streamed by an independent subcontractor. The video
streams were archived and professionally transcribed by the independent subcontractor.
The note taker for each focus group used her notes and reviewed the videos and/or
transcripts to prepare a detailed summary of each discussion. The moderator for each focus
group then reviewed the summary for accuracy. A moderator then systematically reviewed
and manually coded all detailed summaries to identify common themes and any exceptions
to these themes and to identify similarities and differences among the various
subpopulations included in the study.
2-3
3. KEY FINDINGS
This section presents the key findings from the focus group discussions. We present the key
findings for the following topics:
use of tobacco products,
ranking of tobacco products, and
perceptions of tobacco products.
For each topic, we summarize the findings across the 16 focus groups and identify
differences, if any, among groups.
3.1
Use of Tobacco Products
Each focus group began with participants discussing their current or former tobacco use.
Participants who were current tobacco users were asked to tell the group what type of
tobacco they use (e.g., cigarettes, cigars, smokeless tobacco), how long they had used the
product(s), and their preferred brands.
Participants who were former tobacco users told the group what type of tobacco they used
in the past, how long they used the product(s), how long ago they quit using the product(s),
and the brands they used when they were smoking/using tobacco.
Participants then discussed the reasons they smoked or used other tobacco products,
including what they enjoyed about the products, the benefits of using them, and factors that
prompted them to smoke or use tobacco.
3.1.1 Brands Used
A variety of brands were mentioned by focus group participants, although a few stood out
as more common. Across all groups (including both current and former users), Marlboro
brands were mentioned most often. Although the general “Marlboro” name was given by
most participants, specific types—including Marlboro Lights, Marlboro Red, Marlboro
Menthol, and Marlboro 100s—were given by others. Groups with females were especially
likely to name specific versions of the Marlboro brand.
Newport brands were the second most commonly mentioned brand (including Newport,
Newport 100s, and Newport Short), followed by Camel brands (including Camel, Camel
Lights, Camel Red, Camel snus, Camel Crush, and Camel Menthol).
Other cigarette brands with a few mentions included American Spirit, Kool, Pall Mall, and
Parliament (and Parliament Lights) brands. L&M, Maverick, Misty, and Salem were
mentioned by only one participant each.
3-1
Consumer Risk Perceptions of Tobacco Products
The most commonly mentioned cigar or cigarillo was Black & Mild. Other brands mentioned
included Dutch Master, Garcia Vega, Swisher (Swisher Sweets and Swisher Blacks), and
White Owl. Acid, Djaraum, and Havana Gold cigars were mentioned by one participant each.
Skoal and Grizzly brands (including various cuts, and flavors) were the most commonly
mentioned smokeless tobacco products, followed by Copenhagen brands.
There were very few differences between males and females in brand preference, with a few
exceptions. More males than females said they used cigar or cigarillo brands (e.g., Black &
Mild, Dutch Master, Garcia Vega, White Owl), and a few more females than males
mentioned the American Spirit brand. Smokeless brands were also mentioned more often by
males.
Brand preferences were similarly distributed across age groups as well, with no noticeable
differences. With regard to race, groups with only African Americans mentioned the
Marlboro and Newport brands in similar proportions to the other groups, but no respondents
in those groups reported that they used any of the Camel brands. African American only
groups also mentioned the cigar and cigarillo brands more than the other groups.
3.1.2 What Participants Like about Using Tobacco Products
As a warm-up exercise for the focus groups, participants were asked why they like to
smoke/what they enjoy about smoking or using other tobacco products. The majority of
participants across all groups said that it relaxed them, calmed them down, and provided
some stress relief:
“They take the edge off, so you can calm down some and just relax.” (Hispanic male
current smokers, Raleigh)
“When I get mad, I light up. I think in my mind, it’s just something else to focus on.”
(25- to 34-year-old female current smokers, Raleigh)
“If I don’t have one, I’m not a nice person. It calms me down.” (25- to 34-year-old
African American male current smokers, Atlanta)
“It calms me down from whatever the stressful situation is that I just went through.”
(35+-year-old female current smokers, Atlanta)
Many participants mentioned that they enjoyed the social aspect of smoking or using other
tobacco products. They talked about meeting people while outside smoking and the
camaraderie that developed between smokers:
“At a bar, you meet so many different people and talk to so many different people that
otherwise you won’t just by going outside [to smoke].” (18- to 24-year-old male college
students, Raleigh)
3-2
Section 3 — Key Findings
A number of participants said they liked smoking (in particular) because of the break it
offered from working, studying, or other routine parts of their day. The association between
alcohol and tobacco use was also mentioned by many participants, who cited the additional
“buzz” that tobacco gave to drinking. As one participant explained, it provided “kind of
another euphoria” (18- to 24-year-old male light users, Atlanta).
Several participants across groups shared that they did not really enjoy smoking/using
other tobacco products and that it was more of a habit or addiction. As one participant said,
“I don’t enjoy anything about it anymore, I don’t think. I think it’s more of a habit. I never
really have been proud of it. It’s not really a pretty thing, but it happens” (18+-year-old
male smokeless users, Indianapolis).
A few participants across groups mentioned other aspects of smoking/tobacco use that they
enjoyed, including its appetite-suppressing qualities, the routine it provided especially while
eating or driving, and the feeling or flavor of the tobacco.
There were no noticeable differences by gender, age, or race/ethnicity in what participants
said they liked/enjoyed about using smoking.
3.2
Ranking Cigarette Brands in Terms of Harm to Health
Cigarette Brands
American Spirit
Camel Blue
Newport
Marlboro Red (males only)
Virginia Slims (females only)
Basic (all groups except
African American male
group)
Black & Mild (African
American male group only)
Participants were given four handouts to complete that
corresponded to the discussion. The first two handouts
were related to cigarette brands. The moderators
presented examples of cigarettes and asked participants
to think about them in different ways.
For the first handout, participants completed a word
association activity to describe the cigarette brands
displayed. The second handout asked participants to
rank the cigarettes from “least harmful to your health”
to “most harmful to your health.” The sections below
summarize the findings across groups.
3.2.1 Words/Phrases Describing Cigarette Brands
Tables 3-1 through 3-7 list the words and phrases that participants listed on the handouts
for each of the cigarette brands shown. There were no obvious differences in the types of
responses given by gender, age group, or race/ethnicity.
For American Spirit, the most commonly mentioned words/phrases were “natural,”
“Indian/tribe/Native American,” and “cheap.” Table 3-1 lists other words/phrases used to
describe the American Spirit brand.
3-3
Consumer Risk Perceptions of Tobacco Products
Table 3-1.
Words Used to Describe American Spirit
natural (22)
American
just tried them
Indian/tribe/Native American (11)
bar
leisure
cheap (9)
boys
lots of ads & coupons
unfamiliar, never heard of them
(8)
chalk box
Mars bar/Gainesville
cheerleading
more tobacco
cigarette
not in neighborhood
classic
not strong menthol
college students
old people
cool
original or traditional
don’t know brand/box,
plain
don’t like
premium
dry
relaxing/old type of smoke
failed attempt to be healthy
sister
flower child
smell funny
free
smooth
fresh
sweaty gym socks
great tasting
traditional
harsh
trendy
heritage
ugly
interesting
What kind of flavor could it
have?
hippies (7)
hip/hipster (5)
expensive (4)
chemical/additive free (3)
gross (3)
terrible/worse than terrible (3)
yellow/eye catching (3)
bright (2)
healthier/less bad/safer (2)
long-lasting/slow-burning (2)
never tried (2)
new (2)
nope/no way (2)
nothing (2)
ok (2)
organic (2)
interesting logo
Joey
What?
Note: Number in parentheses indicates the number of who participants wrote the word/phrase on the
handout.
Camel Blue was most commonly described with reference to “Joe Camel” or “the camel,” as
being “strong,” and as a brand that has been “around a long time,” is “antique,” or “old
school.” Table 3-2 lists other words/phrases used to describe the Camel Blue brand.
3-4
Section 3 — Key Findings
Table 3-2.
Words Used to Describe Camel Blue
Joe Camel/the camel (11)
average
hate
strong (9)
basic
high school
around a long time/antique/old
school (6)
blue
hippies
Camel crush
like a little
camel smoking
mellow
cheap
men
cigar wannabee
minty
cold
my dad
commercial
nasty
cool air
no tip
coupons
non-filter
coworkers
normal
delicious
not sure
didn’t like them
not the worst
exotic
okay
fancy
plain
friends
rural
girlfriend’s brand
sad camel
good cigarette for the money
so-so
good logo
terrorists
grandfather
too light
happiness
uninterested
hard worker
Western
smooth (5)
unfamiliar/unheard of (5)
classic (4)
cowboy (4)
lights (3)
will/would smoke (3)
Arabian/Egypt (2)
college (2)
cool/cool guy (2)
desert (2)
familiar (2)
foreign (2)
gross (2)
menthol/menthol light (2)
new look/product (2)
nice/nice design (2)
no/no mas (2)
Turkey/Turkish (2)
1st brand I smoked
adult cigarette
harsh
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout.
The most commonly mentioned words used to describe Newport were “menthol” (with some
specifying “strong menthol”), “strong,” and “Black people” or “African Americans.” Table 3-3
lists other words/phrases used to describe the Newport brand.
3-5
Consumer Risk Perceptions of Tobacco Products
Table 3-3.
Words Used to Describe Newport
menthol/strong menthol (27)
urban (2)
hip
strong (10)
what I smoke (2)
home
Black people/African Americans (8)
America
I want one
classic (4)
awesome
light
ghetto/low class (5)
been around
mom
good (5)
best
my 3rd love
most available/popular/ common
(5)
blessing
nice
boring
normal
boys
old school
brother
overpriced
brown filter
piquant
buzz
pleasure
calming
simple
cheap
smoke one of them
chill
stands out
don’t like
state
family
synthetic
flashback
the brand
flavorful
the one people I know use
fresh
too sweet
Great! Can I have one?
vacation
green
youthful
gross
yum
smooth (5)
cool (3)
expensive (3)
harsh/rough (3)
addictive/”crack” (2)
cigarettes (2)
ethnic (2)
favorite (2)
fiberglass (2)
good color (2)
me (2)
minty (2)
nasty (2)
refreshing/relaxing (2)
teen years/teenagers (2)
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout.
Common words used to describe the Marlboro Red brand included “cowboy,” “cowboy
killers,” and “classic.” Table 3-4 lists other words/phrases used to describe the Marlboro Red
brand.
3-6
Section 3 — Key Findings
Table 3-4.
a
Words Used to Describe Marlboro Reda
cowboy (11)
America
point program
classic (6)
brand name
potent
cowboy killers (6)
cancer
quality
original (3)
delicious
ranch with horses
strong (3)
gross
regular
good/great (2)
harsh
robust
Marlboro Man (2)
I like them
satisfaction
old school (2)
legit stuff
tasty
red (2)
nasty
too hot
redneck (2)
non-menthol
tree killer
rough (2)
one I use now
white dude squares
Male groups only
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout.
Female participants commonly described Virginia Slims as being for “older people” or the
“elderly.” They also described the brand as “skinny,” “slim,” “thin,” or “slender.” Table 3-5
lists other words/phrases used to describe the Virginia Slims brand.
Table 3-5.
Words Used to Describe Virginia Slimsa
older person/elderly (11)
dislike
old-fashioned
skinny/slim/thin/slender (6)
do not see often
slim Jims
classy/classy white lady (4)
fancy
small
long (4)
for the smokers who like to
smoke
smooth
former brand
sports
female/feminine (3)
my grandmother (3)
bad taste/yuck (2)
my auntie (2)
my mother (2)
ahhh…
Andre 3000 (Outkast)
classic
college
cute
less tobacco light
like smoking air
maybe
never heard of it
nothing about them
oh no!
okay
old faithful
South Carolina
state
sweet smell of menthol
tasteless
too expensive
used to smoke
weird
women only
you’ve come a long way baby
decent
a
Female groups only
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout.
3-7
Consumer Risk Perceptions of Tobacco Products
A large number of people who saw the Basic brand described it as “cheap.” Others said it
was “generic” or “old,” “old fashioned,” or “old school.” Other commonly mentioned
words/phrases included “basic” or “basic looking” and descriptions related to not knowing
about the brand (e.g., “never heard of”). Table 3-6 lists other words/phrases used to
describe the Basic brand.
Table 3-6.
Words Used to Describe Basica
cheap (47)
harsh (2)
instinct
basic/basic looking (8)
no thank you/nope (2)
mom or friend’s brand
generic (8)
not appealing/not my type (2)
Newport low-brand
old/old fashioned/old school (7)
nothing (2)
normal
bland (6)
ok (2)
not very good
boring (6)
original (2)
OIP
never heard of/never
tried/unknown (6)
African American
outdated
big, bold letters
reds
bottom of the barrel
regular cigarettes
broke
so-so
classic
standard
Confederate south
strong
cowboy
trashy
crack head
value
fake
weak
simple (6)
low/bad quality (4)
gross/disgusting (3)
nasty (3)
plain (3)
terrible (3)
dislike (2)
a
All groups, except the African American male group
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout.
Participants in the one African American male group that saw Black & Milds (African
American males) used a variety of words to describe the brand (Table 3-7).
Table 3-7.
Words Used to Describe Black & Milda
appealing
flavorful
smoke
bathroom
good
smooth
bowel movement
nasty
too strong
eh
a
African American male group only
3-8
Section 3 — Key Findings
3.2.2 Familiarity of Cigarette Brands Used in the Rankings
Most participants in all groups were familiar with most of the cigarette brands, even if they
had not tried them. Across groups, a few participants (and sometimes more) said they were
unfamiliar with the American Spirit and Basic brands. In addition, while most participants
recognized the Camel brand name, some participants were unfamiliar with Camel Blue
specifically.
There were no major differences between gender groups in familiarity with the products,
although the female groups were slightly less familiar with some brands. Younger
participants (in the 18- to 24-year-old groups) were more vocal than older participants
about brands they did not recognize.
Within the female groups (who were asked about Virginia Slims), some participants in the
younger age groups (18 to 24 years old) were unfamiliar with the brand. Most female
participants in the other groups had heard of it and/or smoked it in the past.
