Creative Concept Testing Designed to Prevent Youth ENDS, Cigarette ad Other Tobacco Product

TITLE OF INFORMATION COLLECTION: Creative Concept Testing Designed to Prevent Youth ENDS, Cigarette and Other Tobacco Product Use

STUDY STIMULI:

FAMOUS LUNGS IN A GREAT BIG WORLD

“HOLLYWOOD STUNTIN’ WITH THE ROCK” LUNGS :30

INTRO: Little Lungs in a great big world! The story of a pair of lungs

that smoked as a teen and never grew to normal size.

Open on Little Lungs and a lung version of The Rock on top of a speeding

subway car that’s on fire.

THE ROCK: Alright, L.L., you ready for your first big-time Hollywood

stunt?

LITTLE LUNGS: Heck, yeah!

They start running across the top of the train. They jump from one flaming

train car to another. Then one more. Little Lungs starts to fall behind.

LITTLE LUNGS: My stunted lungs… can’t handle the stunt!

The Rock jumps again. Little Lungs follows, but doesn’t make it. At the

last second, The Rock grabs Little Lungs’ hand, saving him.

LITTLE LUNGS: Whew! That was close!

He’s clotheslined by a traffic light wire,knocking him onto the tracks,

where he’s run over by train car after train car.

AVO: Smoking as a teen can stunt your lungs, keeping them little

forever.

Cut back to The Rock at the back of the train.

THE ROCK: NOOOOOOO!!!!!!!

POSSESSED BY NICOTINE

Open on a TEENAGE GIRL in a high school class. She looks at the clock, then

back at the teacher.

Suddenly, she leaves her seat as if being pulled sideways by an unseen force.

Her classmates are surprised. She slowly bends over backwards.

SFX: back bones cracking

Once her hands reach the floor behind her, she spider walks down the aisle,

like Linda Blair in The Exorcist. Her classmates recoil in fear.

She leaves the classroom and continues to spider walk into the girl’s

restroom. She stands.

SFX: bones cracking

She abruptly takes her cigarettes out of her hoodie pocket.

AVO: Once nicotine takes over your mind, your body soon follows.

SUPER: Are you possessed by nicotine?

MACROSCOPIC METAL

Video

We open on a young man as he pulls his vape away from his mouth.

He then exhales, but instead of blowing a white cloud of vapor,

he blows a “cloud” of metal fragments and barbs into the air.

Some are shiny. Others are rusty. And while they vary in shape,

they’re all sharp.

We see a female student in the school bathroom. She exhales

after vaping, blowing shards of metal into the air.

VO: There’s a lot more to vapes than vapor.

We see a teen sneaking a hit in class. He has a vape in his hand

as he blows metals pieces straight out of his mouth.

VO: You could be inhaling toxic metals, like lead and nickel,

right into your lungs.

He begins to cough.

CARD: Know the Real Cost.

SCARY ENOUGH

Video

OPEN ON A MAN WALKING DOWN A DIMLY LIT HALLWAY, SHOWING US VARIOUS HORRORS

ALONG THE WAY.

THE FIRST IS A SERIES OF GRITTY METALLIC ROBOTS. THEY ARE SHARP, SOMEWHAT

RUSTED AND WORN, AND DECIDEDLY SCARY & MEAN LOOKING. THEY LUNGE AT US. THE MAN

IS UNPHASED AS HE CONTINUES WALKING.

MAN: To show how terrifying it is that when you vape you may be inhaling

toxic metals straight into your lungs, we considered using metal monsters

as a metaphor.

WE COME ACROSS A TEAM OF COMPUTER DESIGNERS. ON THE SCREEN IS AN IMPRESSIVE

DISPLAY OF CGI.

And cutting-edge special effects, so you can see the particles of

lead going into your lungs.

WE HEAR VIOLINS AS WE HAPPEN UPON AN ORCHESTRAL SECTION. THEY ARE PRACTICING

THE KIND OF MUSIC YOU WOULD FIND IN THE BUILD TO THE CLIMAX OF A REALLY GOOD

HORROR MOVIE.

The music woulda made your heart race.

But the truth is, nothing is as scary as the truth.

AS WE ENTER THE MIDDLE OF THE ROOM, A VAPE PEN IS DELICATELY PLACED ON A

PEDESTAL.

That vaping can deliver toxic metal particles — like nickel, tin,

aluminum, lead — directly into your lungs.

HE PICKS UP THE VAPE PEN.

Metal in your lungs. Bwahahahaha—

CONCEPT: Tools of Mouth Cancer

Headline: It takes up to 87 tools to remove mouth cancer… But just one could be enough to get

Body Copy: Dip can cause mouth cancer, which may require jaw removal. Smokeless doesn’t mean harmless. Get a closer look at the grueling operation at TheRealCost.gov/dip.

