Abstract
BackgroundThe popularity and use of electronic cigarettes (e-cigarettes) has increased across all demographic groups in recent years. However, little is currently known about the readability of health information and advice aimed at the general public regarding the use of e-cigarettes.ObjectiveThe objective of our study was to examine the readability of publicly available health information as well as advice on e-cigarettes. We compared information and advice available from US government agencies, nongovernment organizations, English speaking government agencies outside the United States, and for-profit entities.MethodsA systematic search for health information and advice on e-cigarettes was conducted using search engines. We manually verified search results and converted to plain text for analysis. We then assessed readability of the collected documents using 4 readability metrics followed by pairwise comparisons of groups with adjustment for multiple comparisons.ResultsA total of 54 documents were collected for this study. All 4 readability metrics indicate that all information and advice on e-cigarette use is written at a level higher than that recommended for the general public by National Institutes of Health (NIH) communication guidelines. However, health information and advice written by for-profit entities, many of which were promoting e-cigarettes, were significantly easier to read.ConclusionsA substantial proportion of potential and current e-cigarette users are likely to have difficulty in fully comprehending Web-based health information regarding e-cigarettes, potentially hindering effective health-seeking behaviors. To comply with NIH communication guidelines, government entities and nongovernment organizations would benefit from improving the readability of e-cigarettes information and advice.
Highlights
The popularity and use of electronic cigarettes (e-cigarettes) has rapidly increased across all demographic groups in recent years [1]
All 4 readability metrics indicate that all information and advice on e-cigarette use is written at a level higher than that recommended for the general public by National Institutes of Health (NIH) communication guidelines
We collected a total of 54 documents for this study including materials from 27 US government entities, 10 for-profit entities, 7 non-US government entities, 7 nongovernment organizations, and 3 documents that were written for teens by US government entities
Summary
The popularity and use of electronic cigarettes (e-cigarettes) has rapidly increased across all demographic groups in recent years [1]. The US Department of Health and Human Services (HHS) [8] and the National Institutes of Health (NIH) [9] recommend health information to be written at 6th to 7th grade level, which is the expected reading level for age 10 to 13 years in the US education system. These recommendations are made to ensure the understandability of health information and reduce health information deficits in the general population. Little is currently known about the readability of health information and advice aimed at the general public regarding the use of e-cigarettes
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