An interventional study of Modified Risk Claim Type - None and Product Brand - General Snus in Tobacco Product Beliefs and Use, sponsored by Rutgers, The State University of New Jersey. Completed at 1 site in United States. Open to participants aged 21 Years and older, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-03-04.
Sponsored by Rutgers, The State University of New Jersey · Not applicable, Interventional, and Prevention
This study will be an online survey experiment conducted with adults who smoke cigarettes (ages 21+) to examine their reactions to modified risk advertising claims authorized by the Food \& Drug Administration (FDA) for two smokeless tobacco brands (General Snus and Copenhagen), which describe the lower risks of these products compared to cigarette smoking. The study will compare effects of ads with different two different claim types (i.e. claims about reduced lung cancer risk and claims about reduced risks for multiple disease) versus ads with no reduced-risk claims, and examine effects on message and product perceptions, and interest in using the smokeless tobacco products. This study will also examine how smokers' reactions/interest may vary based on the product brand, and asses prior awareness/exposure to the authorized claims.
125 studies on the registry are indexed under Tobacco Use; 64 are open to participants now.
This study's enrollment of 1,257 is above the median of 150 across 119 interventional studies indexed under Tobacco Use.
Browse Tobacco Use studies →Rutgers, The State University of New Jersey is the lead sponsor of 496 studies on the registry; 130 are open to participants now.
Of its 38 completed or terminated interventional studies of FDA-regulated products, 30 (79%) have results posted.
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Exclusion Criteria:
Participants in this group will view 4 ads for the brand General Snus that do not include a modified risk claim.
Behavioral: Modified Risk Claim Type - None · Behavioral: Product Brand - General Snus
Participants in this group will view 4 ads for the brand General Snus that include a modified risk claim about the lower risk of multiple diseases.
Behavioral: Product Brand - General Snus · Behavioral: Modified Risk Claim Type - Multiple Diseases
Participants in this group will view 4 ads for the brand General Snus that include a modified risk claim about the lower risk of lung cancer only.
Behavioral: Product Brand - General Snus · Behavioral: Modified Risk Claim Type - Lung Cancer
Participants in this group will view 4 ads for the brand Copenhagen that do not include a modified risk claim.
Behavioral: Modified Risk Claim Type - None · Behavioral: Product Brand - Copenhagen
Participants in this group will view 4 ads for the brand Copenhagen that include a modified risk claim about the lower risk of multiple diseases.
Behavioral: Product Brand - Copenhagen · Behavioral: Modified Risk Claim Type - Multiple Diseases
Participants in this group will view 4 ads for the brand Copenhagen that include a modified risk claim about the lower risk of lung cancer only.
Behavioral: Product Brand - Copenhagen · Behavioral: Modified Risk Claim Type - Lung Cancer
Participants will view smokeless tobacco ads with no modified risk claim (control)
Participants will views ads for the smokeless tobacco brand General Snus
Participants will views ads for the smokeless tobacco brand Copenhagen
Participants will view smokeless tobacco ads with a claim about lower risks for multiple diseases
Participants will either view smokeless tobacco ads with a modified risk claim about lower risks for lung cancer only
General Relative Harm Perception
Single item measure asking participants how harmful they think daily use of the viewed smokeless tobacco product would be to their health compared to daily cigarette smoking, (1=a lot less harmful, 2=somewhat less harmful, 3=about the same, 4=somewhat more harmful, 5=a lot more harmful). Higher scores mean thinking the viewed smokeless tobacco product is more harmful than cigarettes.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Perceptions of Perceived Relative Risks of Diseases
Assessment of perceived risks of getting various smoking related diseases from using the viewed smokeless tobacco product versus from smoking cigarettes. Responses to 6 parallel questions (each asking about a different disease) were averaged together in this composite item. The question stated: "If you used only \[General Snus/Copenhagen - inserted based on brand condition\] or only cigarettes every day, which product would make it more likely that you would get": 1) lung cancer; 2) heart disease; 3) mouth cancer; 4) stroke; 5) chronic bronchitis; 6) emphysema. Response options to each were on a 5 point scale from (1=much more likely with General Snus/Copenhagen to 5=much more likely with cigarettes). Results presented here are based on the averages responses to the six items. Higher scores mean thinking risks are greater from smoking cigarettes than from using the viewed smokeless tobacco product.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Absolute Harm Perception
Single item measure asking participants how likely or unlikely they think the viewed smokeless tobacco product would be to cause serious health problems during their lifetime, if they used it every day (from 1=not at all likely to 5=extremely likely). Higher scores mean greater likelihood of thinking the product is harmful to health.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Product Use Intentions