CONCEPT: Tools of Mouth Cancer

Video Storyboard “Tool Aisle”

SUPER: SMOKELESS TOBACCO CAN CAUSE MOUTH CANCER, WHICH CAN REQUIRE THE REMOVAL OF YOUR JAW.

NARRATOR: An empty aisle in a hardware store is restocked with scary-looking medical instruments and tools. A sign that says “FOR DIPPERS ONLY” is hung above the aisle.

SUPER: A GRUELING OPERATION INVOLVING UP TO 87 TOOLS. WE PUT THEM ALL HERE...IN THE TOOL AISLE.

NARRATOR: A group of teens walk up and read the aisle sign. Curious, they walk in.

NARRATOR: They see a man wearing a surgeon’s outfit and a hardware store nametag.

The surgeon says, “Can I help you?”

One of the teens looks around at all of the scary-looking tools and says, “Um, what are these for?”

The surgeon says, “These? This is what I use on patients that get mouth cancer from dipping.”

The teen says, “Mouth cancer?”

The surgeon says, “Yep, dip contains up to 30 cancer-causing chemicals. Do you want to know more about the process?”

We see the surgeon explaining the procedure in detail to the terrified teens. He says things like “I use this screw to hold down your jaw,” “this is a new bone plate,” and “this is the feeding tube that will feed you for the first two weeks.”

NARRATOR: The teens are shocked and terrified. Some of them even walk away, not wanting to hear any more.

The surgeon says, “What, you’re not the do-it-yourself type?”

SUPER: DIP CAN CAUSE MOUTH CANCER. KNOW THE REAL COST OF DIP.

TOBACCO FACTS FOR MESSAGE TESTING

Fresh Empire

Cigars

Addiction:

• TF0435 Cigarillo smoking can lead to nicotine addiction.

  • Message variation: Puffin' on cigarillos can make you addicted to nicotine.

Health Effects:

• TF0259: Cigarillo smoking poses significant health risks.

  • Message variation: Smoking cigarillos can lead to all types of health problems.

• TF0260: Cigarillo smoking causes cancers of the lung, oral cavity, esophagus, larynx, pancreas, stomach, and bladder.

• TF0261: Cigarillo smokers have increased risk for coronary heart disease, aortic aneurysms, and chronic obstructive pulmonary disease (COPD).

• TF0263: Cigarillo smokers inhale smoke regardless of whether they think they do.

• TF0294 Cigarillos contain toxic, cancer-causing chemicals that can cause serious health problems.

• TF0351: Using cigarillos instead of cigarettes may not reduce risk. Cigarillos may be even worse for health than cigarettes.

• TF0352: Cigarillo smoking can cause cancers of the mouth and throat, even if a person doesn’t think they inhale.

HPHCs:

• TF0255: Cigarillo smokers inhale similar types of harmful and cancer-causing substances as cigarette smokers.

• TF0256: Cigarillo smokers have higher levels of several toxic and cancer-causing substances in their blood than non-tobacco users.

• TF0258: Cigarillo smokers have blood concentrations of NNAL, a potent cancer-causing chemical that are comparable with that of cigarette smokers.

• TF0344: Cigarillo smokers don’t need to inhale to be exposed to nicotine. Nicotine from cigarillos can be absorbed through fingers and lips.

• TF0345: Cigarillos are not a safe alternative to cigarettes. Cigarillo smoke can expose smokers to at least as much nicotine and carbon monoxide as cigarettes.

• TF0393: Secondhand cigarillo smoke contains many of the same harmful and cancer-causing chemicals as cigarette smoke.

Other:

• TF0204: Cigar and cigarillo smoking causes nearly 9,000 premature deaths each year in the US.

Hookah

Health Effects:

• TF0284: Hookah smokers are at risk for the same kinds of diseases caused by cigarette smoking.

• TF0370: Secondhand hookah smoke is toxic.

• TF0378: Long term use of hookah is associated with mouth and lip cancers.

• TF0379: Smoking hookah significantly increases the risk of gum disease and tooth loss.

HPHCs:

• TF0034a: Hookah smoking delivers the addictive drug nicotine.

• TF0034b: Hookah smoking delivers many of the same toxic chemicals that are in cigarette smoke such as carbon monoxide, metals, and carcinogens.

• TF0283a: Hookah smokers may absorb even more of the toxic chemicals found in cigarette smoke because of the length of the session when smoking hookah.

• TF0283b: A typical 1-hour hookah session can produce as much smoke as 100 cigarettes.

