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The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions

Author

Listed:
  • Olivia A. Wackowski

    (Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ 08901, USA)

  • Jennah M. Sontag

    (Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ 08901, USA)

  • David Hammond

    (School of Public Health and Health Systems, University of Waterloo, Waterloo, ON N2L 3G1, Canada)

  • Richard J. O’Connor

    (Department of Health Behavior, Roswell Park Cancer Institute, Buffalo, NY 14263, USA)

  • Pamela A. Ohman-Strickland

    (Department of Epidemiology & Biostatistics, Rutgers School of Public Health, Piscataway, NJ 08854, USA)

  • Andrew A. Strasser

    (Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA)

  • Andrea C. Villanti

    (Department of Psychiatry, Vermont Center on Behavior and Health, University of Vermont, Burlington, VT 05405, USA)

  • Cristine D. Delnevo

    (Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ 08901, USA)

Abstract

Although e-cigarettes in the United States are required to carry one nicotine addiction warning, little is known about the impact of other potential e-cigarette warning themes, nor about pairing warnings with messages that communicate e-cigarettes’ reduced-harm potential relative to cigarettes. We randomly assigned 876 young adults (ages 18–29) to view e-cigarette ads in a 3 × 2 plus control online experiment that varied by warning theme (i.e., nicotine addiction; nicotine’s impact on adolescent brain development; presence of harmful chemicals) and warning type—i.e., the presence (“relative harm warning”) or absence (“standard warning”) of a relative harm (RH) statement in the warning label (“e-cigarettes may cause harm to health but are less harmful than cigarettes”). Warning believability, informativeness, understandability and support were high across conditions and there were no significant differences by warning theme on e-cigarette harm perceptions or use intentions nor on nicotine (mis)perceptions. Perceived warning effectiveness for discouraging youth initiation was higher for the “brain” and “chemicals” warnings compared to the addiction warning. Warnings with the included RH statement were perceived as less believable and credible and were less frequently correctly recalled. Research should continue to investigate the impact of different e-cigarette warning themes and formats with priority audiences.

Suggested Citation

  • Olivia A. Wackowski & Jennah M. Sontag & David Hammond & Richard J. O’Connor & Pamela A. Ohman-Strickland & Andrew A. Strasser & Andrea C. Villanti & Cristine D. Delnevo, 2019. "The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions," IJERPH, MDPI, vol. 16(2), pages 1-14, January.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:2:p:184-:d:196507
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    References listed on IDEAS

    as
    1. Olivia A. Wackowski & David Hammond & Richard J. O’Connor & Andrew A. Strasser & Cristine D. Delnevo, 2017. "Considerations and Future Research Directions for E-Cigarette Warnings—Findings from Expert Interviews," IJERPH, MDPI, vol. 14(7), pages 1-10, July.
    2. Ce Shang & Frank J. Chaloupka, 2017. "The Trend of Voluntary Warnings in Electronic Nicotine Delivery System Magazine Advertisements," IJERPH, MDPI, vol. 14(1), pages 1-12, January.
    3. Olivia A. Wackowski & David Hammond & Richard J. O’Connor & Andrew A. Strasser & Cristine D. Delnevo, 2016. "Smokers’ and E-Cigarette Users’ Perceptions about E-Cigarette Warning Statements," IJERPH, MDPI, vol. 13(7), pages 1-13, June.
    4. Noar, Seth M. & Francis, Diane B. & Bridges, Christy & Sontag, Jennah M. & Ribisl, Kurt M. & Brewer, Noel T., 2016. "The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies," Social Science & Medicine, Elsevier, vol. 164(C), pages 118-129.
    5. Jacob A. Rohde & Seth M. Noar & Casey Horvitz & Allison J. Lazard & Jennifer Cornacchione Ross & Erin L. Sutfin, 2018. "The Role of Knowledge and Risk Beliefs in Adolescent E-Cigarette Use: A Pilot Study," IJERPH, MDPI, vol. 15(4), pages 1-9, April.
    6. Jennifer R. Mendel & Marissa G. Hall & Sabeeh A. Baig & Michelle Jeong & Noel T. Brewer, 2018. "Placing Health Warnings on E-Cigarettes: A Standardized Protocol," IJERPH, MDPI, vol. 15(8), pages 1-14, July.
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    2. Galper, Emily F. & Gottfredson O'Shea, Nisha & Ritchie, Caroline & Kresovich, Alex & Ma, Haijing & Sutfin, Erin L. & Sheeran, Paschal & Noar, Seth M., 2024. "Identifying promising themes and messages for youth vaping prevention: A national study," Social Science & Medicine, Elsevier, vol. 348(C).
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    4. Zhenyao Cai & Yimin Mao & Ting Gong & Ying Xin & Jiayun Lou, 2023. "The Effect of Servant Leadership on Work Resilience: Evidence from the Hospitality Industry during the COVID-19 Period," IJERPH, MDPI, vol. 20(2), pages 1-14, January.

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