The label “nicotine without tobacco” alters the perception of the addictiveness of these products

In the United States, manufacturers of electronic cigarettes and nicotine pouches have changed the health warnings on these products to indicate that their nicotine is "tobacco-free." A study shows that this label would generally induce a perception of less dependence on these products, and that it would increase the intention to use among the most vulnerable groups.

In the United States, the Food and Drug Administration (FDA) requires manufacturers of tobacco and nicotine products (excluding cigars and pipe tobacco) to place a health warning on these products. This warning must state: “This product contains nicotine. Nicotine is an addictive chemical.”

Some manufacturers marketing synthetic nicotine products have modified this formula, indicating “This product contains nicotine without tobacco.” This is therefore a distortion of the warning, which does not comply with the mandatory wording prescribed by the FDA. A team of researchers from the Yale School of Medicine and University tested the impact of this modified statement on the perceptions of users and non-users of tobacco and nicotine products[1].

Comparing the two health warnings

From an online survey of 4,277 participants, the researchers selected 1,000 participants for their analysis. Among them, there were 20 % non-users of tobacco and nicotine products and 80 % users. The products usually consumed by the latter were conventional cigarettes, e-cigarettes, smokeless tobacco products and nicotine pouches (" nicotine pouches »).

After collecting information about their consumption and profile, participants were randomly presented with the FDA health warning and the one modified by nicotine product manufacturers. They were first asked to indicate which wording seemed more suggestive of the product's addictiveness, and then to state whether this statement made them want to buy the product.

The new label generally refers to less addictive products

The results showed that the label "tobacco-free nicotine" generally suggested a lower addictiveness of the product, but did not encourage purchase of the product. Perceptions of lower addictiveness of the product were twice as high among black and Asian participants as among white or other ethnic minority participants. Perceptions of lower harm of the product were also higher among underage participants and among exclusive users of tobacco products. Asian participants were also those who reported a higher intention to purchase a product bearing this warning than other categories of participants.

The authors of the study therefore draw attention to the changes in perception of products presented with "tobacco-free" nicotine, especially among certain populations that may be more vulnerable (ethnic minorities, minors). They call for more research on the impact of this type of labeling on these particular population categories, and to verify in real situations whether it has a real influence on purchasing and usage behaviors. They also point out that there is no scientific evidence to suggest that synthetic nicotine would be less harmful or less addictive than nicotine from tobacco.

These authors regret the lack of representativeness of their study, but call on the FDA and public authorities to enforce the affixing by manufacturers of the defined health warnings. The authors also report that similar distortions of warnings have been identified on the European Puff Bar website, particularly for the Puff Plus and Puff Flow references.[2]. The term "tobacco-free nicotine" is used in some cases, while the site makes no reference to synthetic nicotine. The consumer is thus left in the dark about all the interpretations

Keywords: synthetic nicotine, tobacco-free nicotine, health warnings, FDA, vaping, nicotine pouches

©Generation Without Tobacco

MF

[1] Morean ME, Gueorguieva R, O'Malley S, et al. Including the term 'tobacco-free nicotine' in the nicotine addiction warning label mandated by the US Food and Drug Administration alters risk perceptions and use intentions. Tobacco Control Published Online First: 28 October 2023. doi: 10.1136/tc-2023-058133

[2] https://puffbar.eu