Avery Rosemary J, Kalaji Motasem, Niederdeppe Jeff, Mathios Alan, Dorf Michael, Byrne Sahara, Safi Amelia Greiner
Jeb E. Brooks School of Public Policy, Cornell University, Ithaca, NY, United States of America.
Department of Communication Studies, California State University, Northridge, Los Angeles, CA, United States of America.
PLoS One. 2023 Jun 23;18(6):e0286806. doi: 10.1371/journal.pone.0286806. eCollection 2023.
A warning on e-cigarette packaging is one way the U.S. government can inform the public of known harms of e-cigarette use. Currently, the only required warning on these products is: "WARNING: This product contains nicotine. Nicotine is an addictive chemical." This exploratory study aims to inform potential future investigations and FDA decisions regarding alternative warnings that may generate fear in addition to being intentionally informational.
Data were obtained from responses by 16 online focus groups with adult (N = 47, age range = 18-64) and youth (N = 32, age range 14-16) participants with various smoking and vaping experiences. We showed each focus group a set of hypothetical e-cigarette warning labels to determine how they respond to currently existing public statements that communicate information on the toxicity of ingredients in e-cigarettes, potential health risks, addiction to nicotine, and the uncertainty of the science regarding health effects of using these products. The focus group interviews were audio recorded and transcribed. Transcripts were subjected to a multiphase coding process to identify common response themes. Codes derived from the Extended Parallel Processing Model were then applied to understand impact of potentially fear-inducing language by warning category and age group.
For adults, all warnings-except those about addiction-gave rise to spontaneous danger control (intended) responses, such as quit intentions. Warnings highlighting cognitive and uncertain effects may be particularly promising for adult consumers of tobacco products because both gengerated danger control and response efficacy without evidence of fear control. However, responses also suggest that warnings risk discouraging some adults who use combustible cigarettes from transitioning to e-cigarettes for harm reduction. For youth, while evidence of response efficacy and danger control emerged among youth exposed to messages in all warning categories but one-addiction-unproductive reactions indicative of fear control were also prevalent among youth respondent across most warning types. On average, youth were more skeptical than adults about the harms of using e-cigarettes.
Implications of study findings for the development of future effective e-cigarette warning messages are explored.
在美国，电子烟包装上的警示是政府向公众告知电子烟使用已知危害的一种方式。目前，这些产品唯一要求标注的警示是：“警告：本产品含有尼古丁。尼古丁是一种成瘾性化学物质。”这项探索性研究旨在为未来可能开展的调查以及美国食品药品监督管理局（FDA）关于替代警示的决策提供信息，这些替代警示除了具有告知性外，还可能引发恐惧。
数据来自16个在线焦点小组的回复，参与者包括成年人（N = 47，年龄范围18 - 64岁）和青少年（N = 32，年龄范围14 - 16岁），他们有不同的吸烟和吸电子烟经历。我们向每个焦点小组展示了一组假设的电子烟警示标签，以确定他们对当前传达电子烟成分毒性、潜在健康风险、尼古丁成瘾以及使用这些产品对健康影响的科学不确定性等信息的公开声明会作何反应。焦点小组访谈进行了录音和转录。对转录文本进行多阶段编码过程，以识别常见的反应主题。然后应用从扩展平行加工模型得出的编码，按警示类别和年龄组来理解可能引发恐惧的语言的影响。
对于成年人，除了关于成瘾的警示外，所有警示都引发了自发的危险控制（预期）反应，如戒烟意图。强调认知和不确定影响的警示对于烟草产品成年消费者可能特别有前景，因为这两种警示都产生了危险控制和反应效能，且没有恐惧控制的迹象。然而，这些反应也表明，警示可能会使一些吸可燃香烟的成年人因担心危害而不愿转向电子烟以减少伤害。对于青少年，除了一个关于成瘾的警示类别外，在接触所有警示类别的信息的青少年中都出现了反应效能和危险控制的证据，但在大多数警示类型的青少年受访者中，表明恐惧控制的无效反应也很普遍。平均而言，青少年比成年人更怀疑使用电子烟的危害。
探讨了研究结果对未来制定有效的电子烟警示信息的影响。
