Introduction:
Little is known about beliefs about “light” cigarettes (“lights”) in African countries where both tobacco industry activity and tobacco control efforts are intensifying. This study in Zambia is the first to examine the prevalence and beliefs about “lights” among smokers in Africa.

Methods:
Data are from 1,214 smokers participating in the International Tobacco Control (ITC) Zambia Wave 1 Survey (2012), a multi-stage clustered sampling design, face-to-face nationally representative probability sample of tobacco users and non-users aged 15 years and older.

Results:
17.0% of respondents’ usual brand of cigarettes was “lights”. 36.5% of smokers believed that “lights” are less harmful; beliefs differed by brand type (42.1% “lights” vs. 38.2% “non-lights”). 42.0% of smokers believed that “lights” are smoother on the throat and chest than regular cigarettes with beliefs differing by brand type. Among smokers who believed that “lights” are smoother, 81.0% believed that these cigarettes are less harmful, much higher than the 4.1% of smokers who did not believe that “lights” are smoother. Smoothness beliefs about “lights” was the strongest predictor of the belief that “lights” are less harmful (p<0.001, OR=131.13, 95% CI 59.4 to 289.5).

Conclusions:
Zambian smokers incorrectly believe that “lights” are less harmful. The highly strong association between the belief that “lights” are smoother and the belief that “lights” are less harmful suggests that tobacco control policies need to use a multi-pronged approach including product regulation, banning misleading descriptors and menthol, and implementing sustained long-term public education campaigns to combat sensory beliefs and misperceptions about “lights”.