3.2.3 Summary of Rankings—Cigarettes
Participants were asked to rank the five cigarette brands shown from 1 (“least harmful to
your health”) to 5 (“most harmful to your health”). As noted earlier, the rankings of
cigarette brands varied somewhat by gender and race/ethnicity. All participants saw
American Spirit, Newport, Camel Blue, and Basic (with the exception of the one group of
African American males that saw Black & Mild cigarillos in place of the Basic cigarettes). In
addition to the brands above, groups with females discussed Virginia Slims and groups with
males discussed Marlboro Red. Because the types of cigarettes viewed varied by gender, we
present the results of the rankings by gender. Sixty-eight female participants1 and 73 male
participants completed the ranking exercise. Some participants did not rank all of the
products, and some participants gave all of the products the same ranking.
Cigarette Brands Ranked as “Most Harmful to Your Health”
Cigarette Brands—
Female Groups
American Spirit
The majority of female participants (n = 41) ranked Newport as
the “most harmful to your health.” The most common reason
given was that Newport was a menthol cigarette, and menthol
Basic
cigarettes were generally considered to be more harmful than
Camel Blue
non-menthol cigarettes. Participants said that menthol “cuts the
Newport
lining in your throat” and “it absorbs more” (18- to 24-year-old
Virginia Slims
female light users, Bethesda). Many participants also said that
menthol cigarettes contained fiberglass, which aided in the
“cutting” and made it more harmful:
1
A completed handout was not available for one participant.
3-9
Consumer Risk Perceptions of Tobacco Products
“I always heard that menthol crystalizes your lungs.” (18+-year-old female former
smokers, Indianapolis)
[Newport has] “things in it… that are more chemical, toxic chemicals.” (35+-year-old
female current smokers, Atlanta)
Participants also mentioned Newport’s “harsh” quality as influencing their ranking.
Participants talked about the burning sensation when you smoke Newport cigarettes and the
cough that many Newport smokers develop as evidence:
“When I started smoking, I started smoking menthol, and when I switched to nonmenthol, I coughed a whole, whole lot less.” (18+-year-old female former smokers,
Indianapolis)
Male participants ranked Newport (n = 34) and Marlboro
participants echoed the comments of female participants in
Cigarette Brands—Male
Groups
American Spirit
their reasons for ranking Newport as the most harmful,
Basic*
including that it was a menthol cigarette:
Camel Blue
Marlboro Red
Newport
Red (n = 30) as “most harmful to your health.” Male
“All the stuff they add to it is worse. The menthol is no
natural thing.” (35+-year-old male current smokers,
Indianapolis)
“…you’re also inhaling the fiberglass that gets in your
lungs, and after years, it tears your lungs up.” (35+year-old male current smokers, Indianapolis)
*Black & Mild was used in the
African American male group
Male participants also believed that Newport was harsh, and they had similar experiences as
the female participants with the brand:
“I know a lot of people [who] smoked Newport and started developing a bad cough, so
they switched from Newport to a real low style of cigarette.” (18- to 24-year-old male
college student current smokers, Raleigh)
A number of male and female participants also brought up the buzz, headache, or sick
feeling they got when they smoked a Newport as a reason to think that it was more harmful
to your health.
Many male participants who ranked Marlboro Red as the most harmful said their ranking
was based on their experience, Marlboro’s reputation, and its popularity (as evidence that it
is more addictive):
“I’ve always heard that Marlboro Reds being like the harshest so that’s why I put that as
[most harmful].” (18- to 24-year-old male college student current smokers, Raleigh)
“They’re like the cowboy killer, like they’re pure cigarette.” (18- to 24-year-old male
college student users, Raleigh)
3-10
Section 3 — Key Findings
“…Marlboro keeps with the whole, like, wild, wild, west type of packaging. Like, it’s not
filtered or any of that type of stuff, so it seems like it’d be a little bit harsher. I know for
a fact it’s harsher, so it seems like it’d be more harmful to you.” (18+-year-old male
former smokers, Bethesda)
“I hear that they sell enough Marlboros, [so that] every man, woman and child can
smoke at least one a day on the planet, so that’s pretty nicotine-spiked.”(35+-year-old
male current users, Indianapolis)
Cigarette Brands Ranked as “Least Harmful to Your Health”
Most female participants (n = 43) ranked American Spirit as the “least harmful to your
health.” The overwhelming reason given was because the product is marketed and
advertised as being natural and additive-free. Participants said they believed the brand only
contained tobacco, with no (or fewer) chemicals, and that it was organic, all which
influenced their perceptions that it was less harmful than the other brands:
“I put more organic, but I don’t know… [I heard] that they’re better…” (18- to 24-yearold female college student users, Raleigh)
“I mean, people who smoke American Spirit, they’re… more, like, vegan and they care
about their health…” (18- to 24-year-old female light users, Bethesda)
“They don’t put in as many additives. I’m sure it’s not pure tobacco… but it’s probably
not as much [additives]” (25- to 34-year-old female current smokers, Raleigh)
The majority of male participants (n = 45) also ranked American Spirit as the “least harmful
to your health”. Male participants cited the same reasons for their ranking, including the
marketing of the brand as a natural, additive-free product:
“Supposedly no additives [so] you’re smoking less chemicals.” (18+-year-old male
former smokers, Indianapolis)
“Tobacco is really not good for you, but all this crap they add to it is worse than tobacco
itself.” (35+-year-old male current smokers, Indianapolis)
“They say there’s no chemicals on the crops supposedly. No additives or anything else
added to it.” (18+-year-old male smokeless users, Indianapolis)
“…when you see all natural, you’re hoping there’s not that many chemicals… and you
think they’re just going to cut the tobacco and let it dry and they roll it up and that’s
what you got… So it’s almost like a healthy cigarette, if there can be such a thing.” (25to 34-year-old African American male current smokers, Atlanta)
Some participants in both male and female groups also mentioned the Native American/
American Indian and other aspects of the American Spirit packaging as a reason that the
brand seemed less harmful:
“Probably too because the Indians that make it, they live for many, many years.” (25+year old Hispanic male current users, Raleigh)
3-11
Consumer Risk Perceptions of Tobacco Products
“I know this is really strange, but, like, the Native American headdress, it reminds—I
kind of feel like—it reminds me of looser tobacco, which is more healthy than cigarette
tobacco.” (18- to 24-year-old female light users, Bethesda)
“There’s a Native American on there, so I figure he’s probably healthy.” (18+-year-old
male former smokers, Indianapolis)
3.3
Ranking Smokeless Tobacco Brands in Terms of Harm to Health
Smokeless Tobacco Brands
Camel snus
Copenhagen
Grizzly
Red Man
Skoal Wintergreen
After the discussion about cigarette brands, the
moderators presented examples of smokeless tobacco
products, and asked participants to rank them from “least
harmful to your health” to “most harmful to your health”
using the third handout. The sections below describe the
findings across groups.
3.3.1 Familiarity of Smokeless Tobacco Brands Used in the Rankings
Familiarity with the smokeless tobacco brands was mixed. Most participants in all groups
were familiar with at least some of the smokeless brands, even if they had not tried them.
Groups with male participants had a higher level of familiarity than groups with female
participants. In several groups of females, participants expressed that their rankings were
based on limited information, and, in a few cases, they did not complete the ranking
exercise.
Groups with younger participants (aged 18 to 24) had slightly more familiarity with the
brands than the older age groups. Groups with African American only participants were
slightly less familiar with the brands shown than the other groups.
No brand stood out as being particularly unfamiliar. However, two brands—Copenhagen and
Skoal—stood out as familiar to the highest numbers of people. More participants in the
younger age groups had seen or heard of Camel snus than in the other groups.
3.3.2 Summary of Rankings—Smokeless Tobacco
Participants were asked to rank the five smokeless tobacco brands shown from 1 (“least
harmful to your health”) to 5 (“most harmful to your health”). All participants saw the same
five brands. As noted, some participants found this exercise difficult because they were
unfamiliar with the products. As a result, some participants based their opinion on
conversation during the group or what they saw on the packaging. Sixty-nine female
participants and 73 male participants completed the ranking exercise. Some participants did
not rank all of the products, and some participants gave all of the products the same
ranking.
3-12
Section 3 — Key Findings
Smokeless Tobacco Brands Ranked as “Most Harmful to Your Health”
Female participants had mixed opinions on the rankings for the smokeless tobacco products,
perhaps due to their unfamiliarity with the products. More female participants (n = 28)
ranked Red Man as “most harmful to your health” than any other brand. The number of
participants ranking the other products as most harmful ranged from 8 to 16 participants.
Participants described the quantity that was used in each hit and the way it looked (e.g.,
juice, tar-looking) as reasons that Red Man seemed most harmful. The association with
baseball (and the knock-off gum Big League Chew) was also discussed:
“It makes me think of like a huge wad of nothing but roast tar coming out of somebody’s
mouth. They’re always coughing and spitting constantly.” (18- to 24-year-old female
current users, Indianapolis)
The packaging of Red Man also influenced those female participants who said it was most
harmful. The pouch made them think that it was “old” and there was concern that it had not
been improved over time:
“Yeah. Like they wouldn’t change anything about it, so it’s just been a stronger product
for so long.” (18+-year-old female former users, Indianapolis)
“…they have had some new things they can do to it to… make it better—maybe this is
still the original recipe, so it could be the most harmful. ‘Cause they don’t have time to
enhance it or make it better.” (25- to 34-year-old African American female current
users, Atlanta)
Skoal (n = 29) received the largest number of most harmful rankings among male
participants. The number of participants ranking the other products as most harmful ranged
from 11 to 19 participants.
Those who ranked Skoal as “most harmful to your health” cited their familiarity with the
brand, its popularity, and its established place in the market as influences on their opinion:
“I just know a lot of that stuff in general leads to lip cancer, and people I’ve known
who’ve died of that. Or have died of, let’s say, gum cancer. Get cancer in general from
it, that’s [Skoal] probably the most common one used, so...” (18+-year-old male former
users, Bethesda)
“Skoal’s… been around quite a while. They got so many different types out there, you
don’t know what all’s in each one of them.” (35+-year-old current users, Indianapolis)
Smokeless Tobacco Brands Ranked as “Least Harmful to Your Health”
Female participants were split on which brands were least harmful, with some ranking
Camel snus (n = 18) as “least harmful to your health” and others ranking Red Man as least
harmful (n = 19). Most participants who ranked Camel snus as “least harmful to your
3-13
Consumer Risk Perceptions of Tobacco Products
health” cited the small amount used in a hit and the pouch, which seems to serve as a
buffer, as reasons for their ranking:
“[smokeless] really does tear your gum lining, and you can feel a little soreness after
you take it out. And the Camel [snus] has like an outside wrapping to it which I think
would be easier on your gum.” (18+-year-old female former users, Indianapolis)
Other participants discussed the new, modern packaging as a reason for ranking Camel
snus as less harmful. These participants said that the package looked more like gum or
mints and that it was less masculine and harsh-looking.
Female participants that said Red Man was “least harmful to your health” cited their belief
that it is a natural product as the main reason. These participants discussed their belief that
it is more “natural,” the no-fuss packaging, and the Native American on the package
(similar to American Spirit) as the basis for their opinions:
“I have probably a misconception that Red Man tobacco is perfectly fine with no
additives… it has no additives and it’s very natural and I think that’s what they want you
to think.” (35+-year-old female current smokers, Bethesda)
“I gave it a 1 [least harmful] because—I guess because there’s an Indian on it. It makes
it kind of like it would be more natural.” (35+-year-old female current smokers,
Bethesda)
“And I said 1 [least harmful] for the Red Man because it’s in a pouch. I don’t know if it’s
more pure, maybe, as opposed to the other ones, so maybe you get less [tobacco] than
the [others]…” (18- to 24-year-old current and light users, Raleigh)
Other participants saw the experience of older people who had used Red Man for a long
time, and were still living, as evidence that it may not be as harmful:
“I relate it to southern farmers or something, you know, and them rolling down the bag
and sticking it in their pocket and you know—and you know those people lived a really
long time.” (35+-year-old female current smokers, Bethesda)
Male participants were similarly split in the smokeless tobacco brands that they said were
least harmful. Camel snus received the most “least harmful to your health” rankings (n =
25), followed by Red Man (n = 23). Male participants that ranked Camel snus as least
harmful gave similar reasons as female participants for their rankings, including the “buffer”
effect they believed the pouch may provide and the smaller quantity used at a time:
“…it’s probably just because of the packaging, but… because it’s in a packet, it’s a
smaller amount and it may be less direct contact with the tobacco.” (18+-year-old male
former users, Bethesda)
“It comes in a little pouch. It’s not directly interacting with your mouth you know, [so]
you’ll do better.” (18- to 24-year-old male college student smokers, Raleigh)
3-14
Section 3 — Key Findings
Male participants that ranked Red Man as least harmful also discussed the ability to see the
product in a more “natural” form (i.e., “leaves”) and the Native American on the package as
the basis for their opinions:
“I think it was kind of the American Spirit effect. It’s got Indians on there too, but also…
it’s in a pouch. It seems less processed. It seems like they just cultivated the tobacco,
threw it in the bag.” (18- to 24-year-old male current users, Bethesda)
“[Indians] don’t have all the chemicals and tools and stuff, so it just seems like it’s
straight from the wild.” (18+-year-old male current smokeless users, Indianapolis)
3.4
Risk Perceptions of Different Types of Tobacco Products in
Terms of Harm to Health
For the fourth handout, participants were asked to rank a combination of two cigarettes and
two smokeless tobacco products from 1 (“least harmful to your health”) to 4 (“most harmful
to your health”). The specific products discussed varied from group to group based on the
discussion and what the moderator chose to select, and therefore not all brands may have
been selected equally for consideration.
