{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T11:40:02Z","timestamp":1765539602384,"version":"3.48.0"},"reference-count":20,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"crossref","award":["U54DA036151"],"award-info":[{"award-number":["U54DA036151"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2024,8,6]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nicotine products increasingly contain synthetic nicotine made in a lab (NML), not from tobacco. \u2018Tobacco-free nicotine\u2019 is most often used to describe NML commercially, but other descriptors are emerging (eg, \u2018non-tobacco,\u2019 \u2018zero-tobacco\u2019). We examined whether terms for NML differentially impact public understanding of nicotine source or risk perceptions relative to each other and to terms for describing nicotine from tobacco (NFT) as \u2018tobacco-derived.\u2019<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>From December 2022 to April 2023, 1000 participants aged 13 and older completed an online survey (mean age: 33.02 (SD=18.15) years, 50.5% female, 16.6% Hispanic, 67.4% White and 79.8% with current tobacco use). Participants read 11 terms describing nicotine and reported on perceived nicotine source (ie, NML, NFT) and addictiveness. Rank-ordered harm was included as a sensitivity analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Significant differences were observed among terms (eg, \u2018zero tobacco nicotine\u2019 and \u2018no tobacco nicotine\u2019 were rated as least addictive overall). \u2018NML\u2019 and \u2018NFT\u2019 adequately conveyed nicotine source and were rated as conveying comparable, yet high addictiveness, making them the optimal terms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many terms for NML and NFT are differentially related to understanding nicotine source and risk perceptions even though no existing research indicates that NML and NFT differ meaningfully from each other on characteristics like addictiveness. In the absence of prohibiting product differentiation by nicotine source, regulatory agencies should promote using the terms \u2018Nicotine from Tobacco\u2019 and \u2018Nicotine Made in a Lab\u2019 and investigate whether products using descriptors conveying reduced harm (eg, \u2018zero-tobacco,\u2019 \u2018no-tobacco,\u2019 \u2018non-tobacco\u2019) should require review as Modified Risk Tobacco Products.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2024-058649","type":"journal-article","created":{"date-parts":[[2024,8,26]],"date-time":"2024-08-26T00:36:00Z","timestamp":1724632560000},"page":"768-774","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Words matter: descriptors for nicotine that comes from tobacco and descriptors for synthetic nicotine that is created in a laboratory differentially impact understanding of nicotine source and risk perceptions"],"prefix":"10.1136","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4865-1155","authenticated-orcid":false,"given":"Meghan Elizabeth","family":"Morean","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie S","family":"O'Malley","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suchitra","family":"Krishnan-Sarin","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,8,21]]},"reference":[{"key":"2025121203351139000_34.6.768.1","unstructured":"Ramamurthi D , Chau C , Lu Z , et al . Marketing of \u201ctobacco-free\u201d and \u201csynthetic nicotine\u201d products. Stanford research into the impact of tobacco advertising. 2022. Available: https:\/\/tobacco-img.stanford.edu\/wp-content\/uploads\/2022\/03\/13161808\/Synthetic-Nicotine-White-Paper-3-8-2022F.pdf [Accessed 13 Feb 2024]."},{"key":"2025121203351139000_34.6.768.2","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056552"},{"key":"2025121203351139000_34.6.768.3","unstructured":"United States Food and Drug Administration . Regulation and enforcement of Non-Tobacco Nicotine (NTN) products. 2023. Available: https:\/\/www.fda.gov\/tobacco-products\/products-ingredients-components\/regulation-and-enforcement-non-tobacco-nicotine-ntn-products#Does%20FDA%20regulate%20NTN [Accessed 10 Apr 2024]."},{"key":"2025121203351139000_34.6.768.4","first-page":"35","article-title":"Synthetic Nicotine: Science, Global Legal Landscape, and Regulatory Considerations","volume":"1047","author":"Berman","year":"2023","journal-title":"World Health Organ Tech Rep Ser"},{"key":"2025121203351139000_34.6.768.