IQOS广告中不同健康警示标签和减少接触信息对美国和以色列成年人认知的影响。
Impact of different health warning label and reduced exposure messages in IQOS ads on perceptions among US and Israeli adults.
作者信息
Berg Carla J, Duan Zongshuan, Wang Yan, Thrasher James F, Abroms Lorien C, Khayat Amal, Romm Katelyn F, Levine Hagai, Bar-Zeev Yael
机构信息
Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA.
Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
出版信息
Prev Med Rep. 2023 Apr 15;33:102209. doi: 10.1016/j.pmedr.2023.102209. eCollection 2023 Jun.
Heated tobacco products (HTPs; e.g., IQOS) are advertised as safer than cigarettes or an alternative, yet required health warning labels (HWLS) in many countries, including the US and Israel, do not consider whether HTP ads undermine HWLs, particularly those that do not explicitly address HTPs. In 2021, a randomized 4 × 3 factorial experiment among 2,222 US and Israeli adults examined IQOS ads with differing: 1) HWLs (i.e., smoking risks, prompt to quit, HTP-specific, control); and 2) ad messages (i.e., slight distancing: "cigarette-like satisfaction, no odor", clear distancing: "looking for an alternative?", control). Outcomes were perceived relative harm (vs cigarettes), exposure to harmful chemicals, and disease risk and likelihood of trying or suggesting IQOS to smokers. Ordinal logistic regression was used, adjusted for covariates. One HWL effect was found: risk (vs control) increased perceived relative harm (aOR = 1.21, CI = 1.03-1.41) and exposure (aOR = 1.22, CI = 1.04-1.42) and decreased likelihood of trying IQOS (aOR = 0.82, CI = 0.69-0.97). Both slight and clear distancing ads (vs control) decreased perceived harm (aOR = 0.85, CI = 0.75-0.97; aOR = 0.63, CI = 0.55-0.72, respectively) and increased likelihood of suggesting IQOS to smokers (aOR = 1.23, CI = 1.07-1.41; aOR = 1.28, CI = 1.11-1.47); slight distancing decreased perceived disease risk (aOR = 0.85, CI = 0.75-0.97); and clear distancing decreased perceived exposure (aOR = 0.73, CI = 0.64-0.83). Clear (vs slight) distancing decreased perceived relative harm (aOR = 0.74, CI = 0.65-0.85) and exposure (aOR = 0.82, CI = 0.71-0.93). One interaction effect was found: the quitting HWL and clear distancing led to particularly low perceived relative harm (aOR = 0.63, CI = 0.43-0.93). Regulatory agencies must monitor the impacts of advertising, including reduced risk/exposure messaging on perceptions of HWL messages, to inform future regulatory efforts.
加热烟草制品（如IQOS）被宣传为比香烟更安全或可作为香烟的替代品，但在美国和以色列等许多国家，要求的健康警示标签并未考虑加热烟草制品广告是否会削弱这些警示标签的效果，尤其是那些未明确提及加热烟草制品的警示标签。2021年，在美国和以色列的2222名成年人中进行了一项随机4×3析因实验，研究了不同的IQOS广告：1）健康警示标签（即吸烟风险、戒烟提示、特定于加热烟草制品的、对照）；2）广告信息（即轻微区分：“类似香烟的满足感，无异味”，明确区分：“在寻找替代品吗？”，对照）。结果包括感知到的相对危害（与香烟相比）、接触有害化学物质的情况、疾病风险以及向吸烟者推荐IQOS的可能性。使用有序逻辑回归，并对协变量进行了调整。发现了一种健康警示标签效应：风险（与对照相比）增加了感知到的相对危害（调整后的比值比[aOR]=1.21，置信区间[CI]=1.03-1.41）和接触（aOR=1.22，CI=1.04-1.42），并降低了尝试IQOS的可能性（aOR=0.82，CI=0.69-0.97）。轻微和明确区分的广告（与对照相比）均降低了感知到的危害（aOR分别为0.85，CI=0.75-0.97；aOR=0.63，CI=0.55-0.72），并增加了向吸烟者推荐IQOS的可能性（aOR分别为1.23，CI=1.07-1.41；aOR=1.28，CI=1.11-1.47）；轻微区分降低了感知到的疾病风险（aOR=0.85，CI=0.75-0.97）；明确区分降低了感知到的接触（aOR=0.73，CI=0.64-0.83）。明确区分（与轻微区分相比）降低了感知到的相对危害（aOR=0.74，CI=0.65-0.85）和接触（aOR=0.82，CI=0.71-0.93）。发现了一种交互作用效应：戒烟健康警示标签和明确区分导致感知到的相对危害特别低（aOR=0.63，CI=0.43-0.93）。监管机构必须监测广告的影响，包括降低风险/接触信息对健康警示标签信息认知的影响，以便为未来的监管工作提供参考。
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