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Objective: In 2017, the U.S. Food and Drug Administration (FDA) announced a proposed regulation to lower nicotine in cigarettes to minimally addictive levels to help smokers quit. We sought to explore effective message strategies communicating about nicotine reduction in cigarettes across the different key audiences that the regulation is most likely to influence.

Methods: We designed four types of messages: efficacy messages, risk messages, a message about alternative sources of nicotine, and a compensation message. Sixteen virtual focus groups were conducted in Atlanta and San Francisco in April-May 2020. Data were analyzed in NVivo 12.0 using a thematic analysis approach.

Findings: Exclusive smokers were receptive to both efficacy messages and risk messages. Dual users were the only group that was open to resorting to alternative sources of nicotine. Former smokers were critical of these messages as promoting the new kinds of cigarettes and potentially encouraging initiation and relapse of smoking. Nonsmokers felt that efficacy messages downplayed the risks of smoking and did not scare people away from smoking. Presenting information that very low nicotine cigarettes (VLNCs) still contain harmful chemicals made smokers question continued smoking in the absence of nicotine and view VLNCs as harmful.

Conclusions: Messages communicating about nicotine reduction in cigarettes might help to motivate smokers to quit and can correct the misperceptions that VLNCs are less harmful. The FDA should consider specific target audiences and use different messages that complement each other in communicating about this regulation.


Author accepted manuscript version of an article published in:

Duong HT, Loud EE, Thrasher JF, et al ‘It brings light to what you really put into your body’: a focus group study of reactions to messages about nicotine reduction in cigarettes Tobacco Control Published Online First: 16 April 2021. doi:


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