3.4.1 Summary of Rankings—Cigarettes and Smokeless Products
As a whole, participants across groups were split on whether cigarettes or smokeless
tobacco products were more harmful to your health. Those who said that cigarettes were
more harmful explained that inhaling the smoke into their bodies affected their lungs, heart,
and organs, whereas smokeless tobacco effects were more external:
“…[how could] putting [smoke] into your lungs and into your throat possibly be good for
you…? …it’s like bad… for our bodies. And that’s why I think cigarettes are worse than
dip and snus… It affects everything… You get smoke into your body that goes
everywhere you know.” (18- to 24-year-old male college student current users, Raleigh)
“I put cigarettes as most harmful because I would think, by inhaling them and the
chemicals, it affects more of your body then…” (18- to 24-year-old female college
student users, Raleigh)
Participants who ranked smokeless tobacco as more harmful than cigarettes said that the
health effects were usually more visible (in gum, lips, and tongue) and that they were felt
more quickly than the effects from smoking:
“… it seems as though the smokeless tobacco harms you faster. It seems to be more
direct to me. And I too… know someone who has tongue and throat cancer… and he
smoked very little, but he chewed tobacco. So it’s kind of concentrated in that area I feel
like, but I think it has a greater effect…” (35+-year-old female current users, Bethesda)
“I know boys who have done this and said… I had to quit because I had a hole in my
mouth.” (18- to 24-year-old female college student users, Raleigh)
3-15
Consumer Risk Perceptions of Tobacco Products
“I know so many people who have huge divots already in their gums… I’m just seeing
people already in high school with major gum and mouth issues from that and yet I
think you’re pretty safe in the short term smoking for a little while…” (18- to 24-year-old
male college student users, Raleigh)
“… the cigarettes are going to take a lot more years to do damage to you than what
those two cans would because you’re packing them in your gum. You’re going to get
gum or mouth cancer 10 times [faster than] lung cancer.” (35+-year-old male current
users, Indianapolis)
Some participants felt that the type of product (cigarettes versus smokeless) had less
relationship to harmfulness and that how “natural” a product is was more influential.
3.4.2 Factors Influencing Risk Perceptions
When considering the ranking of products’ harmfulness, several topics came up across
groups. Product packaging was mentioned by some participants, especially for products that
may have been unfamiliar (e.g., smokeless tobacco products). For cigarettes, the picture of
the Native American on the American Spirit cigarettes was commonly mentioned as a
reason that it appeared to be “natural.” Participants thought about the packaging of
smokeless tobacco in their rankings; some said that the simple, pouch-like packaging of Red
Man meant that it was less threatening, whereas others said that it indicated the product
was cheap and low-quality, and therefore more harmful. The new, modern shape of the
Camel snus package was considered by some participants to be an indication that it was a
cutting-edge improvement over previous products and that it was less harmful. The
association with a tin for gum or mints was also important.
Color was also a consideration for some participants. While a few participants mentioned
color spontaneously, others offered their thoughts when prompted. For example, the bright
yellow packaging of the American Spirit cigarette stood out to some. As one participant said,
“yellow is really not a threatening color, as opposed to, like, red. Every hard cigarette is red.
So I have the idea that that’s going to be softer” (Hispanic current users, Raleigh). Other
participants echoed these thoughts, describing “red” cigarettes as harsh, “like an angry,
loud abrasive type of color, as opposed to like blue, or yellow…” (Hispanic current users,
Raleigh). Other participants disagreed and said that while the use of color may be good for
marketing, it did not influence their perception of risks of the product.
3.4.3 Participants’ Comments on the Ranking Process
The discussion continued with questions related to the process of ranking tobacco products’
harmfulness and the influencing factors. Due to time constraints, not all topics were
discussed in all groups.
Nearly all participants said that the difference in harm between products was small, in some
cases “like eye of a needle small” (35+-year-old male current users, Indianapolis). As
3-16
Section 3 — Key Findings
participants said, “… in the end, you’re still doing a product that is widely accepted to cause
cancer, in some way or another” (18- to 24-year-old male light users, Atlanta) and “at the
end of the day, they’re gonna put you in the grave” (25- to 34-year-old African American
male current users, Atlanta). This was true for differences between specific brands within
tobacco type and for differences between product types (e.g., cigarettes compared with
smokeless tobacco).
When considering the phrase “harmful to your health,” participants generally agreed that it
referred to diseases or conditions that were related to use of the product. Some participants
said that they thought about how quickly the effects could be felt, whereas others
considered how bad the effect would be. Some mentioned thinking about family members or
friends who had been affected by the product. A few participants pointed out that
harmfulness is also related to the quantity a person uses and how long they have used the
product. Participants who felt that “natural” tobacco was less harmful considered additives
in ranking harmfulness because “tobacco is pretty much a plant… and if you add stuff to [it],
it could be worse than it actually is because it’s not natural from the ground” (25- to 34year-old African American females, Atlanta).
Most participants agreed that the products that they currently use (or most recently used)
were generally as harmful as the products discussed.
Participants were mixed on how easy it was to rank products from least harmful to most
harmful to your health. Some participants pointed out that some products were unfamiliar,
and ranking them ended up being more of a guess, whereas others believed that all of the
products in a category should get the same ranking (usually “most harmful”) because the
differences in harm were very small.
When asked if they had previously thought about differences between tobacco products and
how harmful they might be to one’s health, participants’ reactions were mixed. Most
participants who responded that they had considered the differences cited an effort to use a
“lighter” product.
“I thought about it when I wanted to quit smoking and I couldn't at first really cold
turkey. So I thought about going maybe to a Newport Light and then our doctor said
it's all still bad for your system. It doesn't matter.” (18+-year-old female former
smokers, Indianapolis)
“... as I got older, I would… progress from full-flavor down to Ultra Lights… because
I’m getting older and maybe it might make a difference even if it’s a millisecond of
my life.” (18- to 24-year-old female users, Indianapolis)
3-17
Consumer Risk Perceptions of Tobacco Products
Others said that although they had thought about the potential differences in harmfulness,
it did not affect their decisions on which products to use because of their loyalty to a brand
or because they felt that all tobacco products were harmful:
“…you don’t really concern yourself with it. Like it’s not really—I think it’s more
important for people to feel good man. That’s what they really care about.” (18- to
24-year-old male college student users, Raleigh)
“I thought of [harm] to my health but I always assumed that they're all bad so I
didn't really pay much attention.” (18- to 24-year-old female college student users,
Raleigh)
Some participants said that they had not thought about the differences previously, and a
few commented that the experience was thought-provoking.
“Man, it was so fast that I don't really think about it while I'm doing it. I mean, it's
probably the first time I've actually thought about it.” (18- to 24-year-old female
college student users, Raleigh)
“It sort of opens up your eyes… it’s an eye opener… I’d guess you’d say.” (18- to 24year-old male light users, Atlanta)
3.4.4 Beliefs Regarding Manufacturers Marketing a Product as Less
Harmful
When asked if tobacco companies would market a product as being less harmful to your
health, most participants agreed that they would if it were allowed. Participants noted that
the manufacturers’ job is to sell, and “people would be more likely to buy it if it was less
harmful” (18- to 24-year-old female college students, Raleigh). Most participants said they
would not believe any claims of a less harmful product if it were marketed that way.
Some participants generally believed that regulations or restrictions have mostly kept
tobacco companies in check, citing the elimination of using “lights” or “ultra-lights” in
tobacco brand names, but they noted that the switch to colors (e.g., red, blue) might have
the same effect. Many participants considered that marketing a product as “natural” or
“additive-free” (as with American Spirit) gave the impression that “they’re like the healthy
alternative to smoking, still smoking, healthy smoking” (18- to 24-year-old male college
students, Raleigh).
Several female participants said that skinnier cigarettes marketed to women were portrayed
as being less harmful. Others mentioned e-cigarettes as an example of a product that was
marketed as being less harmful.
3-18
4. SUMMARY
We conducted 16 focus groups with current and former users of tobacco products to assess
consumer perceptions of the relative risks of various tobacco products. Findings from these
focus groups will inform the development of the protocol and stimuli to be used in a second
round of focus groups, which will explore the potential impact of modified-risk products and
claims on consumer perceptions.
Participants mentioned a variety of factors when asked to judge the relative risks of the
tobacco products discussed in the focus groups, including the characteristics of the product,
their own experience with the product, what they have heard or observed about the product
from users of the product, the product’s reputation and popularity, product marketing and
advertising, product labeling, the packaging of the product (e.g., color), and the perceived
quality and price of the product. We discuss these factors in more detail below. CTP may
want to take these factors into consideration when developing the stimuli and moderator
guide for the next round of focus groups.
4.1
Product Characteristics
Participants considered menthol cigarettes to be more harmful compared with non-menthol
cigarettes because of beliefs about the additional chemicals added to menthol cigarettes and
the belief that menthol cigarettes contained fiberglass. Participants considered cigarettes
that seemed “harsh” when smoked and caused one to cough to be more harmful compared
with milder cigarettes. Cigarettes that were marketed as additive free were considered to be
less harmful than brands that contain additives.
For smokeless tobacco products, product characteristics considered included the quantity
used in each hit; participants believed that the more used, the greater the harm. Another
consideration was whether the product was enclosed in a pouch, such as snus, which was
generally considered to be less harmful than the other smokeless tobacco products
discussed in the groups.
Participants across groups were split in the type of tobacco product (i.e., cigarettes or
smokeless tobacco) that was generally more harmful to your health. Those who said that
cigarettes were more harmful believed that inhaling the smoke affected their internal organs
and was generally more dangerous. Those who said that smokeless tobacco was more
harmful said that the visible effects (e.g., to teeth and gums) and their belief that effects
were felt more quickly were reasons for their ranking. Some participants believed that the
type of product (cigarettes versus smokeless) had less relationship to harmfulness and that
how “natural” a product was is more influential.
4-1
Consumer Risk Perceptions of Tobacco Products
4.2
Product Packaging, Labeling, and Marketing
Participants commented on the influence of product packaging, especially for products that
were unfamiliar, such as some brands of cigarettes and smokeless tobacco products.
Participants associated the picture of the Native American on the American Spirit cigarettes
with being “natural” and thus less harmful to their health. The various shapes of smokeless
tobacco packages were also mentioned by participants as factors that influenced their
ranking of products. Some agreed that the simple, pouch-like packaging of Red Man meant
that it was less threatening, whereas others felt that it indicated that it was cheap and lowquality, and therefore more harmful. The new, modern shape of the Camel snus package
was considered by some participants to be an indication that it was a cutting-edge
improvement over previous products and an indication that it was less harmful. The
association with a tin for gum or mints gave the impression that the product was less
harmful.
Color was mentioned by a few participants. When prompted, others voiced similar opinions
about the meaning of package color. Participants perceived yellow and blue to be
nonthreatening and thus less harmful to their health and red to be a harsh color and thus
more harmful to their health. Other participants disagreed and said that while the use of
color may be useful for marketing, it did not influence their perception of risk.
Information on the product label was considered by some participants in ranking the
products. For example, American Spirit, which was labeled as “100% Additive-Free Natural
Tobacco,” was considered to be less harmful to your health by some participants.
Manufacturers’ marketing of the product was also considered when ranking the products.
For example, the marketing of American Spirit as being natural and additive free led to the
belief that this brand is less harmful, although the company makes no claim that this brand
is less hazardous than other cigarettes. Most participants believed that manufacturers would
market a product as being less harmful to your health if they were allowed to do so. Some
participants believed that some products were already marketed as less harmful, such as
cigarettes labeled as “natural,” e-cigarettes, and skinnier cigarettes.
4.3
Other Factors
When ranking the products, the price and quality of the product was considered by some
participants. Some participants considered products that were cheap and of low-quality to
be more harmful to their health, whereas others believed that cheaper products were less
harmful because they contained fewer chemicals.
When asked to explain their product rankings, participants made reference to their own
experience with using the products and their familiarity with the products when doing the
rankings. For some participants, if they had not used the product previously or were not
4-2
Section 4 — Summary
familiar with it, they based their rankings on what they had heard or observed about the
product from users of the product or the product packaging. However, some participants
who were not familiar with the products were unable to do the rankings.
The product’s reputation and popularity were factors considered by some participants when
ranking the products. For example, many of the male participants who ranked Marlboro Red
as the most harmful said their ranking was based on Marlboro’s reputation and its popularity
as evidence that it is more addictive and thus more harmful. Other participants believed
that products that are popular are less harmful because so many people use them.
4-3
APPENDIX A:
MODERATOR GUIDE
I.
Welcome and Ground Rules (5 minutes)
MODERATOR: Welcome and thank you for participating in tonight’s discussion. My name is
_________________. Tonight, I am interested in hearing your opinions about tobacco
products. You have been asked to participate in tonight’s discussion because you use (or
have used) some of the various types of cigarettes and other tobacco products that we are
going to look at and discuss tonight.
Before we begin, I want to go over a few ground rules for our discussion tonight, which will
last about an hour.
Your participation is voluntary and you have the right to not answer any question or
withdraw from the study at any time.
If at any time you are uncomfortable with my questions, you can choose not to answer.
Just let me know that you prefer not to answer.
Everything we discuss today will be kept private to the extent allowable by law. Your
name and contact information, which only the study staff knows, will not be given to
anyone else and no one will contact you after this interview is over.
Tonight’s discussion will be audio and video recorded. The recordings will help me write
the final report and will be kept in a secure location and then destroyed at the end of the
study. No names will be mentioned in the final report created from these interviews.
Some of my coworkers are viewing our discussion. They’re watching to make sure that I
ask you all of the questions I have for you today. At the end of our conversation, my
colleague may come out with some last minute questions for you.
Most importantly, there are no right or wrong answers. I want to know your opinions. I
do not work for the people sponsoring this research and I didn’t write the questions
we’re going to look at, so don’t hold back on giving me your honest opinions.
I’m not a medical doctor or an expert on smoking or tobacco, so I can’t answer specific
questions. At the end of our discussion, however, I have some materials that you can
take with you if you’d like.
Please silence your cell phones.
Do you have any questions before we begin?
II.
Tobacco Products Introduction (5 minutes)
You are here tonight because we would like to hear your thoughts about tobacco
products. There are many types of tobacco products on the market. Some you
smoke, some you chew, some you keep tucked in your cheek, and some dissolve in
your mouth.
1.
[For current and light users] Let’s go around the room and have everyone
tell us your first name, what brand and type of tobacco products you currently
use, and how long you have been using those tobacco products.
2.
[For former users] Let’s go around the room and have everyone tell us your
first name, what type of tobacco products you used to use, and when you quit.
A-1
Consumer Risk Perceptions of Tobacco Products
3.
[For smokers] Why do you/did you like to smoke? What do/did you enjoy
about it? [For users of other tobacco products] Why do you/did you use
smokeless tobacco products? What do/did you enjoy about it?
III. Ranking Different Types of Cigarettes and Smokeless Products
in Terms of Harm to Health (30 minutes)
Now I’m going to put on the table a number of different brands of cigarettes. Some
of them may be familiar to you. [Introduce the 5 examples of cigarettes one at a
time, then pass around the examples and let everyone handle them and look at
them.]