Assessment of intentions to use the viewed smokeless tobacco products based on averaging responses to three parallel questions: "Thinking about the ads you saw for \[General Snus or Copenhagen\] products, how interested, in the next 6 months, would you be in: 1) Using or trying these products? 2) Using these products as a way to quit or cut down on your cigarette smoking? 3) Completely switching from cigarettes to these products? Response options to each were on a 5 point scale from (1=not at all interested to 5=extremely interested). Results presented here are based on the averaged responses to these three items. Higher scores mean greater interest in using the products.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Risk Message Recall
Participants are asked to recall (yes/no) if the ads they viewed include any statement saying that using the product can lower risks of certain diseases.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Ad Persuasiveness
A composite measure based on the average of 6 advertisement perceptions, asking participants to rate whether they agreed or disagreed that they ads they viewed: 1) included important information; 2) were understandable; 3) included believable information; 4) included credible information; 5) included information new to me; 6) make me want to learn more about those products. Response options were on a 6 point agreement scale from 1=strongly disagree to 6=strongly agree. Higher scores mean greater agreement that the ads were effective and persuasive.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Claim Believability & Credibility
A composite measure based on the average of 2 claim perception items, asking participants to rate whether they agreed or disagreed that the modified-risk claim in the ads they viewed was : 1) believable 2) credible. Participants responded to this while seeing the claim again on the survey screen. Response options were on a 7 point agreement scale from 1=strongly disagree to 7=strongly agree. Higher scores mean greater agreement that the claims were believable and credible.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Overall Perceived Claim Persuasiveness
A composite measure based on the average of 7 claim perception items, asking participants to rate whether they agreed or disagreed that the modified-risk claim in the ads they viewed was : 1) believable; 2) credible; 3) important; 4) new to me; 5) makes me think using this product could be less harmful to my health than smoking; 6) makes me more interested in trying this product; 7) would make me think seriously about completely switching to this product. Participants responded to this while seeing the claim again on the survey screen. Response options were on a 7 point agreement scale from 1=strongly disagree to 7=strongly agree. Higher scores mean greater agreement that participants thought the claim was persuasive/effective.
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
Switching Comprehension
An item assessing participants' understanding of the need to completely switch to the smokeless tobacco product viewed in order to reduce risks. It said: Please answer the next question based on your understanding of the ads you viewed earlier. Based on the ads, \[General Snus OR Copenhagen, inserted based on condition\] can reduce a smoker's health risks if you: (Select all that apply) 1. Use only \[General Snus/Copenhagen\] and not smoke any cigarettes anymore 2. Use \[General Snus/Copenhagen\] and smoke fewer cigarettes than before 3. Use both products (\[General Snus/Copenhagen\] and cigarettes) about equally 4. None of the above 5. I don't know/not sure
Time frame: Assessed in survey measures completed immediately after viewing the study stimuli
| Milestone | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Started | 213 | 209 | 203 | 209 | 209 | 214 |
| Completed | 213 | 209 | 203 | 209 | 209 | 214 |
| Not completed | 0 | 0 | 0 | 0 | 0 | 0 |
Single item measure asking participants how harmful they think daily use of the viewed smokeless tobacco product would be to their health compared to daily cigarette smoking, (1=a lot less harmful, 2=somewhat less harmful, 3=about the same, 4=somewhat more harmful, 5=a lot more harmful). Higher scores mean thinking the viewed smokeless tobacco product is more harmful than cigarettes.
| score on a scale | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| General Relative Harm Perception | 3.04 ± 0.79 | 2.76 ± 0.81 | 2.84 ± 0.83 | 3.19 ± 0.88 | 3.00 ± 0.82 | 2.97 ± 0.78 |
Assessment of perceived risks of getting various smoking related diseases from using the viewed smokeless tobacco product versus from smoking cigarettes. Responses to 6 parallel questions (each asking about a different disease) were averaged together in this composite item. The question stated: "If you used only \[General Snus/Copenhagen - inserted based on brand condition\] or only cigarettes every day, which product would make it more likely that you would get": 1) lung cancer; 2) heart disease; 3) mouth cancer; 4) stroke; 5) chronic bronchitis; 6) emphysema. Response options to each were on a 5 point scale from (1=much more likely with General Snus/Copenhagen to 5=much more likely with cigarettes). Results presented here are based on the averages responses to the six items. Higher scores mean thinking risks are greater from smoking cigarettes than from using the viewed smokeless tobacco product.
