“Harm” vs. “harm reduction” messages: An analysis of conflicting information about cigars on major health websites in seven countries

Epidemiological evidence suggests that smoking cigars is generally less dangerous than smoking cigarettes, however, many factors (e.g., inhalation, daily intake) influence health risks. Health communications stating that cigars are not safe (i.e., harm statements) encourage avoidance. Whereas “harm reduction” statements, may encourage cigarette smokers to approach the product. Although one can accurately describe a product as harmful and less harmful in the same sentence, at another level there is conflict between the positive (approach) and negative (avoid) information. In light of these concerns, we evaluated how major health websites convey health risk information about cigars. Websites were reviewed for the extent of information provided in two independent content domains: 1) “harm” -information on risks in comparison to nonusers of this product, and 2) “harm reduction”- information on reduced risks in comparison to users of the highest risk product. Ten websites from 7 different countries were reviewed. All websites included harm messages. Six of the 10 websites included harm reduction messages. Websites varied in the extent of information provided about the behavioral factors that influence health risks. Although there is substantial variation across websites, detailed harm reduction information about cigars is available on-line. Given concerns that harm reduction messages are interpreted as “safe,” the presence of harm reduction messages on websites raises the question of whether such information encourages users to approach dangerous products. Potential relationships between conflicting harm/harm reduction themes, motivational orientations (approach vs. avoidance), and health message framing (gain vs. loss) will be discussed.