Can Exposure to Brief Messages Correct Misperceptions?

Johns Hopkins Bloomberg School of Public Health

Status: Completed

Conditions: Beliefs

Treatments: Behavioral: Coherent corrective messages

Study type: Interventional

Funder types: Other

Identifiers

NCT05129592

00015120A

Details and patient eligibility

About

This study seeks to assess the efficacy of educational messages to correct misperceptions. A large proportion of the American population incorrectly believes that nicotine is the chemical responsible for causing cancer in tobacco products.1-3 This misconception may reduce the likelihood that established smokers who are unwilling or unable to quit tobacco product use completely will switch to less harmful non-combustible products. An online experiment will be used to test if corrective messages can reduce this misperception. The experiment will also test the effects of messages on beliefs about the relative harms of other tobacco products discussed in the message and accuracy of inferential beliefs. This will be accomplished by asking participants questions about two tobacco products that are not explicitly discussed in the messages. The experiment will test if the two components of "narrative coherence," a concept identified in previous reviews of misperception correction as effective,4-6 is effective at reducing misperceptions about nicotine. Component 1 provides an explanation for why the new information is correct and component 2 provides an explanation for how the false information came to be believed. This study will use a factorial design to test the efficacy of the component of coherence individually as well as together. Hypotheses and Research Questions:

RQ1: Will participants exposed to different corrective message conditions differ in increased accuracy of beliefs (a) that nicotine does not cause cancer, (b) regarding the relative risk of e-cigarettes compared to cigarettes, (c) regarding the relative risk of very low nicotine cigarettes (VLNC) compared to cigarettes and (d) regarding the relative risk of nicotine replacement therapy compared to cigarettes.

H1: Participants exposed to the nicotine corrective message with both components of coherence will be significantly more likely to increase accuracy of beliefs regarding the relative harms of (a) smokeless tobacco compared to cigarettes and (b) cigarillos relative to cigarettes compared to those exposed to messages with just one component or no components of coherence.

H2: Participants exposed to the nicotine corrective message with both components of coherence will be significantly more likely to increase their intention to switch completely to a noncombustible product compared to those exposed to messages with just one component or no components of coherence.

Enrollment: 193 patients

Sex: All

Ages: 21 to 99 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Are established smokers (have smoked at least 100 cigarettes in their lifetime and currently smoke some or all days)
• Are 21 years of age or older (the legal age of tobacco purchase in the US)
• Have not completed the cognitive interview during message pre-testing.
• Rate their agreement with the following statement as at least 50 out of 100: "To what extent do you agree with the following statement: The substance nicotine causes cancer."
• Are registered with MTurk in the United States.
• Have completed >= 5,000 HIITs within the MTurk system
• Have a HIIT approval rating of >= 97%

Exclusion criteria

• Are not established smokers
• Are younger than 21 years of age
• Participated in cognitive interviews during message pre-testing
• Are not registered with MTurk in the US
• Have completed < 5,000 HIITS
• Have a HIIT approval rating of <97%
• Rate their agreement with the following statement as less than 50 out of 100: "To what extent do you agree with the following statement: The substance nicotine causes cancer."

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Factorial Assignment

Masking: Single Blind

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193 participants in 4 patient groups

Nicotine corrective control

Active Comparator group

Description:

A factual message about nicotine that does not contain a causal explanation for what actually causes tobacco-caused disease or an explanation for why the misperception that nicotine causes cancer may have come to be believed.

Treatment:

Behavioral: Coherent corrective messages

Nicotine corrective with causal explanation

Experimental group

Description:

A factual message about nicotine that contain a causal explanation for what actually causes tobacco-caused disease: tar and chemicals created in tobacco smoke when tobacco is lit on fire.

Treatment:

Behavioral: Coherent corrective messages

Nicotine corrective with reason for misperception

Experimental group

Description:

A factual message about nicotine that contains an explanation for why the misperception may have come to be believed: that health messaging often discuses nicotine and tobacco-caused disease at the same time and people incorrectly make the connection that nicotine causes cancer.

Treatment:

Behavioral: Coherent corrective messages

Nicotine corrective with both components of coherence

Experimental group

Description:

A factual message about nicotine that contains both a causal explanation for what actually causes tobacco-caused disease and an explanation for why the misperception may have come to be believed.

Treatment:

Behavioral: Coherent corrective messages