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Addiction. 2019 Jan 7. doi: 10.1111/add.14550. [Epub ahead of print]

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.

Author information

1
Department of Addictions, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
2
Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada.
3
UK Centre for Tobacco and Alcohol Studies, Nottingham, United Kingdom.
4
School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
5
Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, South Carolina, United States.
6
Roswell Park Cancer Institute, Department of Health Behavior, Buffalo, United States.
7
Department of Psychiatry and Behavioural Sciences, Medical University of South Carolina, Charleston, South Carolina, United States.
8
Cancer Council Victoria, Melbourne, Victoria, Australia.
9
Ontario Institute for Cancer Research, Toronto, Ontario, Canada.

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 11561 respondents from the following samples in the 2016 International Tobacco Control 4-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 (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 not mandatory, were not significantly more likely to report having noticed such warnings than those in Australia, Canada and the US where warnings are not mandatory.

KEYWORDS:

Electronic cigarettes; consumer information; health warnings; tobacco health information; tobacco product labelling

PMID:
30618081
DOI:
10.1111/add.14550

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