• TF0375: The large volume of carbon monoxide consumed by hookah smokers is poisonous.

• TF0367: There is a large number of chemicals in hookah smoke including some that can cause cancer.

  • Message variation: Hookah smoke has a lot of chemicals in it, even some that can give you cancer.

• TF0362: Hookah smoke contains high levels of cancer-causing chemicals, even when used with tobacco-free or herbal shisha.

• TF0363a: Water does not filter out the chemicals in hookah smoke.

Addiction:

• TF0373: Hookah smoking is no less addictive than cigarette smoking.

  • Message variation: Hookah smoking can have you just as addicted as smoking cigarettes.

Other:

• TF0366: Hookah smokers can breathe in bacteria that live in hookah hoses.

• TF0364: There is no proof that any device or accessory can make hookah smoking less risky.

Cigarettes

Addiction:

• TF0016: Addiction keeps people smoking even when they want to quit.

• TF0051: Even smoking occasionally can lead to daily use.

Health Effects:

• TF0069: Smoking makes a person's breath smell like an ashtray.

• TF0068: Smoking causes gum disease that can lead to tooth loss.

  • Message variation: Losing teeth from gum disease is one of the L's that smoking cigarettes can hand you.

• TF0070: Smoking can stain a person's teeth.

• TF0028: Smoking accelerates skin aging and can lead to premature wrinkles.

• TF0090: Smokers generally are much less healthy than nonsmokers. Their overall health is worse and they need to go to the doctor more often. They are also admitted to the hospital more often.

• TF0265: Any amount of smoking—even an occasional cigarette—is harmful.

• TF0075: Smoking can cause cancer almost anywhere in the body.

• TF0026: Teens who smoke may develop smaller, weaker lungs that never grow to their potential size and never perform at maximum capacity.

HPHCs:

• TF0045: Cigarette smoke contains 7,000+ chemicals. Many of these chemicals are toxic, including more than 70 that can cause cancer.

• TF0014: Nicotine can change the way the brain works, causing a person to crave more nicotine.

  • Message variation: Nicotine can mess with your brain and have you craving it more.

Mortality:

• TF0003: Smokers are estimated to lose more than 10 years of life. 

• TF0185: In the U.S., 1 person dies every 66 seconds from smoking and exposure to cigarette smoke.

Social Norms and Myths:

• TF0213: Most high school students say they prefer to date nonsmokers.

E-cigarettes

Addiction:

• TF0237: Like other tobacco products, vapes that contain nicotine may lead to addiction.

  • Message variation: Like other tobacco products, vapes with nicotine may have you addicted.

HPHCs:

• TF0234: Currently, people who vape have no way of knowing how much nicotine or other potentially harmful chemicals they are inhaling.

• TF0235: Vapes that contain nicotine can expose you to similar amounts of nicotine as regular cigarettes.

• TF0244: Vapes produce more than just water vapor. Chemicals that have been found in some vape aerosols include nicotine, volatile organic compounds, polycyclic aromatic hydrocarbons, flavorings, and metal particles.

• TF0245: Chemicals like formaldehyde and acetaldehyde that are known and suspected to cause cancer have been found in some vape aerosols.

  • Message variation: You can find a lot more than just water in vape aerosols. Some of the chemicals found in some vape aerosols, like formaldehyde and acetaldehyde, may cause cancer.

• TF0268: Some of the chemicals found in cigarette smoke like nicotine, formaldehyde, acetaldehyde, and acrolein are also found in some vape aerosols.

• TF0266: Some vapes are marketed as nicotine-free, but those claims may not be accurate.

• TF0333: Many vape liquids contain nicotine.

• TF0388: People who vape may also expose others to potentially harmful chemicals.

• TF0246: Some flavorings in vapes are safe to use in food, but they are not necessarily safe to inhale and may harm the lungs.

Health Effects:

• TF0247: Some vape liquids and vape aerosols contain chemicals that have been reported to damage lung cells in lab studies.

• TF0267: Vapes haven't been fully studied, so the potential health risks to users are unknown.

Adverse Events:

• TF0240 and TF0248: The liquid in vapes may accidentally leak out. Vape liquids containing nicotine may be poisonous if accidentally swallowed or absorbed through the skin.

• TF0239: Vapes have exploded, causing fires and burn injuries.

Other:

• TF0241: Ingredient listings for vapes are currently not required and they are not always accurate. People who vape have no way of knowing exactly what’s in a vape.

The Real Cost Rural

Health Effects:

• TF0036: Smokeless tobacco can cause cancers of the mouth, esophagus and pancreas.

