Reduced-risk warnings versus the US FDA-mandated addiction warning: The effects of e-cigarette warning variations on health risk perceptions.

Introduction:
This article by Christopher Berry and Scot Burton published in Nicotine & Tobacco Research compares the effects of reduced-risk warnings and the US FDA-mandated addiction warning on health risk perceptions of e-cigarettes. The study aims to determine if there are differences in believability, ease of comprehension, and clarity of risk communication between the two types of warnings.

Key Points:

* The study used a between-subjects experiment with a quota sample of 672 smokers, e-cigarette users, dual users, and nonusers.
* Participants were randomly assigned to one of three warning conditions, including the FDA-mandated addiction warning and two reduced-risk warnings.
* After exposure to the warning statement, participants responded to measures of health risk perceptions, believability, ease of comprehension, and perception about the clarity of risk communication.
* Results reveal that the addiction warning is perceived as more believable, easier to comprehend, and more clearly communicating the health risks of e-cigarettes use compared with the reduced-risk warnings.
* In addition, overall health risk perceptions and addiction risk perceptions based on the addiction warning are greater than health risk perceptions based on the reduced-risk warnings.
* However, specific disease-related risk perceptions such as cancer, heart disease, lung disease, and harm to an unborn baby are greater for the reduced-risk warnings.
* The findings provide a comparison of the forthcoming FDA-mandated e-cigarette addiction warning and reduced-risk warnings that have begun to be considered in the literature on several critical outcomes.

Main Message:
The study highlights the importance of considering the impact of different types of warnings on health risk perceptions of e-cigarettes. The results suggest that the addiction warning is more effective in communicating the health risks of e-cigarettes use compared with the reduced-risk warnings. However, reduced-risk warnings may be more effective in communicating specific disease-related risks. Therefore, regulators should consider the potential benefits and drawbacks of different types of warnings when developing e-cigarette regulations.

Berry C, Burton S. Reduced-risk warnings versus the US FDA-mandated addiction warning: The effects of e-cigarette warning variations on health risk perceptions. Nicotine & Tobacco Research. 2019;21(7):979-984. doi:10.1093/ntr/nty177