{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T22:24:36Z","timestamp":1776205476320,"version":"3.50.1"},"reference-count":50,"publisher":"BMJ","issue":"3","funder":[{"DOI":"10.13039\/501100001505","name":"Health Research Council of New Zealand","doi-asserted-by":"publisher","award":["19\/641"],"award-info":[{"award-number":["19\/641"]}],"id":[{"id":"10.13039\/501100001505","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2023,12,13]]},"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n<jats:title>Background<\/jats:title>\n<jats:p>Aotearoa New Zealand proposed a new maximum nicotine content of 0.8\u2009mg\/g for smoked tobacco products, although the new government plans to repeal this legislation. Requiring \u2018Very low nicotine\u2019 (VLN) messages on cigarettes meeting this standard may reinforce misperceptions that they are less harmful than cigarettes currently sold.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>To explore knowledge of nicotine and very low nicotine cigarettes (VLNCs), and perceptions of cigarette packs featuring different low nicotine messages (eg, \u2018Very low nicotine\u2019) and mitigating statements (eg, \u2018No cigarettes are safe\u2019), we surveyed 354 people who smoked, 142 who formerly smoked, and 214 people who had never smoked regularly.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>\nAround half of all respondents believed VLNCs were less harmful than regular cigarettes and around two-thirds incorrectly thought nicotine causes most of the related health problems resulting from smoking. Nearly a third thought VLNCs would be\n<jats:italic>less<\/jats:italic>\nharmful than regular cigarettes; 34% believed they would be just as harmful. Mitigating statements did not affect perceptions of people who smoked, although people who formerly, or who had never smoked regularly, perceived mitigating statements referring to poisons and cancer as significantly more likely than the VLN message to discourage smoking.\n<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Misunderstanding of VLNCs as less harmful than regular cigarettes is widespread; VLN messages may reinforce this misperception, which mitigating statements did not correct among people who smoke. As an alternative to VLN messages, policy makers could consider introducing VLNCs on a specified date and developing public information campaigns; these measures would avoid phase-in confusion and obviate the need for VLN messaging.<\/jats:p>\n<\/jats:sec>","DOI":"10.1136\/tc-2023-058353","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T01:13:17Z","timestamp":1704849197000},"page":"323-329","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Nicotine beliefs and perceptions of low nicotine labels and mitigating statements among people who do and do not smoke: a cross-sectional study from Aotearoa New Zealand"],"prefix":"10.1136","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2459-6393","authenticated-orcid":false,"given":"Philip","family":"Gendall","sequence":"first","affiliation":[{"name":"Public Health, University of Otago Wellington, Wellington, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3450-4579","authenticated-orcid":false,"given":"Lucy","family":"Popova","sequence":"additional","affiliation":[{"name":"School of Public Health, Georgia State University, Atlanta, Georgia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Thrasher","sequence":"additional","affiliation":[{"name":"Health Promotion, Education, and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4362-1539","authenticated-orcid":false,"given":"Janet","family":"Hoek","sequence":"additional","affiliation":[{"name":"Public Health, University of Otago Wellington, Wellington, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,1,9]]},"reference":[{"key":"2025101704051678000_34.3.323.1","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2012-050820"},{"key":"2025101704051678000_34.3.323.2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsr1714617"},{"key":"2025101704051678000_34.3.323.3","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntz162"},{"key":"2025101704051678000_34.3.323.4","unstructured":"Food and Drug Administration . FDA\u2019s comprehensive plan for tobacco and nicotine regulation. 2019. 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