• TF0038: Smokeless tobacco use can cause gum disease that can lead to tooth loss.

• TF0039: People who use smokeless tobacco often develop white patches in their mouths that can turn cancerous.

• TF0295: If you start using smokeless tobacco when you’re a teenager, in ten years you’ll have used about as much tobacco as your body weight.

• TF0296: Smokeless tobacco can stain a person’s teeth.

• TF0305: Any smokeless tobacco use can be harmful – there is no safe level. People who use smokeless tobacco can experience health consequences at any age.

• TF0307: Smokeless tobacco use can increase the risk of heart disease and stroke.

• TF0308: Smokeless tobacco can cause inflammation at the site where it’s placed. It can also contribute to gum disease.

• TF0332: Smokeless tobacco use can cause cavities.

• TF0411: People who use smokeless tobacco can develop red patches in their mouth, which have a high likelihood to turn cancerous.

• TF0417: The white patches in a smokeless tobacco user’s mouth can become more severe if he/she continues to use smokeless tobacco.

• TF0418: The white patches in a smokeless tobacco user’s mouth may disappear over time if he/she stops using smokeless tobacco.

• TF0036: Dip can cause mouth cancer, which can require jaw removal.

HPHCs:

• TF0037: Smokeless tobacco products contain a toxic mix of 4,000 chemicals, including as many as 30 chemicals that are linked to cancer.

• TF0416: The chemicals in smokeless tobacco, including some that can cause cancer, may be absorbed through the linings of the mouth and by swallowing saliva that contains tobacco particles. Then, those carcinogens circulate throughout the body and may cause damage to multiple organs.

• TF0301: Smokeless tobacco products contain Benzo[a]pyrene. Benzo[a]pyrene is carcinogenic to humans.

• TF0297: Smokeless tobacco products contain chemicals such as:

  • Acetaldehyde

  • Arsenic

  • Benzo[a]pyrene

  • Cadmium

  • Nicotine

  • N-Nitrosonornicotine (NNN)

  • 4-(Methylnitrosamino) -1-(3-pyridyl)-1-butanone (NNK)

  • Formaldehyde

  • Chromium

  • Nickel

  • Lead

  • Chrysene

  • Ethyl carbamate (urethane)

    • Message variation: Formaldehyde is a chemical used to preserve dead bodies. It is also found in dip.

    • Message variation: Lead is a chemical found in old paint and dip.

• TF0298: Smokeless tobacco products contain cancer-causing chemicals such as:

  • Arsenic

  • Benzo[a]pyrene

  • Cadmium

  • Crotonaldehyde

  • N-Nitrosonornicotine (NNN)

  • 4-(Methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)

  • Chromium

  • Nickel

  • Chrysene

  • Ethyl carbamate (urethane)

    • Message variation: Arsenic is a chemical found in pesticides. It is also found in dip.

    • Message variation: Cadmium is a chemical found in batteries and dip.

    • Message variation: Chromium is a chemical used to make steel. It is also found in dip.

• TF0299: Smokeless tobacco products contain NNK, which causes cancer in animals and has been linked to an increase in the risk of cancer in humans.

• TF0300: Smokeless tobacco products contain NNN, which causes cancer in animals and has been linked to an increase in the risk of cancer in humans.

• TF0306: The nicotine content of smokeless tobacco products can vary by product type and brand. People who use smokeless tobacco can get as much or more nicotine than cigarette smokers.

Addiction:

• TF0205: Smokeless tobacco products can lead to nicotine addiction.

• TF0426: Smokeless tobacco users continue to crave smokeless tobacco despite harmful consequences and tend to switch to products with higher nicotine levels.

Social Norms:

• TF0427: Interpersonal factors such as family and peer use of smokeless tobacco have a significant impact on the initiation and continued use of smokeless tobacco among youth.

• TF0425: There are a number of factors – like advertising, images of tobacco products in the movies, and tobacco use by family and friends – that increase the risk that teens try tobacco themselves.

• TF0430: The initiation of smokeless tobacco among male youth has been shown to be influenced by their fathers, grandfathers, male cousins, and brothers.

• TF0429: Youth who have a sibling who uses tobacco products and/or smokeless tobacco are more likely to have used smokeless tobacco before.

• TF0428: Youth who perceive friend approval of substance use are more likely to experiment with smokeless tobacco.

Other:

• TF0287: Some smokeless tobacco products can contain fungi such as yeast and mold, as well as bacteria.

• TF0385: Every year, more than 2,300 people in the U.S. are diagnosed with oral, esophageal, and pancreatic cancer because of smokeless tobacco use. For just oral cancer, this number is more than 1,600 people.