Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy

Nakkash, Rima; Tleis, Malak; Chehab, Sara; Wensong, Wu; Schmidt, Michael; Ward, Kenneth D.; Maziak, Wasim; Asfar, Taghrid

doi:10.3390/ijerph18137189

Open AccessArticle

Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy

by

Rima Nakkash

¹,

Malak Tleis

¹

,

Sara Chehab

¹,

Wu Wensong

²,

Michael Schmidt

³,

Kenneth D. Ward

⁴,

Wasim Maziak

^5,6 and

Taghrid Asfar

^6,7,8,*

¹

Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut 1103, Lebanon

²

Department of Mathematics and Statistics, Florida International University, Miami, FL 33199, USA

³

Department of Art, University of Memphis, Memphis, TN 38152, USA

⁴

School of Public Health, University of Memphis, Memphis, TN 38152, USA

⁵

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL 33199, USA

⁶

Syrian Center for Tobacco Studies, Aleppo 2203, Syria

⁷

Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33124, USA

⁸

Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL 33124, USA

^*

Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2021, 18(13), 7189; https://doi.org/10.3390/ijerph18137189

Submission received: 31 May 2021 / Revised: 30 June 2021 / Accepted: 1 July 2021 / Published: 5 July 2021

(This article belongs to the Special Issue Current Status of Tobacco Control Policies)

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Abstract

This study aims to explore the perceived effectiveness of waterpipe (WP) tobacco specific health warning labels (HWLs) among young adult WP smokers and nonsmokers in Lebanon. Before participating in focus group discussions, participants (n = 66; WP smokers n = 30; nonsmokers n = 36; age 18–33) completed a brief survey to rate the effectiveness of 12 HWLs’ and rank them according to four risk themes (WP health effects, WP harm to others, WP-specific harm, and WP harm compared to cigarettes). Differences in HWLs ratings by WP smoking status were examined and the top-ranked HWL in each theme were identified. HWLs depicting mouth cancer and harm to babies were rated as the most effective by both WP smokers and non-smokers. WP smokers rated HWLs which depicted harm to children and infants as more effective than non-smokers. The top-ranked HWLs for perceived overall effectiveness were those depicting “oral cancer”, “harm to babies”, “orally transmitted diseases” and “mouth cancer”. HWLs depicting oral lesions and harm to babies were rated as most effective, while HWLs showing the harmful effects of WP secondhand smoke on infants and children were rated as less effective by nonsmokers compared to smokers. Our study provides evidence on the potential effectiveness of HWLs for further evaluation in Lebanon and the Eastern Mediterranean region. The results will inform and guide the development and implementation of tobacco control policy.

Keywords: waterpipe; health warning labels; hookah

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MDPI and ACS Style

Nakkash, R.; Tleis, M.; Chehab, S.; Wensong, W.; Schmidt, M.; Ward, K.D.; Maziak, W.; Asfar, T. Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy. Int. J. Environ. Res. Public Health 2021, 18, 7189. https://doi.org/10.3390/ijerph18137189

AMA Style

Nakkash R, Tleis M, Chehab S, Wensong W, Schmidt M, Ward KD, Maziak W, Asfar T. Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy. International Journal of Environmental Research and Public Health. 2021; 18(13):7189. https://doi.org/10.3390/ijerph18137189

Chicago/Turabian Style

Nakkash, Rima, Malak Tleis, Sara Chehab, Wu Wensong, Michael Schmidt, Kenneth D. Ward, Wasim Maziak, and Taghrid Asfar. 2021. "Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy" International Journal of Environmental Research and Public Health 18, no. 13: 7189. https://doi.org/10.3390/ijerph18137189

APA Style

Nakkash, R., Tleis, M., Chehab, S., Wensong, W., Schmidt, M., Ward, K. D., Maziak, W., & Asfar, T. (2021). Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy. International Journal of Environmental Research and Public Health, 18(13), 7189. https://doi.org/10.3390/ijerph18137189

Note that from the first issue of 2016, this journal uses article numbers instead of page numbers. See further details here.

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Novel Insights into Young Adults’ Perceived Effectiveness of Waterpipe Tobacco-Specific Pictorial Health Warning Labels in Lebanon: Implications for Tobacco Control Policy

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