Messages matter: The Tobacco Products Directive nicotine addiction health warning versus an alternative relative risk message on smokers' willingness to use and purchase an electronic cigarette

Introduction: This text is a summary of a study examining the impact of health warning labels on electronic cigarettes (e-cigarettes) on smokers' intentions to use these products. The study compares the effects of the European Union (EU) Tobacco Products Directive (TPD) health warning message and an alternative relative risk message on smokers' willingness to use, likelihood of purchase, and intention to use as a quit aid. The study's key points and main message are summarized below.

Key Points:

* The study was a cross-sectional online survey of 81 daily smokers.
* Participants were randomly assigned to view e-cigarette images with either the TPD health warning, the alternative relative risk message, or no message.
* The TPD health warning reduced smokers' willingness to use and likelihood of purchasing e-cigarettes.
* The alternative relative risk message did not significantly increase smokers' willingness to use or likelihood of purchasing e-cigarettes compared to the no message condition.
* However, the alternative relative risk message did increase willingness to use compared with the TPD message.
* The study suggests that the TPD nicotine addiction e-cigarette health warning may reduce smokers' willingness to use and likelihood of purchasing an e-cigarette.
* Further research is needed to understand how messaging may influence product choice and quitting strategies under different regulatory frameworks.

Main Message: The study highlights the importance of considering the potential unintended consequences of health warning labels on e-cigarettes. While the TPD health warning may deter non-smokers from using e-cigarettes, it may also discourage smokers from using these products as a harm reduction tool. The study suggests that combining a reduced risk message with the current TPD health warning may encourage uptake among smokers and deter non-smokers. However, further research is needed to determine the most effective messaging strategies for promoting e-cigarette use as a harm reduction tool while also preventing non-smoker uptake.

Cox, Sharon, Daniel Frings, Reeda Ahmed, and Lynne Dawkins. “Messages Matter: The Tobacco Products Directive Nicotine Addiction Health Warning versus an Alternative Relative Risk Message on Smokers’ Willingness to Use and Purchase an Electronic Cigarette.” Addictive Behaviors Reports 8 (December 2018): 136–39. https://doi.org/10.1016/j.abrep.2018.09.006.