This application is being submitted in response to the Notice of Special Interest (NOSI) identified as NOT-CA-20-039. Over a third of cancer deaths in the United States are attributable to using tobacco and drinking alcohol. These two behaviors synergistically impact the risk of multiple cancers. Little research has been conducted on how to communicate the cancer risks of alcohol and tobacco co-use, despite the fact that co-use of both substances is high. Public health researchers have successfully used strategies?such as media campaigns, point-of-sale advertisements, and warning labels?to communicate about cancer risks linked to tobacco. Comparatively, less research exists about communication strategies to inform messages about the cancer risks of alcohol. No communication strategies, to our knowledge, have been used to communicate about the cancer risks of co-using alcohol and tobacco. The long-term goal of the proposed administrative supplement is to determine whether messages that communicate about the cancer risks of cousing alcohol and tobacco increase risk perceptions, perceived message effectiveness, knowledge, and tobacco quit intentions and decrease alcohol use intentions among individuals who currently co-use tobacco and alcohol. To accomplish this goal, we propose one specific aim that will complement and add significant value to our Parent Study (1R01CA240732-01), which is focused on communicating cancer and other health risks of little cigars and cigarillos (LCCs). Specifically, for this administrative supplement, we aim to develop and experimentally test communication messages about the cancer risks of co-using alcohol and tobacco (e.g., ?alcohol and tobacco both increase your risk of oral cancer?) among a diverse sample of 1,000 adults who currently drink alcohol and smoke LCCs. We will oversample young adults and African Americans because the co-use of alcohol and tobacco is especially problematic among young adults, and African American adults are more likely to use LCCs than white adults. Participants will be recruited from across the US to participate in a series of online experiments. Our working hypothesis is that the most robust communication messages about the cancer risks of alcohol and tobacco (e.g., messages that mention a specific cancer, describe the cancer?s consequences, and include text to promote quitting self-efficacy) will increase risk perceptions, perceived message effectiveness, knowledge, and tobacco quit intentions and decrease alcohol use intentions among co-users of LCCs and alcohol. Messages developed from our administrative supplement and Parent Study can be used in media campaigns, point-of-sale advertising, and warning labels by states, localities, and other countries to increase awareness of cancer risks of co-using alcohol and tobacco. This supplement may also provide data to support a randomized controlled trial to determine if cancer messaging on co-use leads to behavioral changes.
Over a third of cancer deaths in the United States are attributable to using tobacco and drinking alcohol, and these behaviors together are known to synergistically increase cancer risk. Public health strategies?such as media campaigns, point-of-sale advertisements, and warning labels?to simultaneously communicate the cancer risks of alcohol and tobacco co-use have not been developed. The objective of this proposal is to fill a critical gap in the literature by developing and testing cancer communication messages about the co-use of tobacco and alcohol that increase harm perceptions, perceived message effectiveness, knowledge of cancer risk, and tobacco quit intentions and decrease alcohol use intentions among co-users of alcohol and little cigars or cigarillos (LCCs).
