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Updated: Jul 26, 2025

Generation of Electronic Cigarette Aerosol by a Third-Generation Machine-Vaping Device: Application to Toxicological Studies
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Optimising messages and images for e-cigarette warnings.

Allison J Lazard1,2, Mohammad Ebrahimi Kalan2,3, Sydney Nicolla4

  • 1Hussman School of Journalism and Media, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA lazard@unc.edu.

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|June 21, 2023
PubMed
Summary
This summary is machine-generated.

New electronic cigarette (e-cigarette) warnings highlighting diverse health harms, like toxic metals, were more effective than the current addiction warning. Images depicting internal harm or people experiencing negative effects discouraged vaping most significantly.

Keywords:
addictionelectronic nicotine delivery devicespackaging and labelling

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Area of Science:

  • Public Health
  • Behavioral Science
  • Toxicology

Background:

  • Current US Food and Drug Administration (FDA) e-cigarette warnings focus solely on addiction.
  • Existing warnings may become less effective over time and do not cover the full spectrum of vaping-related health risks.

Purpose of the Study:

  • To develop and evaluate novel warning messages and images for e-cigarettes aimed at discouraging use.
  • To assess the effectiveness of warnings addressing various health harms beyond addiction.

Main Methods:

  • 1629 US adults who vaped or smoked were randomized to evaluate 28 different warning messages and images.
  • Messages covered themes like metals exposure, DNA mutation, cardiovascular problems, lung damage, and addiction.
  • Participants also evaluated images depicting hazards, internal harms, or people experiencing harms.

Main Results:

  • All new warning themes discouraged vaping more than the FDA's current warning, increasing negative affect and anticipated social interactions.
  • Warnings about toxic metals exposure were particularly effective.
  • Images of internal or experienced harms were more discouraging than hazard images.
  • New themes increased stigma and the perception of vaping being more harmful than smoking.

Conclusions:

  • E-cigarette warning policies should expand beyond addiction to encompass a wider range of health hazards.
  • Visuals depicting internal bodily harm or individuals suffering from vaping-related issues may enhance warning effectiveness.
  • Broader communication of vaping risks can improve public awareness of associated health dangers.