The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions
Abstract
:1. Introduction
2. Materials and Methods
2.1. Participants and Procedures
2.2. Measures
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Appendix A
References
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N | % | |
---|---|---|
Sex | ||
Male | 434 | 49.6 |
Female | 441 | 50.4 |
Race/Ethnicity | ||
Non-Hispanic white | 563 | 64.3 |
Non-Hispanic black | 93 | 10.6 |
Asian | 69 | 7.9 |
Hispanic | 109 | 12.5 |
Other/mixed race | 41 | 4.7 |
Education | ||
High school of less | 115 | 13.1 |
At least some college | 312 | 35.6 |
College degree or more | 448 | 51.1 |
Employment | ||
Employed for wages | 514 | 58.9 |
Self-employed | 142 | 16.3 |
Out of work | 69 | 7.9 |
Homemaker | 32 | 3.7 |
Student | 116 | 13.3 |
Average Age | 25.0 | |
E-cigarette Status | ||
Ever e-cigarette user | 534 | 61.0 |
Current e-cigarette user | 229 | 26.2 |
Smoking Status | ||
Current smoker | 313 | 35.7 |
Non-smoker | 563 | 64.3 |
Model 1 (Across All Conditions Including Control) a | Model 2 (Experimental Groups Only) b | ||||||
---|---|---|---|---|---|---|---|
Main Effects | Interaction | Main Effects | Interaction | ||||
Warning Condition | Smoker Status | Warning Condition x Smoker | Warning Theme | Warning Type | Warning Theme x Type | ||
F, η2, p | F, η2, p | F, η2, p | F, η2, p | F, η2, p | F, η2, p | ||
Likelihood of buying e-cigarettes 1 | 1.47, 0.010, 0.19 | 284.46, 0.25, <0.001 | 2.76, 0.019, 0.012 | 0.31, 0.001, 0.73 | 0.99, 0.001, 0.32 | 1.55, 0.004, 0.21 | |
Likelihood of using e-cigarettes for harm reduction 1 (among current smokers only) | 1.27, 0.024, 0.27 | 0.45,0 0.003, 0.64 | 6.35, 0.024, 0.012 | 0.06, <0.001, 0.95 | |||
Perceived absolute harm of e-cigarettes 2 | 0.45, 0.003, 0.84 | 38.21, 0.042, <0.001 | 1.43, 0.010, 0.201 | 0.093, <0.001, 0.91 | 1.28, 0.002, 0.26 | 0.02, 0.000, 0.98 | |
Perceived likelihood of disease from e-cigarette use 1 | 1.09 0.007, 0.37 | 10.62, 0.012, 0.001 | 1.05, 0.007, 0.39 | 0.36, 0.001, 0.70 | 0.57, 0.001, 0.46 | 1.41, 0.004, 0.25 | |
Perceived harm of e-cigarettes compared to cigarettes 3 | 0.82, 0.006, 0.55 | 0.015, <0.001, 0.92 | 1.36, 0.009, 0.23 | 0.39, 0.001, 0.68 | 1.10, 0.001, 0.30 | 0.94, 0.003, 0.39 | |
Perceived likelihood of addiction to e-cigarettes 1 | 2.17, 0.015, 0.043 | 10.99, 0.013, 0.001 | 0.87, 0.006, 0.51 | 4.39, 0.012, 0.013 | 0.16, <0.001, 0.69 | 0.89, 0.002, 0.41 | |
Agreement that nicotine causes smoking related cancer 4 | 0.83, 0.006, 0.55 | 3.18, 0.004, 0.075 | 0.36, 0.003, 0.91 | 1.69, 0.005, 0.19 | 0.09, <0.001, 0.76 | 0.18, 0.000, 0.84 | |
Perceived harmfulness of nicotine to health 2 | 0.16, 0.001, 0.99 | 19.31, 0.022, <0.001 | 1.06, 0.007, 0.39 | 0.046, <0.001, 0.96 | 0.008, <0.001, 0.93 | 0.30, 0.001, 0.74 | |