4.
[Pass out Handout #1.] On the handout, for each product, list the first word or
phrase that comes to mind. [After participants have finished the exercise,
choose 3 products and ask…] What word or phrase came to mind when you
looked at [product name]? [List product/words on white board.]
5.
Which products, if any, have you used before or are familiar with?
6.
Which products, if any, have you not used before or are not familiar with?
7.
[Pass out Handout #2.] I’d like you to take a few minutes and rank these
products from the least harmful to your health to the most harmful to your
health, using the numbers 1 through 5, where #1 is least harmful and #5 is
most harmful. Feel free to pick them up and look at them if you want to, but
please do not open the packages.
8.
I want you to know that I don’t know what the correct ranking is, or if there is
a correct ranking. I just want to hear your opinions about which cigarettes are
more or less harmful to your health.
[After participants have finished the individual rankings, randomly choose 3
products and ask…] Where did this product fall in your ranking? Why?
[Remove products from table.] Now I’m going to put a set of smokeless tobacco
products on the table. [Introduce the 5 examples one at a time, then pass around
the examples and let everyone handle them and look at them.]
9.
Which products, if any, have you used before or are familiar with?
10. Which products, if any, have you not used before or are not familiar with?
11. [Pass out Handout #3.] I’d like you to take a few minutes and rank these
products from the least harmful to your health to the most harmful to your
health, using the numbers 1 through 5, where #1 is least harmful and #5 is
most harmful. Feel free to pick them up and look at them if you want to.
12. Again, I don’t know what the correct ranking is, or if there is a correct ranking.
I just want to hear your opinions about which smokeless tobacco products are
more or less harmful to your health.
[After participants have finished the individual rankings, randomly choose 3
products and ask…] Where did this product fall in your ranking? Why?
A-2
Appendix A — Moderator Guide
IV.
Discussion about Ranking Different Types of Cigarettes and
Smokeless Products in Terms of Harm to Health (20 minutes)
Ok, we have just ranked two sets of different cigarettes and smokeless products
from the least harmful to your health to the most harmful to your health. [Put all
products on table.]
13. [Pass out Handout #4.] Now let’s consider these four products. [Select two
products from each ranking exercise, one that was ranked high and one that
was ranked low, and then list the 4 products on the white board in random
order.] How would you rank these four products from least harmful to most
harmful? Once again, #1 is least harmful and #4 is most harmful to your
health.
a. Which products do you consider to be most harmful to your health? Why?
b. [If not mentioned] Is there anything about how the product looks that
helped you decide how harmful it is? If so, what?
c. [If not mentioned] What about the way it’s packaged?
d. [If not mentioned] What about things you’ve heard about the product in the
past?
e. Which products do you consider to be least harmful to your health? Why?
f.
Now, thinking about the product you ranked as least harmful (#1) and the
product you ranked as most harmful (#4): How much do these products
differ in terms of harm to your health?
–
Do you think there are small or pretty big differences in how harmful
these two products are?
–
Do you think there are small or big differences among the remaining
products we looked at tonight?
g. [If not already discussed] When doing the rankings, how were you thinking
about the phrase “harmful to your health”? In your own words, explain what
this means to you. [Probe] When doing the rankings, were you thinking of
harm to yourself personally or harm to others?
h. [Ask a few people and those that use other products] Do you consider the
product you currently/used to use to be more or less harmful to your health
compared with the other products we’ve looked at tonight? Why?
14. What did you think of the ranking exercises? Did you find it easy or hard to
rank the products from least to most harmful to your health? Explain why it
was easy or hard.
15. Before tonight, had you compared or thought about the different tobacco
products and their potential harm to your health?
16. Which do you think are more harmful to your health, cigarettes or smokeless
tobacco products? [Probe] Why do you think that? [If general consensus, ask if
all of the one type are more harmful than all of the other type. Take care to not
presume that users believe smokeless to be less harmful than cigarettes.]
A-3
Consumer Risk Perceptions of Tobacco Products
17. Do you think tobacco product manufacturers would market a product as being
less harmful to your health? Why or why not?
a. Are you aware of any tobacco products that are currently marketed as less
harmful to your health?
b. If yes, which products? Why do you think these products are less harmful to
your health? [Probe on product labels or advertisements.]
V.
Debrief/Closing
18. Do you have any questions before we conclude?
19. Tonight’s discussion is part of a study funded by the Food and Drug
Administration, or FDA. Some FDA team members are viewing tonight’s
discussion online. Before I let you go, let me check to see whether they have
any questions for you. [Note taker takes any questions to moderator or lets
moderator know there are no questions.]
Our discussion has brought up a lot of questions about the health risks of tobacco use. As I
mentioned, I have some brochures available here for you or a friend that you’re welcome to
take with you. [Place brochures near door so participants can pick one up if they choose.]
[FORMER SMOKERS/RECENT QUITTERS ONLY] If you are interested, there is a quit line
mentioned in the brochure that you may call.
Thank you for participating in tonight’s discussion. I appreciate your time and effort.
A-4
APPENDIX B:
HANDOUTS1
1
For each handout, the order of product names was randomized by group.
Handout #1: For each product, please write the first word or phrase that comes to mind.
Marlboro Red/Virginia Slims2: _________________________________________________
Camel Blue:_______________________________________________________________
Newports: ________________________________________________________________
Basic/Black & Mild3: ________________________________________________________
American Spirit: ___________________________________________________________
2
3
Marlboro Red brand was presented in male groups only, while Virginia Slims brand was presented in
female groups only.
Black & Mild brand replaced Basic brand in African American male group only.
B-1
Consumer Risk Perceptions of Tobacco Products
Handout #2: Please rank the products from least harmful to your health to most harmful
to your health, using the numbers 1 to 5, where 1 = least harmful and 5 =
most harmful.
_____ Marlboro Red/Virginia Slims
_____ Camel Blue
_____ Newports
_____ Basic/Black & Mild
_____ American Spirit
B-2
Appendix B — Handouts
Handout #3: Please rank the products from least harmful to your health to most harmful
to your health, using the numbers 1 to 5, where 1 = least harmful and 5 =
most harmful.
_____ Copenhagen
_____ Red Man
_____ Skoal
_____ Grizzly
_____ Camel snus
B-3
Consumer Risk Perceptions of Tobacco Products
Handout #4: Please rank the products from least harmful to your health to most harmful
to your health, where 1 = least harmful and 4 = most harmful. This time
write in the product name next to its ranking #.
1 — Least Harmful _________________________________________________________
2
_________________________________________________________
3
_________________________________________________________
4 — Most Harmful _________________________________________________________
B-4
February 2014
Consumer Perceptions of Modified
Risk/Reduced Exposure Cigarette
Claims
Focus Group Summary Report
Contract No. HHSF223201110005B, Task 6
Prepared for
Sarah Johnson
Center for Tobacco Products
DHHS, FDA/OMPT
9200 Corporate Blvd
Room 310N
Rockville, MD 20850
Prepared by
Sarah Ray
Marjorie Margolis
Carol Schmitt
Katherine M. Kosa
Matthew C. Farrelly
RTI International
3040 E. Cornwallis Road
Research Triangle Park, NC 27709
RTI Project Number 0212926.006.001
RTI Project Number
0212926.006.001
Consumer Perceptions of Modified
Risk/Reduced Exposure Cigarette
Claims
Focus Group Summary Report
Contract No. HHSF223201110005B, Task 6
February 2014
Prepared for
Sarah Johnson
Center for Tobacco Products
DHHS, FDA/OMPT
9200 Corporate Blvd
Room 310N
Rockville, MD 20850
Prepared by
Sarah Ray
Marjorie Margolis
Carol Schmitt
Katherine M. Kosa
Matthew C. Farrelly
RTI International
3040 E. Cornwallis Road
Research Triangle Park, NC 27709
_________________________________
RTI International is a trade name of Research Triangle Institute.
Contents
Section
Page
1.
Introduction
1-1
2.
Study Methods
2-1
3.
2.1
Study Design ........................................................................................... 2-1
2.2
Study Materials ........................................................................................ 2-2
2.3
Analysis .................................................................................................. 2-4
2.4
Participant Characteristics ......................................................................... 2-5
Key Findings
3.1
3-1
Brand Relationship ................................................................................... 3-1
3.1.1 Attitudes toward Brand ................................................................... 3-1
3.1.2 Interaction with Brand .................................................................... 3-5
3.2
Tobacco Companies .................................................................................. 3-6
3.2.1 Attitudes toward Tobacco Companies ................................................ 3-7
3.2.2 Trustworthiness of Tobacco Companies ............................................. 3-9
3.3
Claim Statements and Sample Tobacco Products ........................................ 3-11
3.3.1 First Reactions to Sample Products ................................................. 3-11
3.3.2 Perceptions of Statements ............................................................. 3-12
3.3.3 Perceptions of Products ................................................................. 3-15
4.
Summary
4-1
4.1
Brand Relationship ................................................................................... 4-1
4.2
Tobacco Companies .................................................................................. 4-1
4.3
Claim Statements and Sample Tobacco Products .......................................... 4-2
Appendixes
A
Moderator Guide ......................................................................................A-1
B
Handouts ................................................................................................B-1
iii
Figures
3-1
Trustworthiness of Tobacco Companies .......................................................... 3-10
Tables
Number
Page
2-1
Segmentation of Focus Group Participants ........................................................ 2-1
2-2
Moderator Guide Summary ............................................................................. 2-3
2-3
List of Statements, Phrase Emphasis, Brand, Claim Color, and Format ................. 2-3
3-1
Words and Phrases Used to Describe Your Cigarette Brand: Favorable ................. 3-2
3-2
Words and Phrases Used to Describe Your Cigarette Brand: Unfavorable .............. 3-3
3-3
Words and Phrases Used to Describe Your Cigarette Brand: Product
Description, Brand Imagery, and Other ............................................................ 3-4
3-4
Words and Phrases Used to Describe Tobacco Companies: Unfavorable ................ 3-8
3-5
Words and Phrases Used to Describe Tobacco Companies: Favorable/Neutral ....... 3-9
iv
1. INTRODUCTION
The term “modified risk
tobacco product”
means any tobacco
product that is sold or
distributed for use to
reduce harm or the risk
of tobacco-related
disease associated with
commercially marketed
tobacco products.
~Section 911(b)(1) of
the Food, Drug, and
Cosmetic Act
The Food and Drug Administration (FDA) has the authority to
regulate the manufacture, marketing, and distribution of tobacco
products to protect the public health. Section 911 of the Food,
Drug, and Cosmetic Act authorizes FDA to grant orders to
manufacturers to allow the marketing of products that may
reduce the harm or risk of tobacco-related disease associated
with commercially marketed tobacco products. FDA may allow
the marketing of these products, called modified risk tobacco
products, if it is deemed appropriate for the promotion of public
health. To assess the potential impact that the marketing of
modified risk tobacco products may have on the likelihood of
initiation and cessation of tobacco use, FDA requires information
regarding consumer perceptions of tobacco products and of modified risk tobacco products.
FDA’s Center for Tobacco Products (CTP) contracted with RTI International to conduct focus
groups to assess consumer perceptions of the relative risks of various tobacco products. An
initial round of 16 focus groups explored how consumers make judgments about the
harmfulness of tobacco products. Data from the first round of focus groups informed the
development of a series of cigarette packages featuring fictitious brands and health-related
claims (e.g., less tar, fewer toxins). A second round of 16 focus groups explored consumers’
reactions to these mock cigarette packages and health claims and their relationships to their
cigarette brands. Collecting information on the target audience’s perceptions will help inform
the Agency’s efforts to implement the provisions of the Family Smoking Prevention and
Tobacco Control Act related to modified risk tobacco products.
This report describes the study design and presents the findings from the second round of
16 focus groups. Section 2 describes the study procedures and materials, Section 3
presents the key findings from the focus groups, and Section 4 summarizes the results of
the focus groups and factors to consider in the next round of focus groups.
1-1
2. STUDY METHODS
RTI International conducted 16 focus groups with consumers in four U.S. cities to assess
their perceptions of the reduced exposure and modified risk claims presented on two
fictitious cigarette brands. The study also examined brand loyalty among participants and
how brand loyalty might affect perceptions and use of reduced exposure and modified risk
products that could be marketed in the future. This section describes the procedures and
materials used to conduct the focus groups.
2.1
Study Design
From September to November 2013, RTI conducted 16 focus groups in four locations:
Bethesda, Maryland; Oklahoma City, Oklahoma; Londonderry, New Hampshire; and
Jackson, Mississippi. RTI worked with the Center for Tobacco Products (CTP) to develop the
methodology and focus group segmentation, including age groups, smoking behaviors, and
other characteristics. Table 2-1 shows the subpopulation and location for each focus group.
Table 2-1.
Segmentation of Focus Group Participants
Bethesda, MD
Oklahoma City, OK
Londonderry, NH
Jackson, MS
Female
Light smokersa
Female
Light smokers
Male
Light smokers
Male
Light smokers
Female
Ages 30 to 65
Current smokersb
Male
Ages 30 to 65
Current smokers
Male
Ages 30 to 65
Current smokers
Female
Ages 30 to65
Current smokers
Male
Ages 18 to 24
Urban
Poly-usersc
Male
Quit Interest
Female
Quit Interest
Male
Ages 18 to 24
Urban
Poly-users
Male
Quit interestd
Female
Quit interest
Male
Quit interest
Female
Quit interest
a
Smokes, on average, fewer than 10 cigarettes per day, every day, or smoked, on average, fewer
than 10 cigarettes per day less than 20 days in the past 30 days.
b
Smokes, on average, 10 or more cigarettes per day, every day, or smoked, on average, 10 or more
cigarettes at least 20 days in the past 30 days.
c
The original design specified males who only use smokeless tobacco products (e.g., chewing tobacco,
snuff, or dip). Due to a low incidence rate, we were unable to recruit a full group of smokeless-only
users. Some participants also smoked cigarettes or other tobacco products.
d
Plans to stop smoking within the next 60 days.
