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Member Research & Reports

Member Research & Reports

Rutgers Study Examines the Impact of E-Cigarette Warnings

A recent Rutgers School of Public Health, Center for Tobacco Studies research paper finds that warning labels with messages about harms beyond nicotine’s addictiveness are perceived as believable, informative, understandable and credible among young adults, may provide novel information, and may discourage e-cigarette use among young people.

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.

The Center for Tobacco Studies 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, including: nicotine addiction; nicotine’s impact on adolescent brain development; presence of harmful chemicals and warning type: the presence a “relative harm warning” or absence “standard warning” of a relative harm (RH) statement in the warning label. For example, “e-cigarettes may cause harm to health but are less harmful than cigarettes”.

The researchers, led by Dr. Oliva Wackowski, found that 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 misperceptions. 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.

“This study tested the impact of exposure to text warnings on e-cigarette ads in a new standardized format,” said Dr. Wackowski. “This included different warning themes and the inclusion of a message comparing the harm of e-cigarettes relative to cigarettes. Overall, young adults expressed strong support for e-cigarette warnings and perceived them to be believable, understandable and informative about e-cigarette risks. However, we found few experimental effects of warning exposure on e-cigarette harm and risk perceptions and use intentions,” continued Dr. Wackowski.

“E-cigarettes are less risky than combustible cigarettes and so it is important that research continue to investigate the impact of e-cigarette warnings in combination with potential reduced risk or relative harm statements with priority audiences like adult cigarette smokers and young people who do not currently use tobacco” said Dr. Cristine Delnevo, co-author and director of the Center for Tobacco Studies, who is also co-leader of the Cancer Prevention and Control Research Program at Rutgers Cancer Institute of New Jersey.

The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions,” was recently published in the International Journal of Environmental Research and Public Health.