| score on a scale | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Perceptions of Perceived Relative Risks of Diseases | 3.34 ± 0.60 | 3.44 ± 0.56 | 3.33 ± .71 | 3.29 ± .61 | 3.29 ± .57 | 3.38 ± .53 |
Single item measure asking participants how likely or unlikely they think the viewed smokeless tobacco product would be to cause serious health problems during their lifetime, if they used it every day (from 1=not at all likely to 5=extremely likely). Higher scores mean greater likelihood of thinking the product is harmful to health.
| score on a scale | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Absolute Harm Perception | 3.49 ± 0.91 | 3.10 ± 0.94 | 3.43 ± 0.99 | 3.60 ± 0.98 | 3.35 ± 0.96 | 3.58 ± 0.96 |
Assessment of intentions to use the viewed smokeless tobacco products based on averaging responses to three parallel questions: "Thinking about the ads you saw for \[General Snus or Copenhagen\] products, how interested, in the next 6 months, would you be in: 1) Using or trying these products? 2) Using these products as a way to quit or cut down on your cigarette smoking? 3) Completely switching from cigarettes to these products? Response options to each were on a 5 point scale from (1=not at all interested to 5=extremely interested). Results presented here are based on the averaged responses to these three items. Higher scores mean greater interest in using the products.
| score on a scale | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Product Use Intentions | 1.52 ± 0.85 | 1.55 ± 0.82 | 1.48 ± 0.88 | 1.45 ± .83 | 1.41 ± .75 | 1.36 ± .70 |
Participants are asked to recall (yes/no) if the ads they viewed include any statement saying that using the product can lower risks of certain diseases.
| Participants | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Yes | 25 | 163 | 141 | 16 | 145 | 157 |
| No | 188 | 46 | 62 | 193 | 63 | 56 |
A composite measure based on the average of 6 advertisement perceptions, asking participants to rate whether they agreed or disagreed that they ads they viewed: 1) included important information; 2) were understandable; 3) included believable information; 4) included credible information; 5) included information new to me; 6) make me want to learn more about those products. Response options were on a 6 point agreement scale from 1=strongly disagree to 6=strongly agree. Higher scores mean greater agreement that the ads were effective and persuasive.
| score on a scale | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Ad Persuasiveness | 3.55 ± 0.94 | 3.53 ± 0.97 | 3.37 ± 1.13 | 3.36 ± 1.02 | 3.22 ± 0.95 | 3.34 ± 1.00 |
A composite measure based on the average of 2 claim perception items, asking participants to rate whether they agreed or disagreed that the modified-risk claim in the ads they viewed was : 1) believable 2) credible. Participants responded to this while seeing the claim again on the survey screen. Response options were on a 7 point agreement scale from 1=strongly disagree to 7=strongly agree. Higher scores mean greater agreement that the claims were believable and credible.
| score on a scale | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Claim Believability & Credibility | — | 3.56 ± 1.55 | 3.88 ± 1.74 | — | 2.83 ± 1.55 | 3.91 ± 1.68 |
A composite measure based on the average of 7 claim perception items, asking participants to rate whether they agreed or disagreed that the modified-risk claim in the ads they viewed was : 1) believable; 2) credible; 3) important; 4) new to me; 5) makes me think using this product could be less harmful to my health than smoking; 6) makes me more interested in trying this product; 7) would make me think seriously about completely switching to this product. Participants responded to this while seeing the claim again on the survey screen. Response options were on a 7 point agreement scale from 1=strongly disagree to 7=strongly agree. Higher scores mean greater agreement that participants thought the claim was persuasive/effective.
