Home > Impact of e-cigarette health warnings on motivation to vape and smoke.

Brewer, Noel T and Jeong, Michelle and Hall, Marissa G and Baig, Sabeeh A and Mendel, Jennifer R and Lazard, Allison J and Noar, Seth M and Kameny, Madeline R and Ribisl, Kurt M . (2019) Impact of e-cigarette health warnings on motivation to vape and smoke. Tobacco Control, 28 e64-70.

URL: https://tobaccocontrol.bmj.com/content/28/e1/e64

BACKGROUND: A prevailing hypothesis is that health warnings for electronic cigarettes (e-cigarettes) could drive people away from vaping and towards smoking cigarettes. We consider an alternative hypothesis that e-cigarette warnings discourage both vaping and smoking.

METHODS: Participants were a national convenience sample of 2218 US adults who used e-cigarettes, cigarettes or both. In August 2018, we randomised participants to one of three warning (control text about littering, text-only e-cigarette warning or pictorial e-cigarette warning). We further randomised participants viewing e-cigarette warnings to one of three (nicotine addiction, health hazards of use, or both health hazards and harms of use). The preregistered primary outcome was intentions to quit vaping among e-cigarette users. Secondary outcomes included interest in smoking and Tobacco Warnings Model constructs: attention, negative affect, anticipated social interactions and cognitive elaboration.

RESULTS: Text warnings elicited higher intentions to quit vaping than control among e-cigarette users (=0.44, p<0.001), and pictorial warnings elicited still higher intentions to quit vaping than text (=0.12, p<0.05). Text warnings elicited lower interest in smoking compared with control among smokers (p<0.05); warnings had no other effects on interest in smoking among smokers or non-smokers. Text warnings about health hazards elicited higher intentions to quit vaping than nicotine addiction warnings. E-cigarette warnings also increased Tobacco Warnings Model constructs.

DISCUSSION: E-cigarette health warnings may motivate users to quit vaping and discourage smoking. The most promising warnings include health hazards (other than nicotine addiction) and imagery. We found no support for the hypothesis that e-cigarette warnings could encourage smoking cigarettes.

Item Type:Evidence resource
Drug Type:Tobacco
Intervention Type:AOD prevention, AOD disorder harm reduction
Date:10 July 2019
Subjects:B Substances > Tobacco (cigarette smoking)
B Substances > Tobacco (cigarette smoking) > Nicotine product (e-cigarette / vaping)
F Concepts in psychology > Motivation
J Health care, prevention and rehabilitation > Prevention approach > Prevention through information and education
J Health care, prevention and rehabilitation > Health related prevention > Health information and education
N Communication, information and education > Information use and impact
VA Geographic area > United States

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