Dataset Information

Effect of warning statements in e-cigarette advertisements: an experiment with young adults in the United States.

ABSTRACT: This on-line experiment examined whether the addition of ingredient- or industry-themed warning statements in television advertisements for e-cigarettes would affect young adults' craving for and risk perceptions of e-cigarettes and combustible cigarettes, as well as intent to purchase e-cigarettes.Advertisements for two leading e-cigarette brands were edited to contain a warning statement about product ingredients or about the tobacco industry. Participants were assigned randomly to one of eight treatments or one of two brand-specific control conditions without any warning statement.Young adults (n=900, aged 18-34?years) in a web panel were recruited from three groups: recent e-cigarette users, current smokers who used combustible cigarettes exclusively and non-users of either product.Craving and risk perceptions (addictiveness, harmful to health in general, harmful to others) were measured separately for e-cigarettes and combustible cigarettes. The Juster scale measured intention to purchase e-cigarettes.Exposure to both types of warnings was associated with lower craving for e-cigarettes among e-cigarette users and smokers who experienced any craving (P<0.01) and lower intention to purchase among all participants (P<0.001). Only exposure to ingredient-themed warnings was associated with lower craving for combustible cigarettes (P<0.05). Participants who saw industry-themed warnings reported greater perceptions of general harm (P<0.001), but also rated e-cigarettes as less addictive than the control conditions (P<0.05).The addition of ingredient- or industry-themed warning statements to e-cigarette television advertising similarly reduces craving and purchase intent for e-cigarettes, but has inconsistent effects on perceived risks.

SUBMITTER: Sanders-Jackson A

PROVIDER: S-EPMC5113715 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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Effect of warning statements in e-cigarette advertisements: an experiment with young adults in the United States.

Sanders-Jackson Ashley A Schleicher Nina C NC Fortmann Stephen P SP Henriksen Lisa L

Addiction (Abingdon, England) 20150907 12

<h4>Background and aims</h4>This on-line experiment examined whether the addition of ingredient- or industry-themed warning statements in television advertisements for e-cigarettes would affect young adults' craving for and risk perceptions of e-cigarettes and combustible cigarettes, as well as intent to purchase e-cigarettes.<h4>Design</h4>Advertisements for two leading e-cigarette brands were edited to contain a warning statement about product ingredients or about the tobacco industry. Partici ...[more]

PMID: 25557128

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Project description:IntroductionAdvertisement warnings are often overlooked, which reduces the opportunity for risk communication.MethodsWe used Prolific to survey 1131 young adults (18-35) who currently used e-cigarettes or tobacco products. We randomized participants to one of four warning conditions: black text on white background (BW), white on black (WB), black on yellow (BY), and yellow on black (YB). We examined associations between condition and attention, recall, ad appeal, perceived message effectiveness (PME), and intentions to use e-cigarettes using chi-square and analysis of variance (ANOVA) where appropriate. We conducted logistic regressions by condition for attention and recall controlling for demographics and tobacco use.ResultsThe warning was selected as the most attention-capturing area of the advertisement more often by those exposed to yellow warnings than white (59.9% vs. 46.8%), even after controlling for demographics and tobacco use (p < .05). Recall was greater among those exposed to yellow warnings than white (44.2% vs. 37.3%), which held in controlled models. There were no significant differences between yellow and white warnings for ad appeals, PME, or intentions to use. In subanalyses, WB warnings generated higher PME (10.1 vs. 9.5) and lower intentions to use e-cigarettes (3.0 vs. 3.3) than black on white (BW) (each p < .05).ConclusionsYellow warning color increases attention and recall of the warning, but this increase in attention did not translate to differences in downstream effects. Among currently mandated warning variations, the white text on black background warning appears more effective than the BW. Future research should examine whether differences translate to behavior change.ImplicationsWe tested color variations of the FDA-mandated nicotine text warning on e-cigarette advertisements. Yellow variations (yellow text on black background and BY) better-captured attention and increased warning recall compared to the mandated black and white warnings. Among the FDA-mandated BW and WB warnings, the WB variation appears more effective, generating higher perceived message effectiveness and lower intentions to use e-cigarettes. Given the difficulty in implementing pictorial warnings in the United States, color might represent an alternative to improve warning effectiveness. Findings may also be applicable to those designing tobacco-related health communications.

Project description:Introduction:Prior to the US Food and Drug Administration's (FDA) regulation of electronic cigarettes and warning statements related to nicotine addiction, there was no critical examination of manufacturer/distributor voluntary practices that could potentially inform FDA actions aimed to protect consumers. This study examined the content of warning statements and safety characteristics of electronic cigarette liquid bottles using a national sample. Methods:Research staff randomly selected four electronic cigarette liquid manufacturers/distributors from four US geographic regions. Staff documented the characteristics of product packaging and content of warning statements on 147 electronic cigarette liquids (0-30 mg/ml of nicotine) purchased online from 16 manufacturers/distributors in April of 2016. Results:Data showed that 97.9% of the electronic cigarette liquid bottles included a warning statement, most of which focused on nicotine exposure rather than health. Only 22.4% of bottles used a warning statement that indicated the product "contained nicotine." Of bottles that advertised a nicotine-based concentration of 12 mg/ml, 26% had a warning statements stated that the product "contains nicotine." None of the statements that indicated that the product "contained nicotine" stated that nicotine was "addictive." All bottles had a safety cap and 12% were in plastic shrink-wrap. Fifty-six percent of the websites had a minimum age requirement barrier that prevented under-aged persons from entering. Conclusions:Most manufacturers/distributors printed a warning statement on electronic cigarette liquid bottles, but avoided warning consumers about the presence and the addictiveness of nicotine. Studies are needed to examine manufacturer/distributor modifications to product packaging and how packaging affects consumer behaviors. Implications:These data can inform future FDA requirements related to the packaging and advertising of e-cigarette liquids; regulation related to the content of warning statements, including exposure warning statements, which are not currently mandated; and requirements on websites or language on packaging to help manufacturers adhere to the minimum age of purchase regulation. The data can also be used to help FDA develop additional guidance on the framing of statements on packaging that helps consumers make informed decisions about purchasing the product or protecting young people from use or unintentional exposure to the product.