RTI subcontracted with local market research companies in each of the focus group
locations to recruit participants and provide the facilities for hosting the focus group
discussions. Using convenience sampling, the market research companies recruited from
their databases participants who met the requirements for inclusion in the specific
subpopulations. To be eligible to participate, respondents had to be able to read,
2-1
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
understand, and speak English. Individuals were ineligible for participation if they had other
characteristics that could potentially bias responses (e.g., connections to the tobacco
industry; employment in the public health, advertising, or marketing industries) or if they
had participated in market research in the past 6 months.
Each focus group included 6 to 11 participants, for a total of 143 participants. Upon arrival
to the focus group facility, participants read and signed an informed consent form (approved
by the Food and Drug Administration’s [FDA’s] and RTI’s Institutional Review Boards) and
were rescreened to confirm eligibility. Experienced moderators conducted the focus group
discussions, and trained staff members took notes during the discussions. Each focus group
discussion lasted 1 hour. Participants received a monetary incentive of $50 for participating
in the focus group discussion.
2.2
Study Materials
CTP led the development of a moderator guide to discuss consumer use and perceptions of
tobacco products. Table 2-2 summarizes the topics in the moderator guide, and Appendix A
provides a copy of the moderator guide.
On a handout, participants listed the words that came to mind when they thought of their
cigarette brand and discussed their thoughts about their brand. During each focus group,
participants were asked to name the cigarette brand they smoked and to describe the
interaction they had with their brand (e.g., listservs, coupons). Participants then listed the
words that came to mind when they thought of “tobacco companies in general” and
discussed their attitudes toward tobacco companies. See Appendix B for a copy of the
handouts.
Participants were presented with six different mock cigarette packages consisting of two
fictitious brands (Durham and Carteret) that were developed by RTI and CTP. The fictitious
brands and their packaging were designed to look realistic but to avoid being mistaken for
currently available brands.
The packages had a variety of statements prominently displayed that made health claims
about the product. A total of 12 claim statements, developed by CTP, were used on each of
the brands (with a total of 24 packs). One set of statements made claims that the product
presented modified exposure to a harmful constituent (reduced exposure), while a second
set of statements made claims that the product posed reduced risk of harm to the user
(modified risk). Other characteristics of the statements included general versus specific
claims, positive versus negative framing, familiar versus unfamiliar chemical names, and
references to an organization (bogus) with implied scientific credentials. Each claim
statement emphasized certain words by bolding them and placing them inside the top of the
2-2
Section 2 — Study Methods
Table 2-2.
Moderator Guide Summary
Section
Introduction
Purpose
Moderator described the purpose of the discussion and how the group
would be conducted.
Brand Relationship
Introduction
Participants introduced themselves and briefly discussed their brand of
cigarettes and how long they had used that brand.
Attitudes
Participants were asked to complete a top-of-mind exercise that asked
them to think about their brand of cigarettes and the first words or
phrases they associated with the brand. Follow-up discussion focused
on common themes and their reasons for the associations.
Interaction
Participants discussed the ways that they interacted with the company
that makes their cigarettes and any communications that they receive
from their brand or other brands.
Tobacco Companies
Attitudes
Participants completed a second top-of-mind exercise that asked them
to think about tobacco companies in general (not just the makers of
their preferred brand) and the first words or phrases they associated
with tobacco companies. Follow-up discussion focused on common
themes and their reasons for the associations. Participants also ranked
the level of trust they felt for tobacco companies from 1 (“not at all”) to
7 (“very much”).
Statement and Prototypes
First reactions
Moderator briefly introduced sample product packaging and offered
participants an opportunity to see, hold, open, and read the boxes.
Participants then discussed their initial thoughts about the products,
including what they did and did not like, things they noticed, and
questions the packages brought up.
Perception of statements
Moderator focused on the statements (claims) printed on the packaging.
Participants discussed their thoughts and feelings about them, including
their understanding of the statements’ meaning, whether the
statements were believable, the source of the statements, and the
perceived target audience for statements like those shown.
Perception of product with
statements
Participants discussed other aspects of the sample products. Topics
included participants’ interest in trying or using a product like the
samples shown, their feelings about how the products would taste, and
their opinions on whether statements like those discussed would catch
their attention. Participants also discussed their thoughts on whether
similar products would be successful if they were sold and who they
believed would use them.
Conclusion
Participants shared any final comments.
cigarette package. The claims were presented in a variety of colors (blue, transparent) and
formats (e.g., rectangular packages, stamps with ribbons). Each group viewed six different
cigarette packages and statements (three packages of each brand, each with a different
statement). Table 2-3 lists the combination of different sample statements, colors, and
formats presented during the groups.
2-3
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
Table 2-3.
List of Statements, Phrase Emphasis, Brand, Claim Color, and Format
Claim
All the satisfaction you want, with
less chemicals
Phrase
Emphasis (for
pack flip top
and bolding
within claim)
Claim
Color
Format
Carteret
Claim
Color
Format
Blue
Rectangle
Blue
Frill-edged
full circle
Contains significantly fewer toxins, Fewer toxins
according to the U.S. Toxicological
Association
Blue
Rectangle
Blue
Frill-edged
full circle
Lower tar
Lower tar
Blue
Stamp
w/ribbon
Transparent Half circle
Low nicotine
Low nicotine
Blue
Stamp
w/ribbon
Transparent Half circle
Contains significantly less nicotine
and carbon monoxide levels
compared to regular cigarettes
Less nicotine
Blue
Rectangle
Blue
Frill-edged
full circle
America’s first cigarette with no
formaldehyde
No formaldehyde
Blue
Rectangle
Blue
Frill-edged
full circle
50% lower ethylene oxide
Lower ethylene
oxide
Blue
Stamp
w/ribbon
Transparent Half circle
Independent scientific panel
concluded this product is safer
alternative to regular cigarettes
Safer alternative
Blue
Rectangle
Blue
Frill-edged
full circle
Safer alternative to most
cigarettes
Safer alternative
Blue
Rectangle
Blue
Frill-edged
full circle
100% Natural Tobacco
100% natural
Blue
Stamp
w/ribbon
Transparent Half circle
Contains less than 0.3 mg
nicotine/cigarette
< .3 mg nicotine
Blue
Rectangle
Blue
Frill-edged
full circle
Triple filter charcoal technology:
Safer for smokers
Safer for smokers Blue
Rectangle
Blue
Frill-edged
full circle
2.3
Less chemicals
Durham
Analysis
The focus groups were professionally audio-recorded by the local market research
companies and video-streamed by an independent subcontractor. The audio files were
professionally transcribed by the independent subcontractor. The note taker for each focus
group used her notes and reviewed the audio files and/or transcripts for accuracy. Pregroup questionnaire and handout data were entered into an Excel spreadsheet. A moderator
then systematically reviewed and manually coded all transcripts to identify common themes
and any exceptions to these themes and to identify similarities and differences among the
various subpopulations included in the study, where possible. Handout and participant data
were summarized and included in tables for interpretation.
2-4
Section 2 — Study Methods
2.4
Participant Characteristics
Overall, the total number of participants was 143. Participants were nearly evenly divided
between male (n = 79; 55.2%) and female (n = 64; 44.8%). Participants were evenly
divided across age ranges. Participants were most likely to have some college (n = 54;
37.8%) or a college degree (n = 43; 30.1%). Only eight participants (5.6%) had less than a
high school degree, and only five (3.5%) had a post-graduate degree. The majority of
participants identified as non-Hispanic (n = 134; 93.7%) and Caucasian (n = 83; 57.3%).
The majority of participants reported smoking every day (n = 103; 72.0%). Of the
participants that smoked every day, the majority (n = 66; 64.1%) reported smoking 10 to
30 cigarettes per day. Slightly more than one-quarter of participants who smoked every day
(n = 28; 27.2%) reported smoking less than 10 cigarettes per day, and only nine (8.7%)
reported smoking more than 30 cigarettes per day. Only 40 participants (28.0%) reported
smoking on some days. Of participants who smoked on some days, the majority (n = 29;
78.4%) reported smoking on fewer than 20 days per month. The majority of participants
who smoked on some days (n = 28; 73.7%) smoked fewer than 10 cigarettes per day on
the days they smoked.
Participants were asked to rate how much they wanted to quit smoking on a scale from 1
(not at all) to 5 (a lot). The majority of participants reported their interest in quitting as “3”
(n = 39; 27.3%), “4” (n = 34; 23.8%), or “5” (n = 47; 32.9%). Participants who reported
their interest between 2 and 5 were asked whether they were seriously considering stopping
smoking in the next 6 months. The majority of participants (n = 106; 80.2%) reported that
they were considering stopping smoking in the next 6 months. The majority of participants
(n = 71; 67.6%) also reported that they were planning on stopping smoking in the next 60
days. The majority of participants (n = 106; 85.5%) reported that they did not use chewing
tobacco, snuff, or dip.
2-5
3. KEY FINDINGS
This section presents key findings from the focus group discussions for the following major
topics:
brand relationship,
tobacco companies (including attitudes toward tobacco companies), and
claim statements and sample products.
For each major topic, we analyze the various subtopics included in the discussion. We
summarize the findings across the 16 focus groups and identify differences, if any, among
groups.
3.1
Brand Relationship
Each focus group began with participants discussing their current cigarette use. Participants
were asked to tell the group which brand(s) of cigarettes they use and how long they had
used the brand. In cases where a participant used multiple brands, the discussion focused
on their preferred brands.
Focus group participants mentioned a variety of brands, although a few stood out as more
common. Across all groups (including current and former users), Marlboro brands were
mentioned most often. Although the general “Marlboro” name was given by most
participants, specific types—including Marlboro Lights, Marlboro Red, Marlboro Menthol, and
Marlboro 100s—were mentioned by others.
Newport brands were the second most commonly mentioned (including Newport, Newport
Lights, Newport 100s, and Newport Shorts), followed by Camel brands. Other brands
receiving a few mentions included American Spirit, Benson and Hedges, Kool, Maverick, Pall
Mall, Parliament, and Seneca.
3.1.1
Attitudes toward Brand
Participants participated in an exercise to assess top-of-mind thoughts and reactions about
their usual or preferred brand (Handout 1, Appendix B). They were given a few minutes to
write down the first few words or phrases that came to mind when they saw, heard, or
thought about their brand of choice. Tables 3-1 through 3-3 summarize their responses.
3-1
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
Table 3-1.
Words and Phrases Used to Describe Your Cigarette Brand: Favorable
Cleaner tasting/no cotton taste/great
taste/taste good/tastes decent/
pleased with the taste/taste/taste
fresher/like the way it taste/taste
better/no bad aftertaste/tasty (22)
Smooth/smooth taste/the
smoothness/smooth and stronger
(22)
Calming/calm your nerves/calm me
down/calmness (16)
Relax/relaxing/relaxation/relaxing
after meals/relaxing in the PM (16)
Inexpensive/cheaper/cheap/cheap
cigarette (11)
Stress relief/stress reliever/takes
stress away (10)
Cool/cool taste/crisp, cool,
clean/”Kool as the wind” (7)
Flavor/flavorful (6)
Beer/goes well with a beer/goes well
with Bud Light (5)
Enjoyable/enjoyment/I enjoy
smoking (5)
Mild (5)
Break/break time/take a break (4)
Drinking/goes good with drink (4)
Strong/strong flavor/strong enough
to get the job done (4)
Good/good quality (3)
Light (3)
Minty/peppermint (3)
Soothing (3)
Best/best cigs there are (2)
Good smokes (2)
Doesn’t burn/no burn (2)
Social/socializing (2)
Happy (2)
Girly (2)
It’s affordable/affordability (2)
Good tingly feeling/warm fuzzy
feeling (2)
Cute/pretty (2)
Head change/helps collect my
thoughts (2)
Satisfying (2)
Newport pleasure/Live with
pleasure (2)
Long lasting (2)
Tension relief/release of
pressure (2)
Boss status
Breathtaking
Chill
Choice
Coffee
collective
Comfortable
Concerts
Confident
Consistent
Cost less than Newports
Don’t talk back
Easy to smoke
Fun
Genuine
Going out
Good menthol flavor
Good sensation
Great and awesome brand
Great dessert
Great for pleasure and juicy
conversation
Harsh
Hate sharing
High
I feel like they are doing less
damage to my body
It’s not strong
Like the feeling I get
Me time
Meditate
Middle of the road
More sophisticated
Not too thick
One of the best brands out
there
Security
Player
Quality cigarettes
Refreshing
Reliability
Sexy
Smell/scent
They do not make me cough
They don’t smell like regular
cigarettes
Unique
Value
Variety
Wish they had flavor
Young/young people’s
cigarette
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout. Responses were coded and combined as appropriate. Minor edits were made to correct for
spelling and other errors.
Initial reactions were mostly positive and focused on aspects of smoking that participants
enjoyed. Many participants talked about the flavor of their brand (e.g., full-flavor) and the
way it tastes (e.g., enjoyable):
“I love the flavor, the way they taste….” (Male quit interest, Oklahoma City)
“…the flavor. Everything else is like ‘blah.’” (Male current smokers, Londonderry)
“I wrote ‘crisp, cool, clean, relaxation’.” (Female light smokers, Oklahoma City)
“Smooth, light, relaxing, no bad aftertaste.” (Male light smokers, Jackson)
3-2
Section 3 — Key Findings
Table 3-2.
Words and Phrases Used to Describe Your Cigarette Brand:
Unfavorable
Expensive/$/expense/more
expensive (15)
Need one/need one now/want to
have one/I want one myself/give
me one (7)
Bad smell/stinky/smell/smoke
smell/hate the smell of smoke (6)
Cancer stick/cancer/can cause
cancer (5)
Addictive/addiction (4)
Seems like a quick catching
habit/negative habit/bad
habit/habit (4)
Health/unhealthy/bad for my
health (3)
Bad breath (2)
Death/dying (2)
It goes out very often and you
have to relight often/going out
when not being pulled on (2)
Killer/smoking kills (2)
Nicotine/nicotine rush (2)
Thinking about smoking one
right now/I would like to
smoke (2)
$5 something
Third item on agenda in AM
Baby sister has spot on her
lung
C.O.P.D.
Costs too much
Depressing
Environmental triggers
Guilt
Half my life
Helps me with my boredom
I hate smoking
I know smoking cigarettes is
not good for you
I might have to get some
Ill heart effects
Inconsistent quality
Inconvenient
Lungs
Messy
nasty
Ouch
Secondhand smoke is bad to
the people around you
Sickness
Something to occupy me
Stingy with coupons
The first thing I think of is a
fresh cigarette
What are they putting in
them now?
