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Mutti S.,University of Waterloo | Hammond D.,University of Waterloo | Borland R.,The Cancer Council Victoria | Cummings M.K.,Roswell Park Cancer Institute | And 3 more authors.
Addiction | Year: 2011

Aims To examine perceptions of risk related to type of cigarette brand. Design and setting Cross-sectional findings from wave 5 of the ITC Four Country Survey, conducted with nationally representative samples of smokers in 2006. Participants A total of 8243 current and former adult (≥18 years) smokers from Canada (n=2022), the United States (n=2034), the United Kingdom (n=2019) and Australia (n=2168). Measurements Outcomes included beliefs about the relative risks of cigarettes, including perceptions of 'own' brand. Correlates included socio-demographic, smoking-related covariates and brand characteristics. Findings One-fifth of smokers believed incorrectly that 'some cigarette brands could be less harmful' than others. False beliefs were higher in both the United States and United Kingdom compared to Canada and Australia. Smokers of 'light/mild', 'slim' and 100mm/120mm cigarettes were more likely to believe that some cigarettes could be less harmful [odds ratio (OR)=1.29, 95% confidence interval (CI)=1.12-1.48 and that their own brand might be a little less harmful (OR=2.61, 95% CI=2.01-3.41). Smokers of 'gold', 'silver', 'blue' or 'purple' brands were more likely to believe that their 'own brand might be a little less harmful' compared to smokers of 'red' or 'black' brands (OR=12.48, 95% CI=1.45-107.31). Conclusions Despite current prohibitions on the words 'light' and 'mild', smokers in western countries continue to falsely believe that some cigarette brands may be less harmful than others. These beliefs are associated with descriptive words and elements of package design that have yet to be prohibited, including the names of colours and long, slim cigarettes. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.


Fotuhi O.,University of Waterloo | Fong G.T.,University of Waterloo | Fong G.T.,Ontario Cancer Institute | Zanna M.P.,University of Waterloo | And 3 more authors.
Tobacco Control | Year: 2013

Objective The purpose of this paper is to assess whether smokers adjust their beliefs in a pattern that is consistent with Cognitive Dissonance Theory. This is accomplished by examining the longitudinal pattern of belief change among smokers as their smoking behaviours change. Methods A telephone survey was conducted of nationally representative samples of adult smokers from Canada, the USA, the UK and Australia from the International Tobacco Control Four Country Survey. Smokers were followed across three waves (October 2002 to December 2004), during which they were asked to report on their smoking-related beliefs and their quitting behaviour. Findings Smokers with no history of quitting across the three waves exhibited the highest levels of rationalisations for smoking. When smokers quit smoking, they reported having fewer rationalisations for smoking compared with when they had previously been smoking. However, among those who attempted to quit but then relapsed, there was once again a renewed tendency to rationalise their smoking. This rebound in the use of rationalisations was higher for functional beliefs than for risk-minimising beliefs, as predicted by social psychological theory. Conclusions Smokers are motivated to rationalise their behaviour through the endorsement of more positive beliefs about smoking, and these beliefs change systematically with changes in smoking status. More work is needed to determine if this cognitive dissonancereducing function has an inhibiting effect on any subsequent intentions to quit.


Borland R.,The Cancer Council Victoria | Yong H.-H.,The Cancer Council Victoria | O'Connor R.J.,Roswell Park Cancer Institute | Hyland A.,Roswell Park Cancer Institute | Thompson M.E.,University of Waterloo
Nicotine and Tobacco Research | Year: 2010

Background: There is increasing recognition that the two measures in the Heaviness of Smoking Index (HSI), time to first cigarette of the day (TTFC) and daily consumption (cigarettes per day [CPD]), are strong predictors of quitting behavior. Methods: Use of Waves 1-4 of International Tobacco Control cohort with around 8,000 respondents per wave and 6,000 for prediction of quit outcomes at the next wave. We measured TTFC and CPD at each wave and quit outcomes at the next wave. We also looked at the relative utility of the standard categorical scoring compared with a continuous score using the square root of CPD minus the natural log of TTFC in minutes. Results: We found considerable consistency of the measures across years with a small decrease as duration between measurements increased. For a 3-year gap, the correlations were .72 and .70 for the continuous and categorical composite HSI measures, respectively, and were at least .63 for the individual components. Both TTFC and CPD independently predicted maintenance of quit attempts (for at least 1 month) in each of the three wave-to-wave replications, and these effects were maintained when controlling for demographic factors. CPD also predicted making attempts consistently, but the results for TTFC was not consistently significant. Discussion: Both TTFC and CPD are fairly reliable over time and are important predictors of quitting. There are only small effects of mode of computing the scores, and the two items can be used either individually or combined as the HSI. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


Siahpush M.,University of Nebraska Medical Center | Yong H.,The Cancer Council Victoria | Borland R.,The Cancer Council Victoria | Reid J.L.,University of Waterloo
Nicotine and Tobacco Research | Year: 2010

Introduction: Our aim was to investigate the association between socioeconomic position (income and education) and abrupt versus gradual method of smoking cessation. Methods: The analysis used data (n = 5,629) from Waves 1 through 6 (2002-2008) of the International Tobacco Control Four-Country Survey, a prospective study of a cohort of smokers in the United States, Canada, the United Kingdom, and Australia. Results: Logistic regression analyses using generalized estimating equations showed that higher income (p < .001) and higher education (p = .011) were associated with a higher probability of abrupt versus gradual quitting. The odds of adopting abrupt versus gradual quitting were about 40% higher among respondents with high income ($60,000 and more in the United States/Canada/Australia and £30,000 and more in the United Kingdom) compared with those with low income (less than $30,000 in the United States/Canada/Australia; £15,000 and less in the United Kingdom). Similarly, the odds of abrupt versus gradual quitting were about 30% higher among respondents with a high level of education (university degree) compared with those with a low level of education (high school diploma or lower). Discussion: Higher socioeconomic position is associated with a higher probability of quitting abruptly rather than gradually reducing smoking before quitting. © The Author 2010. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved.


Yong H.-H.,The Cancer Council Victoria | Borland R.,The Cancer Council Victoria | Cummings K.M.,Roswell Park Cancer Institute | Hammond D.,University of Waterloo | And 3 more authors.
Addiction | Year: 2011

Aim This paper examines how smokers' beliefs about 'light/mild' cigarettes in Australia, Canada and the United Kingdom were affected by the removal of misleading 'light/mild' terms from packs. Design, setting and participants The data come from the first seven waves (2002-09) of the International Tobacco Control Policy Evaluation (ITC) Four-Country Survey, an annual cohort telephone survey of adult smokers in Canada, the United States, the United Kingdom and Australia (21613 individual cases). 'Light' and 'mild' descriptors were removed in 2003 in the United Kingdom, in 2006 in Australia and in 2007 in Canada. We compare beliefs about 'light' cigarettes both before and after the bans, with those of smokers in the United States serving as the control condition. Measures Smokers' beliefs about 'light' cigarettes were assessed using a set of statements rated on a five-point 'agree'-'disagree' scale. Findings The proportions of respondents reporting misperceptions about light cigarettes declined between 2002 and 2009 in all four countries. There were marked temporary reductions in reported misperceptions in the United Kingdom and Australia, but not in Canada, following the removal of 'light/mild' descriptors. Conclusions Removal of 'light/mild' descriptors and tar, nicotine and carbon monoxide yield information from cigarette packs is insufficient to effectively eliminate false beliefs. The combination of alternative descriptors and design features that produce differences in taste strength and harshness, independent of actual intakes, are sufficient to produce or sustain the same misbeliefs. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

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