School of Public Health, University of Maryland, College Park, MD, USA.
College of Communication and Creative Arts, Rowan University, Glassboro, NJ, USA.
Nicotine Tob Res. 2022 Aug 6;24(9):1469-1477. doi: 10.1093/ntr/ntac030.
This study examined how health warning labels (HWL) on a waterpipe venue menu captured and held the attention of consumers and influenced waterpipe tobacco smoking (WTS) attitudes, beliefs, and behaviors.
A randomized experiment (N = 96) of young adult waterpipe smokers was conducted in an immersive virtual reality laboratory. Participants viewed one of two virtual reality scenarios, a menu with an HWL and nicotine concentration or menu without an HWL and nicotine concentration. Eye-tracking metrics were collected, and participants completed posttest questionnaires on demographics, tobacco use history, and WTS attitudes, beliefs, and behaviors. T-tests were used to assess group differences, and a mediation analysis conducted to examine the relationship between the HWL and intention to quit WTS.
Participants in the HWL group demonstrated greater visual attention to the warning and nicotine areas and less visual attention to the flavor and ingredients areas of the menu compared to the control group. The HWL group demonstrated greater negative attitudes toward WTS (p = .002), greater perceived risk of decreased lung function (p = .026), and greater intention to quit WTS (p = 0.003). The mediation model indicated the relationship between the HWL on a menu and intention to quit WTS was mediated by an increase in negative attitudes toward WTS.
The HWLs on a menu captured and held the attention of consumers and increased negative attitudes, perceptions of health risk, and intention to quit WTS indicating potential benefit of including a warning label or nicotine concentration on menus to correct misperceptions of WTS.
The study contributes to the broader literature on communicating the harms and risks of WTS. The findings suggest that HWL and nicotine concentration on waterpipe venue menus attract attention from consumers in environments comparable to the real world and the strategy warrants further exploration as a targeted policy intervention to educate the public and reduce the health burden of WTS.
本研究考察了水烟馆菜单上的健康警示标签（HWL）如何吸引并吸引消费者的注意力，并影响水烟烟草使用（WTS）的态度、信念和行为。
在一个沉浸式虚拟现实实验室中，对年轻成年水烟吸烟者进行了一项随机实验（N=96）。参与者观看了两个虚拟现实场景之一，一个有 HWL 和尼古丁浓度的菜单，或一个没有 HWL 和尼古丁浓度的菜单。收集眼动追踪指标，参与者完成关于人口统计学、烟草使用史以及 WTS 态度、信念和行为的后测问卷。使用 t 检验评估组间差异，并进行中介分析以检验 HWL 与戒烟 WTS 意图之间的关系。
与对照组相比，HWL 组对警告和尼古丁区域的视觉注意力更大，对菜单的口味和成分区域的视觉注意力更小。HWL 组对 WTS 的态度更消极（p=0.002），对肺功能下降的感知风险更大（p=0.026），戒烟 WTS 的意图更大（p=0.003）。中介模型表明，菜单上的 HWL 与戒烟 WTS 的意图之间的关系是通过增加对 WTS 的负面态度来介导的。
菜单上的 HWL 吸引并保持了消费者的注意力，并增加了对 WTS 的负面态度、对健康风险的认知和戒烟 WTS 的意图，这表明在菜单上添加警告标签或尼古丁浓度可能有助于纠正对 WTS 的误解，从而带来潜在的益处。
本研究为水烟烟草使用危害和风险的传播的更广泛文献做出了贡献。研究结果表明，水烟馆菜单上的 HWL 和尼古丁浓度可以吸引与现实世界环境相似的消费者的注意力，这一策略值得进一步探索，作为教育公众和减轻 WTS 健康负担的有针对性的政策干预措施。
