Beliefs about the relative harm of light and low tar cigarettes: findings from the International Tobacco Control (ITC) China Survey

Background: Many smokers in Western countries perceive lightor low tarcigarettes as less harmful and less addictive than regular or full flavoured cigarettes. However, there is little research on whether similar perceptions exist among smokers in low and middle incomes, including China. Objective: To characterise beliefs about light and low tarcigarettes among adult urban smokers in China. Methods: We analysed data from Wave 1 of the ITC China Survey, a face-to-face household survey of 4732 adult Chinese smokers randomly selected from six cities in China in 2006. Households were sampled using a stratified multistage design. Findings: Half (50.0%) of smokers in our sample reported having ever tried a cigarette described as light, mild or low tar. The majority of smokers in our sample (71%) believed that lightand/or low tarcigarettes are less harmful compared to full flavoured cigarettes. By far the strongest predictor of the belief that light and/or low tarcigarettes are less harmful was the belief that light and/or low tarcigarettes feel smoother on the respiratory system (p<0.001, OR= 53.87, 95% CI 41.28 to 70.31). Conclusion: Misperceptions about light and/or low tarcigarettes were strongly related to the belief that these cigarettes are smoother on the respiratory system. Future tobacco control policies should go beyond eliminating labelling and marketing that promotes light and low tarcigarettes by regulation of product characteristics ( for example, additives, filter vents) that reinforce perceptions that light and low tarcigarettes are smoother on the respiratory system and therefore less harmful.