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0268464","article-title":"Does it come from tobacco? Young adults\u2019 interpretations of the term \u201ctobacco-free nicotine\u201d in a cross-sectional national survey sample","volume":"17","author":"Morean","year":"2022","journal-title":"PLoS One"},{"key":"2025121203351139000_34.6.768.6","doi-asserted-by":"publisher","DOI":"10.1136\/tc-2023-058133"},{"key":"2025121203351139000_34.6.768.7","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-neuro-061010-113734"},{"key":"2025121203351139000_34.6.768.8","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1080\/10810730.2023.2217431","article-title":"Tobacco Free Nicotine Vaping Products: A Study of Health Halo Effects Among Middle School Youth","volume":"28","author":"Katz","year":"2023","journal-title":"J Health Commun"},{"key":"2025121203351139000_34.6.768.9","doi-asserted-by":"publisher","DOI":"10.1136\/tc-2023-057928"},{"key":"2025121203351139000_34.6.768.10","doi-asserted-by":"crossref","first-page":"107296","DOI":"10.1016\/j.ypmed.2022.107296","article-title":"Curiosity, use, and perceptions of \u201ctobacco-free nicotine\u201d E-cigarettes among U.S. young adults","volume":"164","author":"Camenga","year":"2022","journal-title":"Prev Med"},{"key":"2025121203351139000_34.6.768.11","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056957"},{"key":"2025121203351139000_34.6.768.12","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntac204"},{"key":"2025121203351139000_34.6.768.13","unstructured":"Qualtrics . Fraud detection. n.d. Available: https:\/\/www.qualtrics.com\/support\/survey-platform\/survey-module\/survey-checker\/fraud-detection\/"},{"key":"2025121203351139000_34.6.768.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ssresearch.2011.05.002"},{"key":"2025121203351139000_34.6.768.15","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.addbeh.2018.12.005","article-title":"Youth perception of harm and addictiveness of tobacco products: Findings from the Population Assessment of Tobacco and Health Study (Wave 1)","volume":"92","author":"Strong","year":"2019","journal-title":"Addict Behav"},{"key":"2025121203351139000_34.6.768.16","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.addbeh.2016.12.013","article-title":"Racial\/ethnic differences in electronic cigarette knowledge, social norms, and risk perceptions among current and former smokers","volume":"67","author":"Webb Hooper","year":"2017","journal-title":"Addict Behav"},{"key":"2025121203351139000_34.6.768.17","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1093\/ntr\/ntac245","article-title":"Disparities in Nicotine Addictiveness and Cancer Harm Perceptions Among U.S. Adults: A Trend Analysis Using the Health Information National Trends Survey","volume":"25","author":"Peterson","year":"2023","journal-title":"Nicotine Tob Res"},{"key":"2025121203351139000_34.6.768.18","doi-asserted-by":"crossref","first-page":"306","DOI":"10.3109\/16066359.2012.727505","article-title":"A systematic review of smoking Youths\u2019 perceptions of addiction and health risks associated with smoking: Utilizing the framework of the health belief model","volume":"21","author":"Mantler","year":"2013","journal-title":"Addiction Research & Theory"},{"key":"2025121203351139000_34.6.768.19","doi-asserted-by":"publisher","DOI":"10.1111\/add.15634"},{"key":"2025121203351139000_34.6.768.20","unstructured":"United States Food and Drug Administration . Warning letter. 2015. Available: https:\/\/truthinadvertising.org\/wp-content\/uploads\/2015\/09\/FDA-warning-letter-Santa-Fe-Natural-Tobacco-Co.pdf [Accessed 10 Apr 2024]."}],"container-title":["Tobacco Control"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tc-2024-058649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T11:35:19Z","timestamp":1765539319000},"score":1,"resource":{"primary":{"URL":"https:\/\/tobaccocontrol.bmj.com\/lookup\/doi\/10.1136\/tc-2024-058649"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,21]]},"references-count":20,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,12,10]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/tc-2024-058649"],"URL":"https:\/\/doi.org\/10.1136\/tc-2024-058649","relation":{},"ISSN":["0964-4563","1468-3318"],"issn-type":[{"type":"print","value":"0964-4563"},{"type":"electronic","value":"1468-3318"}],"subject":[],"published":{"date-parts":[[2024,8,21]]}}}