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Exposure to and perceptions of health warning labels on nicotine vaping products: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey.
Addiction. 2019 10; 114 Suppl 1:134-143.A

Abstract

BACKGROUND AND AIMS

The presence and content of health warning labels (HWLs) on nicotine vaping products (NVPs), such as electronic cigarettes, varies by country and manufacturer. We compared proportions of people who report (i) noticing HWLs on NVPs and (ii) feeling concerned having noticed HWLs, by country and by smoking or vaping status. We also examined recall of HWL content and whether this varies by country.

DESIGN

Cross-sectional survey.

SETTING

Australia (AU), Canada (CA), England (EN) and the United States (US). At the time of data collection, HWLs on NVPs were only mandatory in EN.

PARTICIPANTS

A total of 11 561 respondents from the following samples in the 2016 International Tobacco Control Four Country Project: (1) re-contacted smokers and quitters who had participated in the previous wave of the project; (2) newly recruited current smokers and recent quitters; and (3) newly recruited current vapers from CA, EN and US.

MEASUREMENTS

Outcomes included: (1) having noticed HWLs on NVPs, (2) feeling concerned having noticed HWLs, and (3) recall of HWL message content.

FINDINGS

Compared with respondents in EN, respondents in CA were more likely to report having noticed HWLs [odds ratio (OR) = 1.58, P = 0.02], whereas respondents in AU (OR = 0.76, P = 1.00) and the US (OR = 1.54, P = 0.09) were not significantly more or less likely to report having noticed HWLs. Compared with concurrent smokers and vapers, daily smokers, non-daily smokers and quitters were less likely to report having noticed HWLs (ORs = 0.21, 0.33 and 0.19, respectively, all P < 0.001). There were no significant differences in reports of noticing HWLs when comparing concurrent smokers and vapers with daily (OR = 1.62, P = 0.91) or non-daily (OR = 1.15, P = 1.00) vapers. There were no significant differences by country in reporting that HWLs made them concerned about using NVPs. Daily vapers were less likely to report feeling concerned than concurrent users (OR = 0.11, P = 0.017). Among those who reported reading HWLs (n = 688), there was little evidence of differences in recall of the HWL content.

CONCLUSIONS

Respondents in England, where health warning labels on nicotine vaping products are mandatory, were not significantly more likely to report having noticed such warnings than those in Australia, Canada and the United States where warnings are not mandatory.

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Authors+Show Affiliations

McDermott MS
Addictions Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK.
Li G
Department of Psychology, University of Waterloo, Waterloo, ON, Canada.
McNeill A
Addictions Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK. UK Centre for Tobacco and Alcohol Studies, UK.
Hammond D
School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada.
Thrasher JF
Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. Tobacco Research Department, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico.
O'Connor RJ
Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
Cummings KM
Department of Psychiatry and Behavioural Sciences, Medical University of South Carolina, Charleston, SC, USA. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
Borland R
Cancer Council Victoria, Melbourne, VIC, Australia. School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia.
Fong GT
Department of Psychology, University of Waterloo, Waterloo, ON, Canada. School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada. Ontario Institute for Cancer Research, Toronto, ON, Canada.
Hitchman SC
Addictions Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK. UK Centre for Tobacco and Alcohol Studies, UK.

MeSH

AdolescentAdultAgedAttitude to HealthAustraliaCanadaCross-Cultural ComparisonCross-Sectional StudiesDrug LabelingEnglandFemaleHealth SurveysHumansMaleMiddle AgedProduct LabelingSmokingSmoking CessationTobacco Use Cessation DevicesUnited StatesVapingYoung Adult

