Sontag Jennah M, Wackowski Olivia A, Hammond David
Center for Tobacco Studies, Rutgers School of Public Health, New Brunswick, NJ 08901, USA.
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
Prev Med Rep. 2019 Aug 6;16:100966. doi: 10.1016/j.pmedr.2019.100966. eCollection 2019 Dec.
Health warnings on tobacco products can inform users of potential risks. However, little is known about young people's exposure to health warnings on e-cigarette products. This baseline assessment of young people's noticing e-cigarette warnings uses nationally representative data from three countries. Data were collected under Wave 1 of the ITC Youth Tobacco and E-cigarette Survey, conducted in Canada, England, and the US. Online surveys were completed by 16-19-year-olds in July/August 2017 ( = 12,064), when warnings were either newly required (England) or voluntarily carried by some manufacturers (US, Canada). Analyses examined prevalence and correlates of noticing warnings and associations between noticing warnings and product perceptions, adjusting for country, sex, age, race/ethnicity, and cigarette/e-cigarette use status. About 12% reported noticing warnings on e-cigarette packaging in the past 30 days. Noticing warnings was significantly more likely among youth in England (AOR = 1.3, < .01) and the US (AOR = 1.3, p < .01) versus Canada, and was most likely among dual e-cigarette/cigarette users (AOR = 4.69, < .001) versus nonusers. Unaided recall of the keyword "nicotine" was low among those who noticed warnings (7.5%). However, ever e-cigarette users who noticed warnings had higher odds of knowing whether e-cigarettes contained nicotine (AOR = 2.26, < .001). Noticing warnings was significantly associated with higher odds of believing e-cigarettes cause at least some harm to users (AOR = 1.19), are as harmful as cigarettes (AOR = 1.45), and can be addictive (AOR = 1.43). Baseline assessment reveals that youth's noticing of e-cigarette warnings and recall of nicotine-addiction messages was low. Research should track exposure over time as warning requirements are implemented across different countries.
烟草产品上的健康警示可以让使用者了解潜在风险。然而，对于年轻人接触电子烟产品健康警示的情况，我们却知之甚少。这项关于年轻人注意到电子烟警示的基线评估使用了来自三个国家具有全国代表性的数据。数据是在国际烟草控制（ITC）青少年烟草与电子烟调查的第1波中收集的，该调查在加拿大、英格兰和美国开展。2017年7月/8月，16至19岁的青少年完成了在线调查（n = 12,064），当时在英格兰新要求设置警示，在美国和加拿大一些制造商自愿设置警示。分析研究了注意到警示的患病率及其相关因素，以及注意到警示与产品认知之间的关联，并对国家、性别、年龄、种族/族裔以及香烟/电子烟使用状况进行了调整。约12%的人报告在过去30天内注意到了电子烟包装上的警示。与加拿大相比，英格兰（调整后比值比[AOR]=1.3，p<0.01）和美国（AOR = 1.3，p<0.01）的年轻人注意到警示的可能性显著更高，而且与非使用者相比，电子烟/香烟双重使用者注意到警示的可能性最大（AOR = 4.69，p<0.001）。在注意到警示的人群中，对关键词“尼古丁”的自发回忆率较低（7.5%）。然而，注意到警示的曾经使用电子烟的人知道电子烟是否含有尼古丁的几率更高（AOR = 2.26，p<0.001）。注意到警示与更高几率相信电子烟至少会对使用者造成一定伤害（AOR = 1.19）、与香烟一样有害（AOR = 1.45）以及会上瘾（AOR = 1.43）显著相关。基线评估显示，年轻人对电子烟警示的注意以及对尼古丁成瘾信息的回忆程度较低。随着不同国家实施警示要求，研究应长期跟踪接触情况。
