Abstract
IntroductionMany countries have now mandated warning labels on e-cigarette products. One example, the EU TPD health warning states, “This product contains nicotine which is a highly addictive substance. [It is not recommended for use by non-smokers]”. The impact of the EU TPD warning message on intentions to use, has not been explored within an EU population. AimsExamine the effect of i) the TPD e-cigarette health warning and ii) an alternative relative risk message, on smokers' willingness to use, likelihood of purchase, and intention to use as a quit aid. MethodsCross-sectional online study. Ninety-five smokers (55 males; 18–55 years old) were randomly allocated to one of three conditions and viewed ten individually presented e-cigarettes images with either no message, TPD message, or relative risk message. Participants rated i) willingness to use, and likelihood of: ii) purchase, iii) using in the next month, and iv) using in a quit attempt, before and after viewing the images. ResultsFor willingness to use and likelihood of purchase, ANCOVAs showed a significant main effect of Message Type (ps, <.05); ratings were lower in the TPD condition. Message type, however did not significantly change likelihood of using in the next month or using in a quit attempt. ConclusionsPreliminary findings suggest that the TPD e-cigarette health warning may reduce smokers' willingness to use and likelihood of purchasing an e-cigarette. Messages conveying reduced harm or indeed, no message at all, may be more effective in encouraging smokers to switch to these lower risk products.
Highlights
Many countries have mandated warning labels on e-cigarette products
It is possible that health warnings on e-cigarettes may exacerbate these misperceptions by negatively impacting smokers' beliefs and acting as a deterrent to use in a quit attempt (Wackowski, Hammond, O'Connor, Strasser, & Delnevo, 2016)
Mean FTCD scores were 2.42 (SD = 2.47) and participants reported smoking for an average of 8.83 years (SD = 7.13) and on average, 9.63 (SD = 5.91) cigarettes per day (CPD). 33.3% of participants reported attempting to quit in the last year, 24.7% within the last 6 months, 13.6% within the last month and 7.4% in the last week; 21% reported never attempting to quit. 32.1% reported their quit attempt lasting one month, 22.2% lasting one week, 22.2% lasting one day, 9.9% lasting 6 months and 7.4% lasting one year. 34.6% described themselves as knowing they should stop smoking but not wanting to
Summary
Many countries have mandated warning labels on e-cigarette products. One example, the EU TPD health warning states, “This product contains nicotine which is a highly addictive substance. [It is not recommended for use by non-smokers]”. Aims: Examine the effect of i) the TPD e-cigarette health warning and ii) an alternative relative risk message, on smokers' willingness to use, likelihood of purchase, and intention to use as a quit aid. Results: For willingness to use and likelihood of purchase, ANCOVAs showed a significant main effect of Message Type (ps, < .05); ratings were lower in the TPD condition. Conclusions: Preliminary findings suggest that the TPD e-cigarette health warning may reduce smokers' willingness to use and likelihood of purchasing an e-cigarette. Similar results have been found in a US sample (Majeed et al, 2017) Reasons for these misperceptions may include a general misunderstanding of the harms of nicotine use, as well as the wider impact of negative media reporting (McNeill et al, 2018). It is possible that health warnings on e-cigarettes may exacerbate these misperceptions by negatively impacting smokers' beliefs and acting as a deterrent to use in a quit attempt (Wackowski, Hammond, O'Connor, Strasser, & Delnevo, 2016)
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