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

30618081

Citation

McDermott, Máirtín S., et al. "Exposure to and Perceptions of Health Warning Labels On Nicotine Vaping Products: Findings From the 2016 International Tobacco Control Four Country Smoking and Vaping Survey." Addiction (Abingdon, England), vol. 114 Suppl 1, 2019, pp. 134-143.
McDermott MS, Li G, McNeill A, et al. Exposure to and perceptions of health warning labels on nicotine vaping products: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey. Addiction. 2019;114 Suppl 1:134-143.
McDermott, M. S., Li, G., McNeill, A., Hammond, D., Thrasher, J. F., O'Connor, R. J., Cummings, K. M., Borland, R., Fong, G. T., & Hitchman, S. C. (2019). Exposure to and perceptions of health warning labels on nicotine vaping products: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey. Addiction (Abingdon, England), 114 Suppl 1, 134-143. https://doi.org/10.1111/add.14550
McDermott MS, et al. Exposure to and Perceptions of Health Warning Labels On Nicotine Vaping Products: Findings From the 2016 International Tobacco Control Four Country Smoking and Vaping Survey. Addiction. 2019;114 Suppl 1:134-143. PubMed PMID: 30618081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exposure to and perceptions of health warning labels on nicotine vaping products: findings from the 2016 International Tobacco Control Four Country Smoking and Vaping Survey. AU - McDermott,Máirtín S, AU - Li,Grace, AU - McNeill,Ann, AU - Hammond,David, AU - Thrasher,James F, AU - O'Connor,Richard J, AU - Cummings,K Michael, AU - Borland,Ron, AU - Fong,Geoffrey T, AU - Hitchman,Sara C, Y1 - 2019/02/12/ PY - 2019/1/9/pubmed PY - 2020/10/29/medline PY - 2019/1/9/entrez KW - Consumer information KW - electronic cigarettes KW - health warnings KW - nicotine vaping products KW - tobacco health information KW - tobacco product labelling SP - 134 EP - 143 JF - Addiction (Abingdon, England) JO - Addiction VL - 114 Suppl 1 N2 - BACKGROUND AND AIMS: The presence and content of health warning labels (HWLs) on nicotine vaping products (NVPs), such as electronic cigarettes, varies by country and manufacturer. We compared proportions of people who report (i) noticing HWLs on NVPs and (ii) feeling concerned having noticed HWLs, by country and by smoking or vaping status. We also examined recall of HWL content and whether this varies by country. DESIGN: Cross-sectional survey. SETTING: Australia (AU), Canada (CA), England (EN) and the United States (US). At the time of data collection, HWLs on NVPs were only mandatory in EN. PARTICIPANTS: A total of 11 561 respondents from the following samples in the 2016 International Tobacco Control Four Country Project: (1) re-contacted smokers and quitters who had participated in the previous wave of the project; (2) newly recruited current smokers and recent quitters; and (3) newly recruited current vapers from CA, EN and US. MEASUREMENTS: Outcomes included: (1) having noticed HWLs on NVPs, (2) feeling concerned having noticed HWLs, and (3) recall of HWL message content. FINDINGS: Compared with respondents in EN, respondents in CA were more likely to report having noticed HWLs [odds ratio (OR) = 1.58, P = 0.02], whereas respondents in AU (OR = 0.76, P = 1.00) and the US (OR = 1.54, P = 0.09) were not significantly more or less likely to report having noticed HWLs. Compared with concurrent smokers and vapers, daily smokers, non-daily smokers and quitters were less likely to report having noticed HWLs (ORs = 0.21, 0.33 and 0.19, respectively, all P < 0.001). There were no significant differences in reports of noticing HWLs when comparing concurrent smokers and vapers with daily (OR = 1.62, P = 0.91) or non-daily (OR = 1.15, P = 1.00) vapers. There were no significant differences by country in reporting that HWLs made them concerned about using NVPs. Daily vapers were less likely to report feeling concerned than concurrent users (OR = 0.11, P = 0.017). Among those who reported reading HWLs (n = 688), there was little evidence of differences in recall of the HWL content. CONCLUSIONS: Respondents in England, where health warning labels on nicotine vaping products are mandatory, were not significantly more likely to report having noticed such warnings than those in Australia, Canada and the United States where warnings are not mandatory. SN - 1360-0443 UR - https://www.unboundmedicine.com/medline/citation/30618081/Exposure_to_and_perceptions_of_health_warning_labels_on_nicotine_vaping_products:_findings_from_the_2016_International_Tobacco_Control_Four_Country_Smoking_and_Vaping_Survey_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓8 ↑29]

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