Mean (Standard Deviation), by condition | |||||||
Addiction | Addiction + RH | Brain | Brain + RH | Chemicals | Chem. + RH | Control | |
E-cigarette Use Intentions | |||||||
Likelihood of buying e-cigarettes 1 | 1.83 (1.1) | 1.84 (1.1) | 1.77 (1.1) | 2.06 (1.2) | 1.89 (1.2) | 1.83 (1.2) | 1.84 (1.0) |
Likelihood of using e-cigarettes for harm reduction (among current smokers) 1 | 2.52 (1.2) | 2.81 (1.1) | 2.61 (1.2) | 2.98 (1.1) | 2.61 (1.1) | 3.0 (1.1) | 2.89 (1.3) |
E-cigarette and Nicotine Beliefs | |||||||
Perceived absolute harm of e-cigarettes 2 | 2.29 (1.0) | 2.20 (0.9) | 2.2 (0.9) | 2.26 (0.9) | 2.26 (0.9) | 2.10 (0.8) | 2.13 (0.9) |
Perceived likelihood of disease from e-cigarette use 1 | 12.2 (3.9) | 12.5 (3.8) | 12.1 (3.6) | 12.0 (3.9) | 12.6 (3.9) | 11.8 (3.7) | 11.6 (4.1) |
Perceived harm of e-cigarettes compared to cigarettes 3 | 2.29 (1.0) | 2.20 (0.9) | 2.20 (0.9) | 2.26 (1.0) | 2.26 (0.9) | 2.10 (0.8) | 2.13 (0.9) |
Perceived likelihood of addiction to e-cigarettes 1 | 3.64 (1.1) | 3.65 (1.0) | 3.5 (1.0) | 3.57 (1.0) | 3.46 (1.0) | 3.30 (1.0) | 3.4 (1.0) |
Agreement that nicotine causes smoking related cancer 4 | 2.51 (1.0) | 2.54 (1.0) | 2.68 (1.0) | 2.65 (1.0) | 2.71 (1.0) | 2.63 (1.0) | 2.72 (0.9) |
Perceived harmfulness of nicotine to health 2 | 3.57 (1.0) | 3.63 (1.0) | 3.62 (1.1) | 3.62 (1.0) | 3.66 (1.0) | 3.58 (1.1) | 3.57 (1.1) |
% Correctly Recalling Keywords/Concepts for: | Warning Type | p-Value * | |
---|---|---|---|
Standard | RH Warning | ||
% | % | ||
FDA Nicotine Addiction Warning | |||
Nicotine | 84.1 | 65.9 | 0.001 |
Addiction | 66.7 | 41.1 | <0.001 |
Chemical | 43.7 | 19.4 | <0.001 |
E-cigarettes are less harmful than cigarettes | 58.1 | ||
Nicotine Brain Development Warning | |||
Nicotine | 69.3 | 51.2 | 0.003 |
Brain | 65.4 | 49.6 | 0.011 |
Age-related | 78.0 | 57.6 | 0.001 |
E-cigarettes are less harmful than cigarettes | 36.0 | ||
Harmful Chemicals Warning | |||
Chemicals | 36.8 | 38.7 | 0.76 |
Lungs | 32.8 | 21.8 | 0.051 |
Cancer | 64.0 | 50.8 | 0.035 |
E-cigarettes are less harmful than cigarettes | 56.1 |
Focal Statistics for Anova Tests | ||||||
---|---|---|---|---|---|---|
Believable | Understandable | Informative | Discourage Young People | Discourage Smokers | ||
F, η2, p | F, η2, p | F, η2, p | F, η2, p | F, η2, p | ||
Main Effect | ||||||
Warning type | 24.32, 0.032, <0.001 | 5.00, 0.007, 0.026 | 6.05, 0.008, 0.014 | 40.44, 0.051, <0.001 | 20.07, 0.026, <0.001 | |
Warning theme | 3.43, 0.009, 0.033 | 1.36, 0.004, 0.26 | 4.14, 0.011, 0.016 | 13.30, 0.034, <0.001 | 6.06, 0.016, 0.002 | |
Smoking status | 0.87, 0.001, 0.35 | 1.47, 0.002, 0.23 | 0.19, <0.001, 0.66 | 0.022, <0.001, 0.88 | 12.07, 0.016, 0.001 | |
Interaction Effects | ||||||