| score on a scale | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Overall Perceived Claim Persuasiveness | — | 3.51 ± 1.19 | 3.47 ± 1.33 | — | 2.86 ± 1.26 | 3.31 ± 1.29 |
An item assessing participants' understanding of the need to completely switch to the smokeless tobacco product viewed in order to reduce risks. It said: Please answer the next question based on your understanding of the ads you viewed earlier. Based on the ads, \[General Snus OR Copenhagen, inserted based on condition\] can reduce a smoker's health risks if you: (Select all that apply) 1. Use only \[General Snus/Copenhagen\] and not smoke any cigarettes anymore 2. Use \[General Snus/Copenhagen\] and smoke fewer cigarettes than before 3. Use both products (\[General Snus/Copenhagen\] and cigarettes) about equally 4. None of the above 5. I don't know/not sure
| Participants | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) |
|---|---|---|---|---|---|---|
| Use only [General Snus/Copenhagen] and not smoke any cigarettes anymore | 39 | 98 | 83 | 41 | 102 | 89 |
| Use [General Snus/Copenhagen] and smoke fewer cigarettes than before | 25 | 32 | 16 | 16 | 18 | 24 |
| Use both products ([General Snus/Copenhagen] and cigarettes) about equally | 9 | 3 | 12 | 9 | 7 | 6 |
| None of the above | 96 | 44 | 65 | 103 | 50 | 66 |
| I don't know | 55 | 47 | 35 | 44 | 40 | 36 |
Collected over One month. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Group 1 (General Snus-Control Ads) | 0/213 (0%) | 0/213 (0%) | 0/213 (0%) |
| Group 2 (General Snus-Multiple Disease Ads) | 0/209 (0%) | 0/209 (0%) | 0/209 (0%) |
| Group 3 (General Snus- Lung Ads) | 0/203 (0%) | 0/203 (0%) | 0/203 (0%) |
| Group 4 (Copenhagen-Control Ads) | 0/209 (0%) | 0/209 (0%) | 0/203 (0%) |
| Group 5 (Copenhagen-Multiple Disease Ads) | 0/209 (0%) | 0/209 (0%) | 0/209 (0%) |
| Group 6 (Copenhagen- Lung Ads) | 0/214 (0%) | 0/214 (0%) | 0/214 (0%) |
| Age, Continuous(years) | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) | Total |
|---|---|---|---|---|---|---|---|
| Mean | 53.6 (21 to 84) | 53.5 (26 to 81) | 54.5 (21 to 82) | 53.9 (22 to 85) | 54.1 (24 to 87) | 54.5 (24 to 90) | 54 (21 to 90) |
| Sex/Gender, Customized(Participants) | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) | Total |
|---|---|---|---|---|---|---|---|
| Male | 106 | 105 | 99 | 98 | 109 | 102 | 619 |
| Female | 107 | 104 | 104 | 111 | 100 | 112 | 638 |
| Race/Ethnicity, Customized(Participants) | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) | Total |
|---|---|---|---|---|---|---|---|
| White, Non-Hispanic | 171 | 157 | 143 | 135 | 156 | 156 | 918 |
| Black, Non-Hispanic | 25 | 25 | 29 | 41 | 25 | 26 | 171 |
| Other, Non-Hispanic | 2 | 8 | 6 | 6 | 4 | 12 | 38 |
| Hispanic | 12 | 29 | 21 | 26 | 19 | 19 | 126 |
| 2+ Races, Non-Hispanic | 3 | 3 | 4 | 1 | 5 | 1 | 17 |
| Region of Enrollment(participants) | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) | Total |
|---|---|---|---|---|---|---|---|
| United States | 213 | 209 | 203 | 209 | 209 | 214 | 1257 |
| Smoking frequency(Participants) | Group 1 (General Snus-Control Ads) | Group 2 (General Snus-Multiple Disease Ads) | Group 3 (General Snus- Lung Ads) | Group 4 (Copenhagen-Control Ads) | Group 5 (Copenhagen-Multiple Disease Ads) | Group 6 (Copenhagen- Lung Ads) | Total |
|---|---|---|---|---|---|---|---|
| Smoke every day | 176 | 165 | 161 | 166 | 166 | 164 | 998 |
| Smoke some days | 37 | 44 | 42 | 43 | 43 | 50 | 259 |
Documents are hosted by the registry — open the source record to download them.
Plan to share: Yes — The study ad stimuli, survey instrument, codebook, and de-identified dataset will be deposited to a data repository - we anticipate this will be the National Addiction and HIV Data Archive Program (NAHDAP), currently managed by ICPSR at the University of Michigan.
Supporting information: Analytic code
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Rutgers, The State University of New Jersey