From Perceptions to Behaviors: A Comprehensive Approach to Examine the Impact of Public Health Communication Messaging about the Continuum of Risk for Tobacco Products

PROJECT SUMMARY Effective communication strategies are urgently needed to convey the relative risks of tobacco products accurately among adults who currently use combustible tobacco while minimizing such appeal among youth populations. There is a significant gap in research on the impacts of communicating the continuum of tobacco products risks to diverse audiences. Current research has primarily been limited to cross-sectional studies of single message exposures among adults. As such, there is insufficient evidence on how messaging about the continuum of risk of tobacco products would influence the message response, receptivity, behavioral precursors, and tobacco use behaviors among the diverse audiences that these messages must reach. The long-term objective of this project is to optimize future public health communication on the continuum of risk for tobacco products to minimize tobacco use harms among adults who use tobacco products and prevent youth initiation and progression of tobacco product use. Our proposed project, in direct response to RFA-OD-23-021, will assess the effects of FDA tobacco product risk continuum messaging on adult users of combustible tobacco products (including those who have not yet been able to quit) and youth/young adults using an integrated study design that captures the full range of relevant outcomes, from immediate message response and receptivity to longer-term behavior. This project is guided by a theoretical framework integrating key constructs in health communication (Message Impact Framework), persuasion (McGuire's persuasion framework), behavioral economics, and behavioral change theories (Reasoned Action). Our specific aims are to: (1) Generate rankings of messages and identify effective message features based on perceived message effectiveness, and message comprehension; (2) Characterize effects of messages and message features on response and receptivity, and precursors to behavior, including behavioral intentions, and (3) Specify immediate and long-term behavioral effects of tobacco product risk continuum messages. Approach: We will deploy a nimble framework to: refine messaging and develop control messages (message rating survey, cognitive interviews); formally test message response, receptivity, and effects on behavioral precursors (online national experiments, eye-tracking and neuroimaging); and assess immediate and long-term effects on behavior (mobile device-based message delivery and laboratory smoking topography studies) among samples of adults who use combustible tobacco, youth/young adults who use non-combustible tobacco, and youth/young adults who do not use tobacco. Impact: The successful completion of this project will provide FDA with clear, rigorous, and comprehensive evidence regarding the effectiveness of the specific messages provided for this study, as well as theory-informed insights regarding broader message strategies to optimize future public health communication on the continuum of risk for tobacco products to diverse audiences.