{
  "abstract": "Background Smoking remains disproportionately high among people with serious psychological distress (SPD) and low socioeconomic status (SES). The US Food and Drug Administration proposed reducing nicotine in combusted tobacco products to minimally addictive levels. Effective messaging is needed to explain very low nicotine cigarettes (VLNCs) and to motivate these priority groups to use the policy to quit.Methods In 2024, we conducted 12 focus groups (n=70) in Atlanta, GA, with adults who smoked: individuals experiencing SPD (n=18), low SES (n=27) and neither (n=25). Participants reviewed and discussed 12–14 VLNC messages, including two targeted themes (anxiety/medication for SPD; financial cost for low SES) and three general themes (quitting benefits, regaining control and managing cravings). Data were analysed in NVivo 14.0 using thematic analysis.Results Across groups, financial cost messages motivated participants to consider quitting, particularly when emphasising that VLNCs would cost the same as current cigarettes. Participants with SPD found SPD-targeted messages relatable, but some questioned whether nicotine worsens anxiety. General messages resonated broadly, promoting hope, empowerment and self-reflection. Craving management messages were seen as practical and spurred personal discussions. Visuals featuring relatable characters and believable scenarios enhanced receptivity.Conclusions Under a reduced nicotine policy, general messages highlighting quitting benefits, regaining control and managing cravings could anchor cessation campaigns. Targeted elements should still address salient barriers for people with SPD (contextualising nicotine’s relationship to anxiety), but mixed responses suggest further refinement is needed. Financial cost messages, although designed for low SES audiences, resonated across all groups and could be used broadly.",
  "authors": [
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Di Pei"
    },
    {
      "affiliations": [
        "Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Adebusola Ogunnaike"
    },
    {
      "affiliations": [
        "Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Winnie Ni"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Jordan D Foster"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Folashayo P Adeniji"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Vanessa Mallory"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA",
        "School of Public Health, Universitas Ahmad Dahlan, Yogyakarta, Jogja, Indonesia"
      ],
      "name": "Nurul Kodriati"
    },
    {
      "affiliations": [
        "Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "Samantha L Petillo"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Katherine C Henderson"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Aubrey Juris"
    },
    {
      "affiliations": [
        "Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA"
      ],
      "name": "Prudence Nkansah"
    },
    {
      "affiliations": [
        "Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA"
      ],
      "name": "James F Thrasher"
    },
    {
      "affiliations": [
        "Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA"
      ],
      "name": "Nicholas A Giordano"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Claire Adams Spears"
    },
    {
      "affiliations": [
        "TRSConsulting56 LLC, Lilburn, Georgia, USA"
      ],
      "name": "David L Ashley"
    },
    {
      "affiliations": [
        "Putney Consulting, Bow, New Hampshire, USA"
      ],
      "name": "Christin D’Ovidio"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Terry Frank Pechacek"
    },
    {
      "affiliations": [
        "Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, Georgia, USA"
      ],
      "name": "Lucy Popova"
    }
  ],
  "title": "‘Light at the end of the tunnel’: reactions to targeted and generally applicable reduced nicotine policy messages among priority populations of people who smoke",
  "uid": "b3161c5e-1686-5840-ab13-e5883273047f"
}