{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T11:11:56Z","timestamp":1781521916317,"version":"3.54.1"},"reference-count":25,"publisher":"BMJ","issue":"6","funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U54CA180905"],"award-info":[{"award-number":["U54CA180905"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010628","name":"Center for Tobacco Products","doi-asserted-by":"publisher","award":["U54CA180905"],"award-info":[{"award-number":["U54CA180905"]}],"id":[{"id":"10.13039\/100010628","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Tob Control"],"accepted":{"date-parts":[[2024,7,9]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We tested whether snus marketing with modified risk tobacco product (MRTP) claims: (a) promotes accurate knowledge about snus\u2019s health effects in young adults and (b) encourages use intentions in only those who use combustible tobacco without attracting other young adult populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A randomised between-subjects experiment was embedded in a 2020 web survey of participants from Los Angeles (aged 19\u201323 years). Participants viewed mass-marketed snus advertising materials with (n=1212) vs without (n=1225) US Food and Drug Administration-authorised MRTP claims. After advertising exposure, snus use intention and perceptions of snus harms relative to cigarettes or e-cigarettes were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Advertisements with versus without MRTP claims did not affect snus use intention (18.0% vs 19.4%) but produced a higher prevalence of perceptions that snus was less harmful than cigarettes (12.6% vs 9.1%; p=0.007) and e-cigarettes (8.0% vs 5.8%; p=0.04). MRTP claim exposure effects did not differ by past 30-day e-cigarette or combustible tobacco use. Snus use intentions after marketing exposure, collapsed across MRTP claim conditions, were higher in those who did versus did not report past 30-day use of e-cigarettes (38.4% vs 14.3%; adjusted OR (95%\u2009CI) 2.95 (2.28 to 3.81); p&lt;0.001) or combustible tobacco (44.0% vs 16.2%; adjusted OR (95%\u2009CI) 2.26 (1.62 to 3.16); p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although some young adults who vape or smoke may have snus use intentions, snus MRTP claims might not affect young adults\u2019 snus use intentions, regardless of whether they vape\/smoke. MRTP claims might modestly increase the accuracy of perceived harms of snus relative to cigarettes while also slightly causing unsubstantiated perceptions of lower harm than e-cigarettes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/tc-2024-058651","type":"journal-article","created":{"date-parts":[[2024,7,31]],"date-time":"2024-07-31T14:53:19Z","timestamp":1722437599000},"page":"733-738","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Effects of exposure to snus marketing with versus without modified risk tobacco product claims on snus use intention and perceived harm among young adults"],"prefix":"10.1136","volume":"34","author":[{"given":"Reid C","family":"Whaley","sequence":"first","affiliation":[{"name":"Department of Population and Public Health Sciences, Keck School of Medicine University of Southern California, Los Angeles, California, USA"},{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7193-8720","authenticated-orcid":false,"given":"Erin A","family":"Vogel","sequence":"additional","affiliation":[{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"},{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana Coba","family":"Clementel","sequence":"additional","affiliation":[{"name":"Dana and David Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3331-0326","authenticated-orcid":false,"given":"Jessica L","family":"Barrington-Trimis","sequence":"additional","affiliation":[{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"},{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"McConnell","sequence":"additional","affiliation":[{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"},{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Sussman","sequence":"additional","affiliation":[{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"},{"name":"Departments of Population and Public Health Sciences and Psychology, and School of Social Work, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6744-6988","authenticated-orcid":false,"given":"Alyssa F","family":"Harlow","sequence":"additional","affiliation":[{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"},{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9064-6603","authenticated-orcid":false,"given":"Jennifer B","family":"Unger","sequence":"additional","affiliation":[{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"},{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3818-141X","authenticated-orcid":false,"given":"Alayna P","family":"Tackett","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1217-525X","authenticated-orcid":false,"given":"Adam M","family":"Leventhal","sequence":"additional","affiliation":[{"name":"USC Institute for Addiction Science, Los Angeles, California, USA"},{"name":"Department of Population and Public Health Sciences, University of Southern California, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,7,31]]},"reference":[{"key":"2025121203350793000_34.6.733.1","unstructured":"National Cancer Institute and Centers for Disease Control and Prevention . Smokeless Tobacco and Public Health: A Global Perspective. Bethesda, MD: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Institutes of Health, National Cancer Institute, 2014:14\u20137983."