Placing Health Warnings on E-Cigarettes: A Standardized Protocol.

Area of Science:

• Public Health
• Tobacco Control
• Behavioral Science

Background:

• E-cigarette use is a growing public health concern.
• Effective tobacco control interventions are needed to reduce e-cigarette use.
• Current methods for evaluating health warnings may not reflect real-world exposure.

Purpose of the Study:

• To develop and evaluate a novel protocol for assessing e-cigarette health warnings.
• To test the feasibility and acceptability of applying warning labels directly to e-cigarette devices and refills.
• To examine the impact of these naturalistic warnings on user behavior and quit intentions.

Main Methods:

• Developed a protocol for applying e-cigarette warnings to users' own devices and refills.
• Recruited national and local convenience samples of adult e-cigarette users for two studies.
• Assessed participant willingness to use labeled devices, adherence to labeling, and changes in conversations and quit intentions over three weeks.

Main Results:

• Most participants were willing to have their e-cigarette devices and refills labeled.
• A high percentage of participants used devices with warning labels most of the time.
• Significant increases were observed in conversations about e-cigarette harms, quitting, and intentions to quit.

Conclusions:

• The naturalistic labeling protocol is feasible, acceptable, and demonstrates high participant retention.
• This protocol can generate valuable evidence on the effectiveness of e-cigarette warnings.
• Findings can inform tobacco warning policies to reduce e-cigarette use.