Smokers' and nonsmokers' beliefs about harmful tobacco constituents: implications for FDA communication efforts

Nicotine Tob Res. 2014 Mar;16(3):343-50. doi: 10.1093/ntr/ntt158. Epub 2013 Oct 22.


Introduction: Legislation requires the U.S. Food and Drug Administration (FDA) to release information to the public about harmful constituents in tobacco and tobacco smoke. To inform these efforts, we sought to better understand how smokers and nonsmokers think about tobacco constituents.

Methods: In October 2012, 300 U.S. adults aged 18-66 years completed a cross-sectional Internet survey. The questions focused on 20 harmful tobacco constituents that the FDA has prioritized for communicating with the public.

Results: Most participants had heard of 7 tobacco constituents (ammonia, arsenic, benzene, cadmium, carbon monoxide, formaldehyde, and nicotine), but few participants had heard of the others (e.g., acrolein). Few participants correctly understood that many constituents were naturally present in tobacco. Substances that companies add to cigarette tobacco discouraged people from wanting to smoke more than substances that naturally occur in cigarette smoke (p < .001). Ammonia, arsenic, carbon monoxide, and formaldehyde being in cigarettes elicited the most discouragement from smoking. Constituents elicited greater discouragement from wanting to smoke if respondents were nonsmokers (β = -.34, p < .05), had negative images of smokers (i.e., negative smoker prototypes; β = .19, p < .05), believed constituents are added to tobacco (β = .14, p < .05), or were older (β = .16, p < .05).

Conclusions: Our study found low awareness of most tobacco constituents, with greater concern elicited by additives. Efforts to communicate health risks of tobacco constituents should consider focusing on ones that elicited the most discouragement from smoking.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Ammonia / adverse effects
  • Arsenic / toxicity
  • Awareness
  • Carbon Monoxide / toxicity
  • Cross-Sectional Studies
  • Culture*
  • Female
  • Formaldehyde / adverse effects
  • Health Surveys
  • Humans
  • Internet
  • Male
  • Middle Aged
  • Smoking / psychology*
  • Tobacco / adverse effects
  • Tobacco / chemistry*
  • United States
  • United States Food and Drug Administration
  • Young Adult


  • Formaldehyde
  • Ammonia
  • Carbon Monoxide
  • Arsenic