Warning type x theme | 4.01, 0.011, 0.018 | 3.58, 0.010, 0.028 | 0.68, 0.002, 0.508 | 0.63, 0.002, 0.533 | 1.08, 0.003, 0.339 | |
Warning type x smoking status | 0, <0.001, 0.989 | 0.05, <0.001, 0.826 | 0.16, <0.001, 0.693 | 0.36, <0.001, 0.549 | 0.01, <0.001, 0.927 | |
Warning theme x smoking status | 3.11, 0.008, 0.045 | 3.6, 0.010, 0.028 | 0.88, 0.002, 0.415 | 0.19, 0.001, 0.828 | 0.17, <0.001, 0.844 | |
Warning type x warning theme x smoking status | 2.25, 0.006, 0.106 | 3.49, 0.009, 0.031 | 0.5, 0.001, 0.604 | 0.03, <0.001, 0.975 | 0.01, <0.001, 0.995 | |
Overall Mean Agreement (Across Groups) | Mean Agreement (St. Deviation) by Warning Theme | Mean Agreement (St. Deviation) by Warning Type | ||||
Agreed the warning they viewed: | FDA | Brain | Chemicals | Standard | RH | |
Is believable | 3.20 (0.7) | 3.31 (0.7) | 3.17 (0.7) | 3.17 (0.8) | 3.35 (0.7) | 3.10 (0.7) |
Easy to understand | 3.41 (0.6) | 3.45 (0.6) | 3.36 (0.6) | 3.40 (0.6) | 3.46 (0.6) | 3.36 (0.6) |
Would inform people about e-cigarette risks | 3.01 (0.7) | 2.92 (0.8) | 3.00 (0.7) | 3.1 (0.7) | 3.07 (0.7) | 2.94 (0.7) |
Would discourage young people from starting e-cigarettes | 2.69 (0.9) | 2.47 (0.9) b,c | 2.86 (0.8) f | 2.73 (0.8) f | 2.88 (0.8) | 2.45 (0.9) |
Would discourage current smokers from using e-cigarettes | 2.27 (0.9) | 2.12 (0.9) b | 2.36 (0.9) f | 2.33 (0.9) | 2.41 (0.9) | 2.12 (0.9) |
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Wackowski, O.A.; Sontag, J.M.; Hammond, D.; O’Connor, R.J.; Ohman-Strickland, P.A.; Strasser, A.A.; Villanti, A.C.; Delnevo, C.D. The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions. Int. J. Environ. Res. Public Health 2019, 16, 184. https://doi.org/10.3390/ijerph16020184
Wackowski OA, Sontag JM, Hammond D, O’Connor RJ, Ohman-Strickland PA, Strasser AA, Villanti AC, Delnevo CD. The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions. International Journal of Environmental Research and Public Health. 2019; 16(2):184. https://doi.org/10.3390/ijerph16020184
Chicago/Turabian StyleWackowski, Olivia A., Jennah M. Sontag, David Hammond, Richard J. O’Connor, Pamela A. Ohman-Strickland, Andrew A. Strasser, Andrea C. Villanti, and Cristine D. Delnevo. 2019. "The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions" International Journal of Environmental Research and Public Health 16, no. 2: 184. https://doi.org/10.3390/ijerph16020184
APA StyleWackowski, O. A., Sontag, J. M., Hammond, D., O’Connor, R. J., Ohman-Strickland, P. A., Strasser, A. A., Villanti, A. C., & Delnevo, C. D. (2019). The Impact of E-Cigarette Warnings, Warning Themes and Inclusion of Relative Harm Statements on Young Adults’ E-Cigarette Perceptions and Use Intentions. International Journal of Environmental Research and Public Health, 16(2), 184. https://doi.org/10.3390/ijerph16020184