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The effects of the European e-cigarette health warnings and comparative health messages on non-smokers' and smokers' risk perceptions and behavioural intentions.
BMC Public Health. 2018 Nov 14; 18(1):1259.BP

Abstract

BACKGROUND

Article 20 of the EU Tobacco Products Directive [TPD] stipulates that e-cigarette packets and refill products must carry a nicotine addiction health warning. Although previous studies conducted in North America have found that perceived harm, addictiveness and intention to use declined following exposure to e-cigarette health warnings, possible effects of the TPD health warnings on smokers and non-smokers has not been studied. This study will investigate the effects of the EU TPD e-cigarette health warnings and a comparative harm message (COMP; developed specifically for this study) on smokers' and non-smokers' perceptions of harm, addictiveness and social acceptability of e-cigarettes. Additionally, the potential effects of the TPD warnings and the COMP on smokers' intentions to purchase and use e-cigarettes will be explored.

METHODS/DESIGN

A sample of 2400 UK residents will be recruited in this experimental, randomised design, with Smoking status (Smoker vs. Non-smoker), TPD presence (TPD1 vs. TPD2 vs. No-TPD) and COMP presence (Presence vs. Absence) as between subjects independent variables, and Time (pre-post exposure of images) as a within subjects factor. Dependent variables comprise self-reported perceived harm, addictiveness, social acceptability, e-cigarettes' effectiveness, intentions to purchase and use e-cigarettes. Cigarette dependence, previous e-cigarette exposure, and baseline intentions to quit will be measured as covariates.

DISCUSSION

Health warnings, such as those implemented by the TPD, may help to prevent non-smokers from e-cigarettes use, but it is possible that they may inadvertently deter smokers from initiating use and substituting their tobacco smoking for e-cigarettes use if their content is deemed too negative. It is hoped that this study will help identify the most effective message or combination of messages that encourage use among smokers without promoting use among non-smokers.

TRIAL REGISTRATION

ISRCTN registry ISRCTN76967031 ; date of registration: 23/10/18.

Links

PMC Free PDF

Authors+Show Affiliations

Kimber C
Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA, UK. kimberc3@lsbu.ac.uk.
Frings D
Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA, UK.
Cox S
Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA, UK.
Albery I
Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA, UK.
Dawkins L
Centre for Addictive Behaviours Research, Division of Psychology, School of Applied Sciences, 103 Borough road, London South Bank University, London, SE1 0AA, UK.

MeSH

AdultBehavior, AddictiveElectronic Nicotine Delivery SystemsFemaleHealth CommunicationHealth Knowledge, Attitudes, PracticeHumansIntentionMaleNon-SmokersProduct LabelingPsychological DistanceRisk AssessmentSmokersSmokingSmoking CessationUnited Kingdom

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

30428933

Citation

Kimber, Catherine, et al. "The Effects of the European E-cigarette Health Warnings and Comparative Health Messages On Non-smokers' and Smokers' Risk Perceptions and Behavioural Intentions." BMC Public Health, vol. 18, no. 1, 2018, p. 1259.
Kimber C, Frings D, Cox S, et al. The effects of the European e-cigarette health warnings and comparative health messages on non-smokers' and smokers' risk perceptions and behavioural intentions. BMC Public Health. 2018;18(1):1259.
Kimber, C., Frings, D., Cox, S., Albery, I., & Dawkins, L. (2018). The effects of the European e-cigarette health warnings and comparative health messages on non-smokers' and smokers' risk perceptions and behavioural intentions. BMC Public Health, 18(1), 1259. https://doi.org/10.1186/s12889-018-6161-7
Kimber C, et al. The Effects of the European E-cigarette Health Warnings and Comparative Health Messages On Non-smokers' and Smokers' Risk Perceptions and Behavioural Intentions. BMC Public Health. 2018 Nov 14;18(1):1259. PubMed PMID: 30428933.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effects of the European e-cigarette health warnings and comparative health messages on non-smokers' and smokers' risk perceptions and behavioural intentions. AU - Kimber,Catherine, AU - Frings,Daniel, AU - Cox,Sharon, AU - Albery,Ian, AU - Dawkins,Lynne, Y1 - 2018/11/14/ PY - 2018/08/20/received PY - 2018/10/29/accepted PY - 2018/11/16/entrez PY - 2018/11/16/pubmed PY - 2018/12/12/medline KW - E-cigarettes KW - Electronic cigarettes KW - Health messages KW - Motivation to quit KW - Quit intentions KW - Risk perceptions KW - Tobacco products directive KW - Warning labels SP - 1259 EP - 1259 JF - BMC public health JO - BMC Public Health VL - 18 IS - 1 N2 - BACKGROUND: Article 20 of the EU Tobacco Products Directive [TPD] stipulates that e-cigarette packets and refill products must carry a nicotine addiction health warning. Although previous studies conducted in North America have found that perceived harm, addictiveness and intention to use declined following exposure to e-cigarette health warnings, possible effects of the TPD health warnings on smokers and non-smokers has not been studied. This study will investigate the effects of the EU TPD e-cigarette health warnings and a comparative harm message (COMP; developed specifically for this study) on smokers' and non-smokers' perceptions of harm, addictiveness and social acceptability of e-cigarettes. Additionally, the potential effects of the TPD warnings and the COMP on smokers' intentions to purchase and use e-cigarettes will be explored. METHODS/DESIGN: A sample of 2400 UK residents will be recruited in this experimental, randomised design, with Smoking status (Smoker vs. Non-smoker), TPD presence (TPD1 vs. TPD2 vs. No-TPD) and COMP presence (Presence vs. Absence) as between subjects independent variables, and Time (pre-post exposure of images) as a within subjects factor. Dependent variables comprise self-reported perceived harm, addictiveness, social acceptability, e-cigarettes' effectiveness, intentions to purchase and use e-cigarettes. Cigarette dependence, previous e-cigarette exposure, and baseline intentions to quit will be measured as covariates. DISCUSSION: Health warnings, such as those implemented by the TPD, may help to prevent non-smokers from e-cigarettes use, but it is possible that they may inadvertently deter smokers from initiating use and substituting their tobacco smoking for e-cigarettes use if their content is deemed too negative. It is hoped that this study will help identify the most effective message or combination of messages that encourage use among smokers without promoting use among non-smokers. TRIAL REGISTRATION: ISRCTN registry ISRCTN76967031 ; date of registration: 23/10/18. SN - 1471-2458 UR - https://www.unboundmedicine.com/medline/citation/30428933/The_effects_of_the_European_e_cigarette_health_warnings_and_comparative_health_messages_on_non_smokers'_and_smokers'_risk_perceptions_and_behavioural_intentions_ DB - PRIME DP - Unbound Medicine ER -