Prime Affect Research, Dublin, Ireland.
Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC.
Nicotine Tob Res. 2020 Apr 21;22(5):814-821. doi: 10.1093/ntr/ntz029.
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.
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.
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.
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.
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.
美国食品和药物管理局（FDA）要求在电子烟（e-cigarette）广告上添加警示语，但目前尚不清楚这些警示语是否适用于社交媒体。鉴于社交媒体在电子烟营销中的关键作用，我们通过探索各种推文内容对电子烟感知健康度、尼古丁危害、尝试电子烟可能性和警示语回忆的影响，为 FDA 的决策提供信息。
本研究采用 2×4 被试间实验，参与者观看了一个虚构的电子烟品牌的推文。该推文内容有四个版本（电子烟产品、电子烟使用、电子烟的社会背景、不相关内容），并与两个警示语版本（无、有）交叉。通过社交媒体广告招募成年电子烟使用者（N=994）完成一项调查，并随机分配至观看其中的 8 条推文之一。多变量回归分析考察了推文内容和警示语对电子烟感知健康度、感知危害和尝试电子烟可能性的影响，以及推文内容对警示语回忆的影响。协变量包括烟草和社交媒体使用情况以及人口统计学特征。
有警示语的推文比没有警示语的推文更能引起参与者对电子烟品牌的负面健康认知（p<0.05）。与不相关内容的推文相比，展示电子烟产品（p<0.05）或使用（p<0.001）的推文能引起更高的警示语回忆。
这是第一项研究电子烟社交媒体营销中警示语效果的研究。警示语会导致对电子烟健康风险的认知更负面，但对尼古丁危害或尝试电子烟的可能性没有影响。不同的推文内容会引起不同的警示语回忆。研究应探索电子烟品牌在推文中使用不同的警示语内容（文本、大小、位置）如何影响健康风险认知。
FDA 2016 年的裁决要求在含有尼古丁的电子烟广告上添加警示语，但并未具体说明这是否适用于社交媒体。本研究首次考察了电子烟在推文中的警示语如何影响电子烟的感知健康度和危害，这很重要，因为电子烟品牌正在自愿在 Twitter 和 Instagram 上添加警示语。警示语影响了参与者对电子烟品牌的健康认知，但没有影响对尼古丁危害或尝试电子烟的可能性。我们还发现，推文内容中出现电子烟时，对警示语的回忆更高。这些发现表明，扩大对电子烟社交媒体营销的警示语要求值得进一步探讨和 FDA 考虑。