Project description:IntroductionIn 2018, the United States Food and Drug Administration (FDA) required that electronic cigarette (e-cigarette) manufacturers, packagers, importers, distributors, and retailers display an addictive or alternate warning statement on e-cigarette visual advertisements. Few studies have investigated the FDA-mandated and other warnings on social media. This study examined the prevalence and content of warning statements in e-cigarette-related YouTube videos.MethodsIn 2019, The Virginia Commonwealth University Center for the Study of Tobacco Products conducted bi-monthly (February-June) YouTube searches by relevance and view count to identify e-cigarette-related videos. Overall, 178 videos met the inclusion criteria. Staff coded each video for the presence of a visual/verbal warning statement, warning statement type (eg, FDA-mandated, addiction/tobacco, safety/toxic exposure, health effects), sponsorship, and tobacco product characteristics. A data extraction tool collected the video URL, title, upload date, and number of views, likes/dislikes, and comments.ResultsOnly 5.1% of videos contained FDA-mandated and 21.9% contained non-mandated warnings. All videos with FDA-mandated and 46.2% of non-mandated warnings were represented visually. Only 13.1% of industry-sponsored videos uploaded after the mandate effective date had an FDA-mandated warning statement and videos with FDA-mandated and non-mandated (v. no) warnings had significantly fewer views, likes, dislikes, and comments. Among all non-mandated warnings, 31.3% featured an addiction/tobacco, 18.8% a safety/toxic exposure, and 37.5% a health effects warning.ConclusionsThe prevalence of FDA-mandated warning statements in e-cigarette related YouTube videos was low. FDA enforcement of the warning statement mandate on YouTube could increase the public's understanding of the addictive nature of nicotine in e-cigarettes.ImplicationsThe FDA has the authority to regulate the advertisement and promotion of e-cigarettes on the Internet. These data can inform future FDA requirements related to the language content and visual representation of addiction/tobacco, safety/exposure, and health effects warning statements that appear in YouTube videos and other visual social media popular among young people. Such data would help consumers make informed decisions about purchasing e-cigarette products, using e-cigarettes, and avoiding unintentional harm related to e-cigarettes. In addition, these data may help social media platforms make decisions on whether they will prohibit advertisements that promote or facilitate the sale of tobacco products.

Project description:INTRODUCTION:It is unclear whether warnings on electronic cigarette (e-cigarette) advertisements required by the US Food and Drug Administration (FDA) will apply to social media. Given the key role of social media in marketing e-cigarettes, we seek to inform FDA decision making by exploring how warnings on various tweet content influence perceived healthiness, nicotine harm, likelihood to try e-cigarettes, and warning recall. METHODS:In this 2 × 4 between-subjects experiment participants viewed a tweet from a fictitious e-cigarette brand. Four tweet content versions (e-cigarette product, e-cigarette use, e-cigarette in social context, unrelated content) were crossed with two warning versions (absent, present). Adult e-cigarette users (N = 994) were recruited via social media ads to complete a survey and randomized to view one of eight tweets. Multivariable regressions explored effects of tweet content and warning on perceived healthiness, perceived harm, and likelihood to try e-cigarettes, and tweet content on warning recall. Covariates were tobacco and social media use and demographics. RESULTS:Tweets with warnings elicited more negative health perceptions of the e-cigarette brand than tweets without warnings (p < .05). Tweets featuring e-cigarette products (p < .05) or use (p < .001) elicited higher warning recall than tweets featuring unrelated content. CONCLUSIONS:This is the first study to examine warning effects on perceptions of e-cigarette social media marketing. Warnings led to more negative e-cigarette health perceptions, but no effect on perceived nicotine harm or likelihood to try e-cigarettes. There were differences in warning recall by tweet content. Research should explore how varying warning content (text, size, placement) on tweets from e-cigarette brands influences health risk perceptions. IMPLICATIONS:FDA's 2016 ruling requires warnings on advertisements for nicotine-containing e-cigarettes, but does not specify whether this applies to social media. This study is the first to examine how e-cigarette warnings in tweets influence perceived healthiness and harm of e-cigarettes, which is important because e-cigarette brands are voluntarily including warnings on Twitter and Instagram. Warnings influenced perceived healthiness of the e-cigarette brand, but not perceived nicotine harm or likelihood to try e-cigarettes. We also saw higher recall of warning statements for tweets featuring e-cigarettes. Findings suggest that expanding warning requirements to e-cigarette social media marketing warrants further exploration and FDA consideration.

Dataset Information

Effect of warning statements in e-cigarette advertisements: an experiment with young adults in the United States.

Publications

Effect of warning statements in e-cigarette advertisements: an experiment with young adults in the United States.

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