Textual health warning labels on snus (Swedish moist snuff): do they affect risk perception?

Connie Villemo Nilsen,Karl Halvor Teigen,Oddgeir Friborg,Frode Svartdal

doi:10.1186/s12889-018-5461-2

Connie Villemo Nilsen, Karl Halvor Teigen + Show 2 more

Open Access

https://doi.org/10.1186/s12889-018-5461-2

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Abstract

BackgroundTo strengthen the risk message on snus warning labels, the European Union in 2016 removed “can” from the warning “This tobacco product (can) damages your health and is addictive.” We tested how these and other textual warnings affect risk perception.MethodsSnus-using and non-using Norwegians aged 16–72 participated in two online survey experiments. Participants in Study 1 (N = 196) were randomized to read one of four warning labels. Outcome variables included ratings of likelihood of health damage from snus and perceived severity of such damages. Study 2 (N = 423) used similar outcome measures but added a baseline measure allowing for a pre-post comparison, as well as a control group receiving no warning label. Data were analysed using ANOVA and non-parametric tests.ResultsStudy 1 indicated that removing “can” from the EU warning increased long-term risk perception, but adding “causes cancer” had no effect on risk perception. In Study 2, risk perception increased from pre to post, regardless of label manipulation. “Causes cancer” and “damages your health” were indicated as most alarming when participants compared and ranked all warnings.ConclusionsAdding “causes cancer” or removing “can” from “damages your health” did not strengthen short-time (1 year) risk perception, but the latter increased long-term (10 years) risk perception in Study 1. In the pre-post design in Study 2, risk perception increased regardless of warning label.

Highlights

To strengthen the risk message on snus warning labels, the European Union in 2016 removed “can” from the warning “This tobacco product damages your health and is addictive.” We tested how these and other textual warnings affect risk perception
The overall ANOVA indicated that females regarded snus use as more risky than males (MFemales = 6.5 vs. MMales = 4.9), F(1, 277) = 33.426, p = .000, partial η2 = . 108, and snus-users regarded snus as less risky compared to non-users (MUsers = 4.5 vs. MNon-users = 6.8), F(1, 277) = 84.030, p = .000, partial η2 =
The correlation between Risk perception and the summed hazards ranged between r = .57–.62, indicating that 62–68% of the variance in risk estimates are determined by other factors than perceived health hazards from snus

Summary

Introduction

To strengthen the risk message on snus warning labels, the European Union in 2016 removed “can” from the warning “This tobacco product (can) damages your health and is addictive.” We tested how these and other textual warnings affect risk perception. To strengthen the risk message on snus warning labels, the European Union in 2016 removed “can” from the warning “This tobacco product (can) damages your health and is addictive.”. We tested how these and other textual warnings affect risk perception. Snus is considered as less harmful compared to smoking [2], the risks associated with snus use should be communicated to users and potential new Whereas the effect of warning labels for smoked tobacco has been thoroughly researched, comparable studies on smokeless tobacco (SLT) are scarce [3]. Males remembered the warnings somewhat better than females, which is reasonable as males tried or purchased such products

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