Are Some of the Cigar Warnings Mandated in the U.S. More Believable Than Others?

Kristen Jarman,Sarah Kowitt,Adam Goldstein,Jennifer Cornacchione Ross

doi:10.3390/ijerph14111370

Abstract

Background: Text warnings are mandated on cigars sold in the United States (U.S.), however little published research has examined effectiveness of cigar warnings. This is the first study examining the believability of cigar warnings among adults in the U.S. Methods: Adults in the U.S. (n = 5014) were randomized in a phone survey to receive one of three cigar-specific mandated warning messages (“Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”, “Cigar smoking can cause lung cancer and heart disease”, and “Cigars are not a safe alternative to cigarettes”) with one of four warning sources (no source, Surgeon General, CDC (Centers for Disease Control and Prevention), FDA (Food and Drug Administration)). Results: Most adults found the cigar warnings very believable (66.9%). Weighted logistic regression results indicate that the message “Cigar smoking can cause lung cancer and heart disease” was associated with higher odds of being very believable (AOR: 2.05, 95% CI: 1.55, 2.70) and the message “Cigars are not a safe alternative to cigarettes” was associated with lower odds of being very believable (AOR: 0.71, 95% CI: 0.55, 0.92) compared to the message “Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”. Warning source had no impact on believability. Conclusions: We tested three of the currently mandated cigar warnings in the U.S. and found significant differences in believability between them. Further research on cigar warnings may improve communication to the public on cigar health risks, ultimately preventing uptake of cigars and promoting cessation among cigar users.

Highlights

More than one third of adults in the United States (U.S.) has used a cigar in their lifetime, and 5%have used a cigar in the past month [1]
Our findings indicate that of the three mandated cigar warnings tested in this study, the warning that “Cigar smoking can cause lung cancer and heart disease” was significantly more believable than the warning “Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”
We assessed the believability of the cigar warnings among at-risk populations, including people who are more likely to use cigars or tobacco products (men, young adults (18–25), people that identify as Black non-Hispanic or other non-Hispanic, people who identify as lesbian, gay, and bisexual, people with lower educational attainment, and people with lower income) [4]

Summary

Introduction

More than one third of adults in the United States (U.S.) has used a cigar in their lifetime, and 5%have used a cigar in the past month [1]. Text warnings are mandated on cigars sold in the United States (U.S.), little published research has examined effectiveness of cigar warnings. This is the first study examining the believability of cigar warnings among adults in the U.S Methods: Adults in the. U.S (n = 5014) were randomized in a phone survey to receive one of three cigar-specific mandated warning messages (“Cigar smoking can cause cancers of the mouth and throat, even if you do not inhale”, “Cigar smoking can cause lung cancer and heart disease”, and “Cigars are not a safe alternative to cigarettes”) with one of four warning sources (no source, Surgeon General, CDC (Centers for Disease Control and Prevention), FDA (Food and Drug Administration)). Further research on cigar warnings may improve communication to the public on cigar health risks, preventing uptake of cigars and promoting cessation among cigar users

Methods

Discussion

Conclusion