Wish I had an e-cig right now
Wrinkles
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout. Responses were coded and combined as appropriate. Minor edits were made to correct for
spelling and other errors.
In addition, many participants discussed the ways that smoking in general, and their brand
specifically, contributed to stress relief and feelings of relaxation.
“… it’s my place. I feel nice and secure. It’s my own little world, nobody bothering
me.” (Male current smokers, Oklahoma City)
“…when I’m having a stressful day.., I can go out in the garage and smoke a
cigarette, and that just relieves all the stress that’s going on for the day.” (Male quit
interest, Oklahoma City)
“You just take a drag and it’s kind of like, whoosh. The pleasure center.” (Female
quit interest, Oklahoma City)
“The first thing I do when I get in my truck after work is smoke. It’s a sign of
freedom. I’m free for the rest of the day.” (Female quit interest, Jackson)
Some participants talked about the social aspect of smoking and how cigarettes become
part of a familiar routine:
“It goes well with a beer.” (Male light smokers, Jackson)
“…social like drinking beer, hanging out. I only smoke when I go out with my
friends.” (Female light smokers, Oklahoma City)
3-3
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
Table 3-3.
Words and Phrases Used to Describe Your Cigarette Brand: Product
Description, Brand Imagery, and Other
Cowboy/cowboys/cowboy
man/cowboy killer (11)
Menthol (10)
Marlboro Man (7)
Green box/green/short green
pack/green and white (5)
Well known/popular (5)
Can find them anywhere/buy them
everywhere/always available
everywhere/readily available (4)
Reds/red package/red/red box (4)
Smaller/small/short (3)
100s (3)
Brand/brand of choice (2)
Country (2)
Everyone I know smokes
Marlboro/Marlboro is a common
brand to smoke (2)
First brand/first ever cigarette (2)
Gold pack/white and gold box (2)
Lights/ultra-lights (2)
Smoke (2)
Thin/slim (2)
Will give away prizes/win prizes
(2)
Car racing
Common
Convenient
Cool
Cool colors
Crush bead
Crushes
Different in a way which there
aren’t many smokers who
smoke Kool
Ease of purchase
High school
Horse
I started smoking this brand
because my mother and father
smoked this brand
It’s a clove
Light up a cig
Like Newports
Walmart
Well-designed packaging
Western
Big company
Ethnic
Hearty
Men
Menthol 100s box
Marlboro Lights
Masculine
Money
Motorcycle racing
My brand seems to be the
popular one
Natural
Newport
Non-menthol
Only smoke Newport because
it’s the brand everyone
around me smokes
Original
Outdoors
Phillip Morris Co.
Recessed filter
Regular/menthol switch
Shorts
Small cigar
Smoker sign up
Smoking Joe
SOS
Spin the wheel
Stereotypical African
American brand
Tennis tournament
That first touch
Tough
White pack
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout. Responses were coded and combined as appropriate. Minor edits were made to correct for
spelling and other errors.
Others talked about the quality of their cigarette brand and the ideas that were associated
with it. Participants who smoked Marlboro brands were particularly likely to write down
words or phrases that described the Marlboro image:
“… if you go to a country concert, a lot of people will be smoking that brand.”
(Female light smokers, Bethesda)
“…for Marlboro, I said ‘tough.’” (Female light smokers, Bethesda)
“[The packaging] evokes exotic adventure like a little Indiana Jonesy….” (Male light
smokers, Londonderry)
“I think of the Marlboro Man.” (Male light smokers, Londonderry)
3-4
Section 3 — Key Findings
Although the exercise was designed to elicit attitudes toward the smoker’s brand,
participants described negative associations with cigarette smoking that were not brandspecific. Many talked about the health effects of smoking and their concern about what their
cigarette use may be doing to them:
“…even though this is my brand, I still think of dying when I do the cigarette….”
(Female light smokers, Bethesda)
“Everything I have about cigarettes is pretty negative, so I just put ‘death,’
‘sickness,’ ‘cancer,’ and ‘bad breath.’” (Male light smokers, Londonderry)
Others talked about the effects of smoking on a person’s appearance and the problems with
odors:
“I don’t know. I’m just tired of smoking ‘em, tired of the taste, the smell.” (Male quit
interest, Oklahoma City)
“And most of all the smell in my clothes. Because I used to smoke in the house, but
now I don’t… and I can tell a complete difference.” (Male quit interest, Bethesda)
“Nasty. I’m trying to quit… When I get a pack, I smell it coming. I go into places now
and I’ve smoked all my life and it’s just nasty. It’s a nasty, disgusting habit.” (Male
quit interest, Londonderry)
Some participants said that, although they realized smoking was bad, it was an addiction
that they found hard to overcome:
“I wrote ‘I need one now.’ And it’s a bad habit.” (Male current smokers,
Londonderry)
“I said ‘I want one now.’ I said, ‘but I want to not want one anymore’…. I wish I
didn’t. Addictive.” (Female quit interest, Jackson)
Many participants brought up the cost of cigarettes. Some said they thought their brand was
cheaper than others or that it was an affordable option, but most participants said that
cigarette smoking was an expensive habit:
“It tastes decent, but the quality’s really expensive.” (Male quit interest, Bethesda)
“It’s expensive. I said when they went up to four dollars, I was gonna quit. Now
they’s five, I’m still smoking, so….” (Female quit interest, Oklahoma City)
3.1.2
Interaction with Brand
In a follow-up conversation, participants were asked about the ways that they interacted
with the company that makes their brand of cigarettes. Responses were mixed, with some
participants saying that they received no communication from their preferred brand, and
others saying that they regularly got mail or e-mail from the companies. Nearly all who
3-5
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
received mail from their brands said that it included coupons of various types. Only a few
participants said they did not like receiving the coupons or other mail from their brand:
“They get your e-mail and then they send you coupons… I even got birthday
presents from them.” (Female light smokers, Oklahoma City)
“They send me like two dollars off a pack. If you’re gonna send me two dollars off a
pack, I’m gonna smoke that.” (Female quit interest, Oklahoma City)
“From Marlboro I get a birthday card… Congratulations for beating cancer and getting
one more year….” (Male light smokers, Londonderry)
“I feel pretty good, because you actually get money off the product that you’re
using, and that helps a little bit.” (Male poly-users, Jackson)
A few participants in most groups said that they had visited the cigarette company’s Web
site. While there, they commonly reported that they signed up to receive discounts or
entered sweepstakes to win prizes. A few others mentioned that brand representatives at
bars and clubs would hand out promotional materials for anyone who signed up for a
mailing list.
“…Every year they give away hats and bottle openers—and Zippos—and stuff like
that. So I go sign up whenever I get something in the mail.” (Male poly-users,
Bethesda)
“They have coupons and gifts that you can enter, too. … Marlboro actually has a
ranch, and you can enter to go to the ranch, all expenses paid, which I do quite
regularly.” (Female current smokers, Bethesda)
“Well, like when you go to a bar, sometimes they’ll come and get your license and
then they send you coupons and stuff like that. They used to give you free packages
of cigarettes, [but] now they give you coupons.” (Female light smokers, Oklahoma
City)
The moderator probed on questions of interaction with tobacco brands via social media,
including Facebook, Twitter, and Instagram. Very few participants in any of the groups
reported that they had looked for their brand on social media sites, and only a few of those
reported interacting with the company that makes their brand on social media.
Some participants mentioned that they had participated in brand loyalty programs (e.g.,
“Marlboro Miles,” “Camel Cash”) but that those programs had been discontinued.
3.2
Tobacco Companies
After the discussion about participants’ preferred brands, moderators talked about tobacco
companies as a whole. Participants were reminded to think about all tobacco companies that
make cigarettes and other tobacco products (including smokeless tobacco and cigars) and
not just the company that makes their preferred brand.
3-6
Section 3 — Key Findings
3.2.1
Attitudes toward Tobacco Companies
Participants participated in a second exercise to gauge their initial thoughts and reactions to
tobacco companies as a whole (Handout 2, Appendix B). They were given a few minutes to
write down the first few words or phrases that came to mind when they saw, heard, or
thought about tobacco companies or the tobacco industry. Tables 3-4 and 3-5 summarize
their responses. Responses did not differ significantly by gender, age group, or
race/ethnicity.
Unlike the discussion related to preferred brand, initial reactions to tobacco companies were
mostly unfavorable. Many participants focused on the money that tobacco companies make,
with words and phrases like “money,” “rich,” “millionaires,” “wealth,” “power,”
“conglomerates,” and “big business” making up a large portion of the responses and
discussion. While many participants felt that it was self-explanatory, a few elaborated:
“…You have tobacco companies, who have lobbyists on their side, [and] … tobacco
companies make so much money, but that money is funneled to other places. And I
believe that they have political parties that back them, and that’s how they have so
much money and wealth and there’s more power that’s then involved with it.”
(Female current smokers, Bethesda)
“They’re conglomerates.” “Yeah, I wrote money and power.” (Female quit interest,
Londonderry)
“They’re making tons of money… I mean cigarettes have been around forever. How
much money do they need?” (Male light smokers, Jackson)
Some participants talked about their other negative perceptions of the tobacco companies,
including inappropriate marketing practices, chemicals and other additives to cigarettes, and
the idea that tobacco companies only care about making money, and not about the lives of
their customers:
“I think the cigarette companies are evil. They have a total disregard for the lives of
their customers. They’re unwilling to make cigarettes safer by removing toxic
additives and not making them more addictive than they were naturally.” (Female
light smokers, Bethesda)
“I think of drug dealers.” (Male quit interest, Bethesda)
“I don’t think that they tell the truth about everything they put in cigarettes.”
(Female quit interest, Oklahoma City)
“They’ve been lying to us for a hundred years about the dangers of smoking…” (Male
current smokers, Londonderry)
3-7
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
Table 3-4.
Words and Phrases Used to Describe Tobacco Companies:
Unfavorable
Rich/filthy rich (14)
Money maker/making money/has
money/a lot of income (8)
Greedy (7)
Money (7)
Big business/huge (6)
Killers/killing people/killing people
over time to get rich (5)
Addiction/addictive products (4)
Big money (4)
Cancer (4)
Liars/fact bender/lies about danger of
smoking (4)
Profits/tremendous profits/large profits
(4)
Wealthy (4)
Billionaires/billionaire owners/billion
dollar industry (3)
Manipulative (3)
Money hungry (3)
That’s how they make their
money/they are making money off of
us/mega rich off poor me (3)
Big money in bed with government/
government kickbacks (2)
Causing death/mass genocide/
life takers (3)
Chemicals (2)
Conglomerates/monopolies (3)
Deception (2)
Drug dealers/worse than drug
dealers (3)
Evil/evil business (3)
Bad/bad guys (2)
Making money killing/They kill
millions and yet are the
billionaires of the world (2)
Millionaires (2)
Not concerned about
health/They don’t care (2)
Mad/aggravated/angry (2)
Power/power hungry (2)
Produced a product that is
addictive and harmful…/They
know they are pushing addictive
products (2)
Selfish (2)
All about dollar bill and by any
means
Assholes
Bank
Bastards
Corporations that provide a
toxic luxury item
Expensive
Exploitation
Malice
Masking the ill effects
Money control
Parasitic
Profiteers
Negative societal effects
Selling death to addicts
Sneaky
Total disregard for the lives
of their customers
Underhanded
Undertakers
Unwilling to remove toxic
chemicals and make
cigarettes more addictive
than they actually are
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout. Responses were coded and combined as appropriate. Minor edits were made to correct for
spelling and other errors.
“They’re predators. There’s no doubt about that. And they… do false advertising to
entice these children to come in and think this is so cool to smoke, and you can do
it; it’s not going to hurt you.” (Female quit interest, Jackson)
“My first was ‘greed’ and ‘deceptive and false advertising.’ They make it look so
glamorous and cool.” (Male quit interest, Londonderry)
Tobacco companies did have a few defenders in the groups. Some participants said they felt
that the industry was unfairly picked on and that they were operating a legal business that
should be left alone:
“I wrote ‘discriminated.’… They’re just like anything else negative—picked on and
taxed—and ridiculed—and bullied.” (Male poly-users, Bethesda)
“I have ‘harassed by the government’.” (Female current smokers, Bethesda)
“I think we need more tobacco. As… a smoker, I think too that they’re infringing on
my rights, the public, because I want to go to the café and eat my dinner and sit
3-8
Section 3 — Key Findings
there [and] smoke a cigarette. I can’t do that anymore.” (Male current smokers,
Oklahoma City)
Table 3-5.
Words and Phrases Used to Describe Tobacco Companies:
Favorable/Neutral
Forever/been around forever/
historic/long history in this country
(5)
Lack of advertisements (3)
Affordable (2)
Carolina/North Carolina (2)
Competitive (2)
Coupons/incentives (2)
Taxes (2)
Advertisements
Assertive
Bold
Freedom
Good promoters and hustlers
Great marketing
Go for it. We need more.
Gonna stick with my brand
I think they are giving what
the public wants
Lower prices
Lucrative
Lung
Marlborough
Philip Morris
Ongoing
Quality
Reliable
Savvy
Smart
Strong
Thank goodness they make it
They came up with a great
idea
Trendy
Warning labels
Well-established
Young
Note: Number in parentheses indicates the number of participants who wrote the word/phrase on the
handout. Responses were coded and combined as appropriate. Minor edits were made to correct for
spelling and other errors.
3.2.2
Trustworthiness of Tobacco Companies
Participants then rated how much they trusted tobacco companies as a whole, on a scale
from 1 (not at all) to 7 (very much). Although ratings of trust were low overall, reactions
were mixed (Figure 3-1).
Participants who gave the tobacco companies a low rating of trust (1, 2) pointed to
deceptive marketing techniques, selling an addictive product, and a feeling that the
companies do not care about their customers as reasons for their ratings:
“Why would I trust something, like a company, that’s trying to kill me?...” (Female
light smokers, Bethesda)
“I don’t think they would put the warning signs on there if the government didn’t
make them do it.” (Male poly-users, Bethesda)
“… I don’t feel like they give a damn… whether you live or die. They’re making
money off of you with every pack that you buy, and they want you to buy as many
packs as they can possibly sell you.” (Female quit interest, Oklahoma City)
“If you look at the grand scheme of things, it’s a 50/50 with them. They’re doing
better today I think with the labels… and people are smarter, but you can’t
unsqueeze a tube of toothpaste. They squeezed it pretty hard.” (Male light smokers,
Londonderry)
“That’s like asking somebody, ‘Do you trust your drug dealer?’” (Male light smokers,
Jackson)
3-9
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
“I feel like they’re out to get the money. They don’t care if I get sick. They just want
me to buy the product.” (Female current smokers, Jackson)
Figure 3-1.
