- freely available
Int. J. Environ. Res. Public Health 2016, 13(7), 655; https://doi.org/10.3390/ijerph13070655
2. Materials and Methods
2.3. Procedures and Stimulus Materials
3.1. Warning Statement Ratings and Perceptions
3.1.1. Message 1: Poisonous Liquid
“If it can’t have contact with your outer skin, it shouldn’t have contact with your inner lungs. Usually they don’t have ’avoid contact with skin’ warnings unless it will like deteriorate something” (male, current e-cigarette user, age 23).
3.1.2. Message 2: Contains Toxins
“But that could also potentially stop people who are trying to switch…. then they keep smoking cigarettes which have significantly more toxins I’d be willing to bet.” (male, current e-cigarette user, age 19).
3.1.3. Message 3. Not Safe Alternative to Smoking
“It wouldn’t change my mind, but for someone else it might because obviously it’s saying that it’s not a safer alternative to cigarettes, so then why go to it” (female, current e-cigarette user, age 35).
“I think it’s a really intimidating warning label...You know, it’s not safe, it’s not completely harmless, but in comparison to cigarettes I definitely think it is safer. So this kind of I think gives the impression that it’s not safer than cigarettes.” (male, current e-cigarette user, age 19).
3.1.4. Message 4: Contains Nicotine; Addictive
3.1.5. Message 5: Not Tested for Use in Quitting Smoking
3.1.6. Message 6: Unknown Health Effects
3.2. Perceptions of Existing Warnings in E-Cigarette Ads
“It makes you wanna trust them more…over a different company. They’re telling you what’s in the product, instead of other companies making you guess and research yourself…” (male, current e-cigarette user, age 23).
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|Presented Warning Statements||% Rated as 1 or 2||% Rated as 3||% Rated as 4 or 5||Average Rating|
Warning: The liquid in this product includes chemicals. Poisonous if swallowed. Avoid contact with skin
Warning: E-cigarette vapor contains known toxins
|Message 2a (Alternative version of above 1): |
Warning: E-cigarettes contain at least 10 toxic substances including lead and formaldehyde 2
Warning: This product is not a safe alternative to cigarettes 3
Warning: This product contains nicotine derived from tobacco. Nicotine is an addictive chemical 4
Warning: This product has not been tested or approved for use in quitting smoking 5
Warning: The health effects of e-cigarettes are unknown
|Message 6a (Alternative version of above 1)|
Warning: The long-term health effects of e-cigarettes are unknown
|A. Perceptions that Message 1 might be exaggerated:|
|B. Perceptions that Message 4 might dissuade smokers:|
|C. Perceptions that Message 4 is not strong enough:|
|D. Perceptions that Message 5 may not be effective because e-cigarettes do help people quit|
|E. Perceptions that Message 5 may suggest e-cigarettes haven’t been tested/approved for safety more generally|
|Vuse||“Vuse contains nicotine extracted from the tobacco plant. Nicotine is addictive and no tobacco product has been shown to be safe.”|
|MarkTen||“Warning: This product is not intended for use by women who are pregnant or breast feeding, or persons with or at risk of heart disease, high blood pressure, diabetes, or taking medicine for depression or asthma. Nicotine is addictive and habit forming, and it is very toxic by inhalation. Nicotine can increase your heart rate and blood pressure and cause dizziness, nausea, and stomach pain. Inhalation of this product may aggravate existing respiratory conditions.”|
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