Given the high rate of adoption of snus use observed in our study, future studies should determine the impact of snus marketing on awareness, attitudes and uptake in an effort to reduce tobacco consumption of all types among all age groups. Funding This work was supported by the U.S. National Cancer Institute (“type”:”entrez-nucleotide”,”attrs”:”text”:”CA085739″,”term_id”:”34939046″,”term_text”:”CA085739″CA085739 selleck chemicals to P.F.S.). Declaration of Interests None declared.
Smoking cessation agents aimed at addressing symptoms of nicotine withdrawal and cravings are psychotropic medications. As such, they may provide cues (e.g., symptom reduction, side effects) to participants that they indeed are receiving the active drug (Hughes & Krahn, 1985).

The felt effects of the active drug may be apparent and create greater expectancy for the therapeutic effects of the drug. Consequently, smoking cessation pharmacological clinical trials may be vulnerable to differential outcomes resulting from expectation bias. The properties of psychotropic drugs may limit researchers�� ability to control for participant expectations, introducing a potential confound that could impact the validity of the results. Conversely, a lack of expectation for the drug, as would occur if participants believed they were assigned to placebo, may serve to reduce the positive effect of expectancy on treatment outcome (Oken, 2008). As such, clinical trials are advised to assess perceptions of treatment assignment (Price, Finniss, & Benedetti, 2008) and whether these perceptions impact study outcomes (Hughes & Krahn, 1985).

Several nicotine replacement therapy (NRT) trials have reported participants�� perceived group assignment and examined the association between perceived assignment and smoking abstinence (Mooney, White, & Dacomitinib Hatsukami, 2004). However, only two studies investigated the impact of perceived treatment assignment on smoking abstinence in double-blind, randomized, clinical trials of bupropion (Schnoll et al., 2008; Thomas et al., 2008). Both trials included smokers who consumed at least 10 cigarettes per day (cpd). Thomas et al.��s sample was exclusively African American, whereas Schnoll et al.��s sample was predominantly White. In contrast to studies finding no relationship between perceived treatment assignment and smoking abstinence in NRT trials (Mooney et al., 2004), both bupropion studies found that perceiving bupropion assignment was positively associated with biochemically verified smoking abstinence at end-of-treatment and long-term follow-up even after controlling for actual treatment assignment. Their findings may indicate that participants�� expectations of receiving the active drug enhanced the treatment effect of bupropion.