Trustworthiness of Tobacco Companies
60
Number of Participants
50
40
30
20
10
0
1
2
3
4
Not at all
5
6
7
Very much
Rating
Others who gave them low trust ratings said tobacco companies were not transparent about
what was in the products, especially a long list of chemicals.
“They added more chemicals than they used to when they first came out… It’s a lot
different now.” (Female quit interest, Londonderry)
“Because they don’t tell you everything they do. And everything that’s in them.”
(Female quit interest, Oklahoma City)
Other participants said they had a range of trust that fell somewhere in the middle (3, 4, 5).
These participants reported being torn between the health risks, questionable marketing,
and motives of the companies versus the consistency, availability, and quality of the
products.
3-10
Section 3 — Key Findings
“…I don’t trust that they worry about people’s well-being… but one thing I do trust is
that they’re consistent with their product… If it was illegal and you were just buying,
it would be different every time. I trust their consistency.” (Male quit interest,
Bethesda)
“It’s like two ends of the spectrum. If you’re thinking about ‘Are they doing things for
the public welfare?’ that’s a zero. If you’re talking about, ‘Do they have the
knowledge to make their product?’ well, that’s very high…. [W]ell then, it’s
somewhere in the middle.” (Male current smokers, Oklahoma City)
“I feel neutral I guess. I obviously trust them enough to smoke their cigarettes, you
know, but I know no matter what cigarettes you’re ever gonna smoke, it’s gonna
cause a problem… But I don’t think their intentions are to like purposely take my life
away or anything…” (Female quit interest, Oklahoma City)
“I trust them a little bit, because I trust that if I buy a regular pack, it’s going to be
regular. And if they’re menthols, menthol.” (Male quit interest, Londonderry)
“… I don’t trust that, obviously what they’re putting in my cigarette is good, but I
know that if I’m stressed in that moment, it will help.” (Male quit interest,
Londonderry)
“Well, you’ve got to trust a little bit for keeping a good product out there…” (Male
poly-users, Jackson)
Fewer participants rated the companies on the high end of the scale (6, 7). Those who did
focused on the consistency and quality of the product, and their relative health as measures
for trust:
“The product I smoke is a quality product… I feel fine—and just me, personally—I
trust the companies are giving me the product that I’m paying for.” (Male poly-users,
Bethesda)
“It hasn’t killed me yet, and I’ve known just as many people die with lung cancer
that don’t smoke as [that do].” (Male poly-users, Jackson)
“I mean, it hasn’t been tampered with or [is] poison. You’re getting what you want.”
(Female quit interest, Jackson)
3.3
Claim Statements and Sample Tobacco Products
The moderator distributed a subset of six packs to each focus group (three each of the
Carteret and Durham brand), each with a different claim statement. Participants were
encouraged to look at the packs, feel them, and pass them around. The sections below
describe the findings across groups.
3.3.1
First Reactions to Sample Products
After passing them around, the moderator asked for initial reactions to the sample product
boxes with no cues or prompting. Some participants immediately noticed the statements
that were on the packages, whereas others talked about other aspects of the packaging. To
3-11
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
streamline discussion, the moderator focused discussion on perceptions of these other
aspects and postponed conversation about the specific statements until the next section of
the guide.
Participants reported that they were particularly struck by the coloring of the “Carteret”
packaging. It was clear that most of them had not seen an orange cigarette pack, and some
participants noted the novelty of the color. Comments on the “Durham” samples
concentrated on the perceived flavor and its appeal for men.
Several participants across types of groups noted that both brands appeared to be “value”
brands. They said the packages made it seem that these brands would be cheaper than
some of the brands they were familiar with.
“These would be the cheapest cigarettes you can find.” (Male quit interest, Oklahoma
City)
“They look rather generic.” (Male quit interest, Londonderry)
“Bottom of the shelf cigarettes.” (Male quit interest, Londonderry)
3.3.2
Perceptions of Statements
Initial reactions to the statements on the sample packages were somewhat varied within all
groups. There were no clear differences between group types. Some participants focused on
specific claim statements, whereas others looked at the group of statements all together.
Many expressed initial skepticism about the validity of the claims. Some participants were
surprised to see chemical names (e.g., formaldehyde) mentioned on a cigarette package,
either because they did not know their cigarettes contained them or because they did not
want to be reminded:
“‘No formaldehyde.’ Are you serious? That would make people be like, okay, this is
better for me because there’s no formaldehyde. But in reality, it don’t matter.” (Male
quit interest, Bethesda)
“‘100% tobacco’ is the only one that wouldn’t bother me, because I know I’m
injecting something bad for you, stop reminding me. And when you tell me there’s
less tar, they’re saying there is tar… I don’t want to think about that as I’m doing it.”
(Male current smokers, Oklahoma City)
“I think it makes me realize all the bad stuff that’s actually in a cigarette. It’s 50% of
this, so that still means there’s 50% still in there.” (Male quit interest, Oklahoma
City)
“Well, yeah. Less—we’ve got less this, less this, less this. So you’re still smoking a
cigarette, but it’s got less of all this, [so]… instead of an hour later, you’re gonna
want another 30 minutes later.” (Female current smokers, Jackson)
3-12
Section 3 — Key Findings
Understanding of Intent
Many participants across all groups said they thought the intent of the claims was to get
smokers to switch brands to something they perceived to be healthier or to recruit new
smokers who have not indicated brand loyalty.
“I think that just draws more people—and especially the people that don’t smoke
cigarettes because of all the bad stuff in them… I think it would maybe bring some
more people out of their shell to try them at least.” (Male poly-users, Bethesda)
“What it actually means to me is basically that they’re trying to get new people to
smoke. Maybe that might influence them. All of us are regular smokers. We’re going
to stay loyal [to our] brand and that’s it…. That’s just for somebody new or
whatever.” (Male light smokers, Londonderry)
“They’re promoting themselves… as a better brand.” (Female quit interest,
Londonderry)
Some participants across all types of groups said they thought the claim statements were
designed to help people feel better about their decision to smoke:
“It makes it easier to justify to yourself that it’s okay to have it.” (Male light
smokers, Londonderry)
“It’s wool over your eyes; think this is better for you… when really, it may not be
better for you.” (Female current smokers, Jackson)
“…or not even good for you. Or even: ‘We’re gonna sell these fake cigarettes for the
same money, they’re still gonna buy ‘em, and they’re thinking they’re getting what
they want when they really ain’t.’” (Female current smokers, Jackson)
A few participants said that they thought the statements were also designed to “cover” the
tobacco companies, which had been under scrutiny in recent years.
Believability
Most participants said they did not believe the statements that were presented on the
sample packages would be true (if they were on actual cigarette packages). Some types of
statements stood out as particularly problematic. For example, statements that used broad
terms like “lower” or “safer” prompted questions from some participants about the definition
of those terms and the reference points:
“Maybe this is a little lower in tar, but how much? And how much difference is that
going to make to you, and what else did they put in it to make up for that tar?”
(Female light smokers, Bethesda)
“Low and lower doesn’t mean anything. Low nicotine compared to what? None of
those have anything backing them up.” (Male poly-users, Bethesda)
3-13
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
“Especially when they’re a new brand—lower compared to what? Compared to
Marlboro Reds? Sure. You don’t really know what the comparison is, if these are all
new brands…” (Male poly-users, Bethesda)
“But when you tell someone the same satisfaction with less chemicals, well that’s the
company telling you you’ll get the same satisfaction. It’s for the consumer to decide,
‘Am I getting the same satisfaction?’” (Male current smokers, Oklahoma City)
Other participants said they did not find any of the statements believable:
“They don’t want people to quit smoking. That’s how they make their money.”
(Female light smokers, Oklahoma City)
“My deal is I don’t believe them. Just because it’s on the box, it doesn’t necessarily
mean that—like, this has happened. Just because it says 100% natural tobacco, how
do I know?” (Male current smokers, Oklahoma City)
“I think it’s all just a gimmick to get someone to buy the brand.” (Male current
smokers, Londonderry)
“I think it’s a falsehood myself, low nicotine. Because they say it’s proven that one
cigarette is just as bad as the other. Studies have shown that lights and low nicotine
are not necessarily low in nicotine. They’re not necessarily what they say they are.”
(Male quit interest, Londonderry)
A few participants said they thought there was some truth to the claims, because they
believed that the statements would have to be approved by FDA or the companies could be
sued for false advertising if they were found to be untrue.
Only some participants across groups said they would try to verify the information in the
statements. Those who said they might try to determine if they were true said that they
would look up ingredients or other information on the company’s Web site, via Google, or
another online resource.
Source
Most participants across all types of groups said they believed that statements like those
shown on the sample packages would come from the tobacco companies or manufacturers
as a way to advertise or promote a product that was perceived as “better” or “healthier.”
Some participants even specified that the statements would come from a marketing or
advertising department or agency.
“It looks like marketing… it’s just more of a quick statement for marketing: ‘this is
better than what we used to do.’” (Male current smokers, Oklahoma City)
“Yeah, because they promote themselves and they want you to pick the healthier
alternative… if they could make it seem like they’re the safer alternatives and they
put it in a pretty package and they say, ‘Here, try these,’ you’re still going to get
addicted. But you’re buying their product.” (Female quit interest, Londonderry)
3-14
Section 3 — Key Findings
3.3.3
“I think it’s the cigarette company doing as much advertising as they can since
everything else was taken away. That’s their little mini-advertisement.” (Male light
smokers, Londonderry)
Perceptions of Products
When asked how statements like those on the sample products would influence participants’
perceptions of the products, the most common reaction was that it would have no effect at
all. The participants in these groups expressed loyalty to their brand, and they emphasized
that they likely would not even notice the statements. This sentiment held true whether the
statements were proposed for versions of their current brands or for a newly introduced
brand (like Durham or Carteret).
“… after you’re smoking for so long, you’re like, ‘I already know what I want, can you
give me my [brand]?’ I don’t even know what the pack says, I couldn’t even tell you
what it says.” (Female current smokers, Bethesda)
“…when I walk into a store to buy my cigarettes, I don’t even notice any others. I
walk in, I tell them exactly what I want, I walk out.” (Female current smokers,
Bethesda)
“I would never notice it, unless it was like the whole entire box…” (Female quit
interest, Oklahoma City)
“It’s still going to be harmful, no matter what. So something like that is not going to
make me change from what I normally smoke.” (Female quit interest, Oklahoma
City)
“You wouldn’t see them at first because they’re behind the counter. Most people
can’t read that far anyway.” (Male current smokers, Londonderry)
A few participants across groups said that having the statements on the packages might
make them feel better about smoking.
“Just to try it if it… tasted almost like mine—you gotta realize, I smoke a pack a day
and if I change brands, I could live a little longer…” (Male quit interest, Oklahoma
City)
“I think it’d make you actually think about… just how much you were—taking in. And
right now, it’s no thought.” (Male poly-users, Jackson)
Personal Interest in Trying Product
When asked if they would consider trying products with statements like those on the sample
packages, brand loyalty and not wanting to try something unknown were the most
commonly mentioned reasons participants gave for declining:
“I wouldn’t waste my money on it. If I’m going to buy something that’s killing me,
I’m going to buy something I like.” (Male quit interest, Londonderry)”
3-15
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
“So I think I’m really loyal to that brand, and it wouldn’t even cross my mind, I’m
certain, to buy something else.” (Female light smokers, Bethesda)
“I’m not looking for a new cigarette. I don’t know what someone would have to do to
convince me to purchase another pack of cigarettes other than what I smoke.”
(Female current smokers, Bethesda)
Other participants said they would be interested in trying the products, especially if they
were free or if someone offered them a sample. These participants expressed curiosity
about the taste and interest in knowing whether the products would satisfy their cravings
for a cigarette.
Attention-Getting Statements
Most participants across all groups reported that they noticed statements or notices on
packages that offered discounts and coupons (e.g., $1 off; buy two, get one free). Other
statements that participants said would get their attention are unlikely to be on cigarette
packs or advertising and indicate the extent to which smokers are aware of the health
effects of smoking, of their addiction, and of their desire to overcome it.
“Non-addictive. So I can pick them up and put them down whenever I want.” (Male
light smokers, Londonderry)
“If they actually put all the ingredients on it that would get my attention. I would
actually stop and read them just to find out what I’ve been putting in myself for 30
years.” (Male current smokers, Londonderry)
“Cigarettes are no longer harmful.” (Female light smokers, Oklahoma City)
“Something positive and upbeat… on [the sample packages], they’re talking about
the bad things that are in it—which is negative marketing. They should reverse it…”
(Female current smokers, Bethesda)
Perceived Likelihood of Product Success
Participants were asked whether they thought that products like those shown as samples
would be successful if introduced in the United States. Reactions were mixed. Those who
said they thought the products would be successful saw their alleged health benefits as
consistent with the public’s interest in healthier options for food and other products as the
primary reasons. Participants emphasized that a new brand would have to be advertised
heavily and priced well in its introduction to be successful.
“Everybody’s going healthy. Everybody—now it looks like a healthy cigarette. So I
think it would blend in. Even… a smoker. It’s all in the mindset, so you’re smoking
healthier.” (Male poly-users, Jackson)
“… There’s a certain crowd it’ll appeal to just so they can feel better about
themselves.” (Female light smokers, Oklahoma City)
3-16
Section 3 — Key Findings
“…From a marketing perspective, if they were thinking of launching like a safer…
cigarette, that probably the technique would be to get it into the hands of…
influencers…” (Female light smokers, Bethesda)
Those who said they did not think the new products would be successful mentioned brand
loyalty among smokers, the difficulty breaking into a well-established and crowded market,
and a perception that the products looked cheap and generic.
“Probably not. I mean cigarette smokers are like a lot of beer drinkers. They tend to
be brand loyal.” (Male light smokers, Londonderry)
“I don’t think they could fight the big boys.” (Male quit interest, Londonderry)
“They look generic, and I don’t think the young people would go for it at all.”