},{"key":"2025121203350793000_34.6.733.2","doi-asserted-by":"publisher","DOI":"10.1136\/tc.12.4.349"},{"key":"2025121203350793000_34.6.733.3","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2011.191"},{"key":"2025121203350793000_34.6.733.4","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/ckw032"},{"key":"2025121203350793000_34.6.733.5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1607538"},{"key":"2025121203350793000_34.6.733.6","unstructured":"FDA grants first-ever modified risk orders to eight smokeless tobacco products. U.S. Food and Drug Administration. n.d. Available: https:\/\/www.fda.gov\/news-events\/press-announcements\/fda-grants-first-ever-modified-risk-orders-eight-smokeless-tobacco-products"},{"key":"2025121203350793000_34.6.733.7","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17186807","article-title":"Smokers\u2019 and young adult non-smokers\u2019 perceptions and perceived impact of snus and E-cigarette modified risk messages","volume":"17","author":"Wackowski","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2025121203350793000_34.6.733.8","doi-asserted-by":"crossref","DOI":"10.1016\/j.pmedr.2021.101608","article-title":"Exploring the implications of modified risk claim placement in tobacco advertising","volume":"24","author":"Wackowski","year":"2021","journal-title":"Prev Med Rep"},{"key":"2025121203350793000_34.6.733.9","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-14-997","article-title":"Nonsmokers\u2019 responses to new warning labels on smokeless tobacco and electronic cigarettes: an experimental study","volume":"14","author":"Popova","year":"2014","journal-title":"BMC Public Health"},{"key":"2025121203350793000_34.6.733.10","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntv140"},{"key":"2025121203350793000_34.6.733.11","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2018-054315"},{"key":"2025121203350793000_34.6.733.12","doi-asserted-by":"crossref","first-page":"107016","DOI":"10.1016\/j.addbeh.2021.107016","article-title":"Perception and intention of using less harmful and less addictive hypothetical modified risk tobacco products among never tobacco users in the United States","volume":"122","author":"Ahuja","year":"2021","journal-title":"Addict Behav"},{"key":"2025121203350793000_34.6.733.13","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1111\/add.13952","article-title":"Adult interest in using a hypothetical modified risk tobacco product: findings from wave 1 of the population assessment of tobacco and health study (2013-14): adult interest in using a modified risk tobacco product","volume":"113","author":"Pearson","year":"2018","journal-title":"Addiction"},{"key":"2025121203350793000_34.6.733.14","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph18020576","article-title":"Harm perceptions and beliefs about potential modified risk tobacco products","volume":"18","author":"Morgan","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2025121203350793000_34.6.733.15","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2019-055560"},{"key":"2025121203350793000_34.6.733.16","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.8950"},{"key":"2025121203350793000_34.6.733.17","doi-asserted-by":"publisher","DOI":"10.1037\/0278-6133.15.5.355"},{"key":"2025121203350793000_34.6.733.18","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056479"},{"key":"2025121203350793000_34.6.733.19","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19052685","article-title":"Differences in young adults\u2019 perceptions of and willingness to use nicotine pouches by tobacco use status","volume":"19","author":"Vogel","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025121203350793000_34.6.733.20","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/ntr\/ntaa159","article-title":"Smokers\u2019 exposure to perceived modified risk claims for e-cigarettes, snus, and smokeless tobacco in the United States","volume":"23","author":"Wackowski","year":"2021","journal-title":"Nicotine Tob Res"},{"key":"2025121203350793000_34.6.733.21","doi-asserted-by":"publisher","DOI":"10.1093\/ntr\/ntaa239"},{"key":"2025121203350793000_34.6.733.22","doi-asserted-by":"publisher","DOI":"10.1136\/tobaccocontrol-2021-056810"},{"key":"2025121203350793000_34.6.733.23","doi-asserted-by":"crossref","unstructured":"Johnston LD , Miech RA , O\u2019Malley PM , et al . Monitoring the future national survey results on drug use 1975-2020: overview, key findings on adolescent drug use. 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