(Female current smokers, Bethesda)
Target Audience for Product
The most commonly mentioned target audience for the new products focused on youth:
kids, young people, and new smokers. Participants discussed that new smokers represent
an opportunity to build brand loyalty with something new, rather than trying to change the
habits of established smokers. In addition, some participants talked about how young
people have more information about healthy behaviors and the health effects of smoking
than older adults did when they started smoking. As a result, young people may look for a
healthier alternative to currently available cigarettes:
“So you got to target newer smokers—because anyone who has been smoking for a
while or just knows the brands that are out there, they’re more likely to try one of
the old standards before they try something new.” (Male poly-users, Bethesda)
“Maybe it’s just a gradual introduction to it—and [it] doesn’t appear to be too
threatening.” (Male poly-users, Bethesda)
“You know what they say in school about [cigarettes] and try to get you not to
smoke and everything. They might go to the store and say, oh, well, look at this. It’s
probably better.” (Female light smokers, Oklahoma City)
Some participants also mentioned that the products might target people who are trying to
quit smoking:
“…if you’re trying to quit, you’re looking for lower nicotine, you’re looking for fewer
toxins… By looking at these cigarettes, the majority of these packs imply to me that
they’re… not as strong as a regular cigarette.” (Female current smokers, Bethesda)
“It advertises lower nicotine and less carbon monoxide and if you’re trying to quit
something, that’s in your face, like ‘whoa—both those things are kind of bad for me,
maybe I should quit’.” (Male light smokers, Londonderry)
3-17
4. SUMMARY
During the first round of focus groups, we investigated the product marketing,
characteristics, packaging, and other factors that consumers use to draw conclusions about
the health risks of tobacco products. In this second round of research, we focused on
gaining a better understanding of how current tobacco users might respond to cigarettes
marketed as reduced exposure or modified risk products. Trying or adopting these products
would require consumers to switch from their usual brands. As a result, we also investigated
brand loyalty among smokers, how brand loyalty might affect consumers’ perceptions of
these products, and the likelihood they would try or eventually adopt them. The findings
from these 16 focus groups will inform the development of an experimental study to assess
participants’ reactions to advertisements for tobacco products marketed as “safer” than
currently available products.
4.1
Brand Relationship
Marlboro was most commonly reported as participants’ preferred brand, followed by
Newport. Virtually all participants were brand loyal. High satisfaction with their current
brand stemmed from a combination of product taste, nicotine delivery (feelings of stress
relief and relaxation from smoking), and associative imagery conveyed by the brand’s
advertising. Participants used the product packaging and claims on the “new” brands to
draw some conclusions about the quality and characteristics of those brands. For instance,
some participants across groups noted that the fictitious brands appeared to be “value”
brands. Although extensive probing on this topic was not possible, it may be that a lesserknown, less established, and less popular brand would automatically be considered to be
“value,” “generic,” or “bottom shelf.”
Implications for experimental study: Brand loyalty will have to be carefully measured
and accounted for in the experimental study. The tobacco industry’s historical use of brand
extensions (particularly the products formerly marketed as “light”) suggests that they are
well aware of consumer resistance to brand switching and may prefer to market any
approved reduced exposure or modified risk products as an extension of current brands. In
addition to measuring and accounting for brand loyalty, we may want to consider creating
an extension of a current brand (to the extent legal) as one condition of the experimental
design.
4.2
Tobacco Companies
Focus group participants were not naïve about the tobacco industry’s history of marketing
products they knew were addictive and unhealthy. They were also well aware that tobacco
companies are in business to make a profit. However, some participants had positive
4-1
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
opinions about these companies because they felt that the cigarettes they produce are of
consistent and high quality.
Implications for experimental study: There are two general implications for the
experimental study related to participant perceptions of tobacco companies. First,
participants viewing a “bogus” brand with no large parent company may question the
consistency and quality of a brand manufactured by a company that is not recognized as a
major manufacturer. Second, some participants attributed the claims on the bogus brands
they viewed to tobacco companies. The extent to which participants find tobacco companies
credible could affect their judgments of claims on bogus brands presented in the
experimental study.
4.3
Claim Statements and Sample Tobacco Products
Participants in each focus group were exposed to six different statements. The moderator
guide was designed to elicit a general discussion about the believability of the statements as
a whole and any judgments about the products participants made as they viewed the
packages and statements. Discussion also focused generally on why and the extent to which
participants thought they or other smokers would be interested in trying the presented
products. Although the moderator guide was not designed to elicit a discussion comparing
and contrasting specific statements or types of statements, we did note some general
consensus among participants that may help FDA determine which claims—or types of
claims—would be most like those tobacco companies might use and those consumers might
find most believable.
Broad, general terms, like “lower” “safer” and “fewer,” were met with a very high
level of skepticism.
Chemical names had a mixed effect that appeared to depend less on the familiarity
of the chemical than its perceived attributes. For example, participants were familiar
with “formaldehyde” and “arsenic,” but some expressed surprise and concern that
these chemicals were in their current brands (although not in the “new” brands).
Claim statements that included chemical names (e.g., formaldehyde, ethylene oxide)
sometimes had a “boomerang” effect. In many cases, participants did not see these
statements as appealing for their health benefits. Instead, the presence of the
chemical names reminded participants of the dangerous ingredients in tobacco and
the potential harm of products that contain those chemicals.
Lower nicotine was not perceived favorably, as participants expressed concern about
not getting the level of nicotine they got from their current product.
There were no clear conclusions about the effect of including “credentials” (e.g., a
source like the “U.S. Toxicological Association) on participant reactions to the claims.
However, most participants said they thought these claims would come from the
tobacco companies. As summarized earlier, participants may have trust in the
consistency and the quality of the products these companies produce, but most did
4-2
Section 4 — Summary
not appear to find the companies trustworthy in other domains. Some participants
questioned whether similar claims might come from FDA or would have to be
approved by FDA and might therefore be more credible than those developed by the
tobacco industry.
Finally, all of the focus group participants were well-established smokers, with a majority of
smokers saying that they had smoked for 5 years or more. A subset of participants were
identified as potential quitters. Most participants expressed little interest in trying these
products, although there was some openness to these products among a few smokers
interested in quitting.
4-3
APPENDIX A:
MODERATOR GUIDE
OMB Control No. 0910-0497
Expiration Date: 06/30/2014
Paperwork Reduction Act Statement
The public reporting burden for this collection of information has been estimated to average
1.1 hours per response, including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information.
An agency may not conduct or sponsor, and a person is not required to respond to, a
collection of information unless it displays a currently valid OMB control number.
Moderator’s Guide:
Consumer Knowledge and Perceptions about Tobacco Products
(Round 2)
Welcome and Ground Rules
MODERATOR: Welcome and thank you for participating in tonight’s discussion. My name is
_________________. Tonight, I am interested in hearing your opinions about tobacco
products. You have been asked to participate in tonight’s discussion because you use (or
have used) some of the various types of cigarettes and other tobacco products that we are
going to discuss tonight.
Before we begin, I want to go over a few ground rules for our discussion tonight, which will
last about an hour.
Your participation is voluntary and you have the right to not answer any question or
withdraw from the study at any time.
If at any time you are uncomfortable with my questions, you can choose not to
answer. Just let me know that you prefer not to answer.
Everything we discuss today will be kept private to the extent allowable by law. Your
name and contact information, which only the study staff knows, will not be given to
anyone else and no one will contact you after this interview is over.
Tonight’s discussion will be audio recorded. The recordings will help me write the
final report and will be kept in a secure location and then destroyed at the end of the
study. No names will be mentioned in the final report created from these interviews.
[If applicable: Some of my coworkers are viewing our discussion. Some are watching
from behind this glass and some are viewing the discussion remotely. They’re
watching to make sure that I ask you all of the questions I’m supposed to ask you.
Near the end of our conversation, I’m going to go check and see if they have any last
minute questions for you.]
Most importantly, there are no right or wrong answers. I want to know your
opinions. I do not work for the people sponsoring this research and I didn’t write the
A-1
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
questions we’re going to look at, so don’t hold back on giving me your honest
opinions.
I’m not a medical doctor or an expert on smoking or tobacco, so I can’t answer
specific questions. At the end of our discussion, however, I have some materials that
you can take with you if you’d like.
Please silence your cell phones.
Do you have any questions before we begin?
Brand Relationship
1. Introduction (5 minutes)
As I mentioned, tonight’s discussion is about cigarettes and other tobacco products.
You’ve been invited to participate because you all have firsthand experience with
tobacco—which means you have a lot of information to share.
We are going to start by talking about the cigarettes you smoke. To start: Let’s go
around the room and have everyone tell us your first name, what brand of
cigarettes you currently use, and how long you have been using that brand.
2. Relationship with Brand: Attitudes (5 minutes)
[HANDOUT 1 – 4–5 top of mind]
Ok, so as we heard, you all smoke a variety of different brands of cigarettes. Now I
want you to think a little more about your brand of cigarettes and answer a few
questions.
Turn to page 1 of the handout and list 4–5 words/phrases that come to mind when
you think about your brand of cigarettes. Just jot down the first things that come to
mind when you think about your brand of cigarettes. [IF NEEDED: You don’t need to
write a lot here—or spend too long on this.]
What are some of the things you wrote down?
3. Relationship with Brand: Interaction (5 minutes)
So, thinking about the company that makes your cigarettes, let’s talk about how you
interact with them.
Are there ways—other than purchasing their cigarettes—that you interact with them?
Have you ever contacted them? (Have you ever called? Or visited their website?)
Maybe you’ve participated in a loyalty program or contest they’ve run?
Does your brand contact you? Are you on any listservs or mailing lists?
Do you receive offers or coupons from the company that makes your brand?
How often do you hear from them?
Is there any other type of communication you receive on a regular basis?
(What is it?)
How do you feel about them contacting you?
4. Tobacco Companies: Attitudes (5 minutes)
[HANDOUT 2 – p.2 – top of mind and industry trust]
A-2
Appendix A — Moderator Guide
Ok, now we’re going to think about tobacco companies in general. Turn to the last
handout and take a minute to complete these two questions about tobacco
companies. [IF NEEDED: When we say, “Tobacco Companies,” we are talking about
tobacco companies in general/overall, not the company that makes your brand]
When you hear the words “tobacco companies,” what comes to mind?
[Write responses on white board.]
How do “tobacco companies” relate to their customers? How do “tobacco
companies” view their customers?
How trustworthy would you say “tobacco companies” are in general?
[If not mentioned above: When you think about “tobacco companies,” do you think
of your brand of cigarettes—or something different?]
5. Statements and Products
Introduction of Prototypes (10 minutes)
Ok, now we’re going to look at some sample products. This is a brand that was made
up for the sake of tonight’s discussion. We are using this made-up brand because we
wanted to give you a cigarette pack to react to, but since you all smoke different
brands of cigarettes, we didn’t want to pick any one specific brand.
Note to moderator: If participants get distracted by novelty of brand (e.g., “well, I
can’t say because I don’t know this brand”), redirect with, “Well, imagine this was
your brand. How would you feel about it then?”
First reactions to prototypes: Pass around prototypes.
What do you think of this product? What comes to mind when you see this?
Perceptions of Statements (10 minutes)
(prototypes stay in circulation.)
a. What comes to mind when you read these statements?
b. Understanding: What do you think these statements mean?
c. Believability: Do you believe these statements? Any of them? Why or why not?
Do some seem more believable than others? Which ones? Why?
d. Source/Attribution: Who is making the statement?
Are tobacco companies allowed to make statements like this (or make any
kind of statement they want)? If not, who would stop them?
Can you imagine this coming from another source (than already mentioned)?
[The government? Tobacco Companies? Public Health Organization? Medical
Association?]
What would it look like if it came from [Gov/Industry/Brand]? What would be
different?
e. Verification: How would you decide whether or not this statement is true? Where
could you look for more information? Who would/could you ask to determine
whether or not these statements are true?
f.
Intention of claims: What is the purpose of this statement? Who is it intended
for?
A-3
Consumer Perceptions of Modified Risk/Reduced Exposure Cigarette Claims
g. Product type: What other type of tobacco product can you imagine these
statements being applied to? (Cigarettes? Another type of tobacco product? A
product that doesn’t exist yet?)
Perceptions of Product (with Statement) (10 minutes)
a. Would you be interested in trying this product? Why or why not? What would
interest you? What would make you hesitant to try it?
[If not mentioned] Do you have an idea of how it would taste? Would it
satisfy your craving for a cigarette?
If not interested: What kind of statement would get your attention? Is there
something you can imagine seeing on a cigarette package that would get your
attention? (Do you think that’s realistic?)
If a tobacco product with a statement like this were sold in the U.S., would it
be successful? Why or why not?
Who would be interested in trying this product?
Who would use this product (on a regular basis)?
b. What would people think of you if they saw you using a product like this? Would
it be positive or negative?
False Close
That is all the questions I have for you. Before we finish, I’m going to run back and check
with my colleagues to see if I missed anything or if they have any additional questions for
you.
Debrief/Closing (5 minutes)
In today’s discussion, we mentioned some statements about less harmful tobacco products,
and viewed some examples of products claiming to be less harmful. It’s important for you to
know that the statements I showed you, and the sample package of cigarettes, were madeup for the sake of tonight’s discussion. In other words, they are hypothetical and those
products and statements do not actually exist. In fact: There is no safe tobacco product.
This study was sponsored by the Food & Drug Administration. Part of the mission of the FDA
is to communicate to the public about the harmfulness of tobacco use. In order to do this, it
is important that they understand people’s thoughts about different types of tobacco
products—and about the harmfulness of tobacco products in general. Your participation has
been very valuable and we appreciate you taking the time to come here tonight and share
your thoughts and ideas with us.
If you are interested in learning more, please help yourself to one of these brochures on
your way out.
A-4
APPENDIX B:
HANDOUTS
Handout #1—Think about your brand of cigarettes. Please write the first words or
phrases that come to mind.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Handout #2—Think about tobacco companies in general. Please write the first words or
phrases that come to mind.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
How much trust do you feel for tobacco companies? (Circle your response)
Not
At All
1
Very
Much
2
3
4
5
6
7
B-1
| File Type | application/pdf |
| Author | murchie |
| File Modified | 2015-12-29 |
| File Created | 2015-12-29 |