Presence of Nicotine Warning Statement on US Electronic Nicotine Delivery Systems (ENDS) Advertisements 6 Months Before and After the August 10, 2018 Effective Date.

Introduction:
This text provides an analysis of the presence and features of nicotine warning statements on electronic nicotine delivery systems (ENDS) advertisements in the United States. The study compares ads that first ran six months before and after the August 10, 2018 effective date when the FDA required ads for covered tobacco products to feature a standard nicotine warning statement.

Key Points:

* The study included 459 ads, with 191 ads that first ran before the effective date and 268 ads that first ran after.
* Static ads, including online/mobile, print, and outdoor ads, made up the majority of the sample, followed by video ads and radio ads.
* The presence of the nicotine warning statement increased after the effective date for static (27.7% to 84.3%), video (62.5% to 95.9%), and radio ads (66.7% to 85.7%).
* Of the ads that included the warning statement after the effective date, most static ads (97.0%) placed the warning at the top of the ad as required, and many video ads (60%) featured the warning for the entire ad duration.
* However, 13.4% of ENDS ads in the sample that first appeared or ran following the effective date did not contain the required warning.
* Among radio ads with a warning present, warnings were almost exclusively read during the last third of the radio advertisement and were read at the same speed or faster than the rest of the ad content.
* The study highlights the importance of consistent presentation and display of warning statements in order to effectively inform the public about the harms of nicotine addiction associated with ENDS use.

Main Message:
The study demonstrates that while the presence of nicotine warning statements on ENDS ads increased after the August 10, 2018 effective date, a notable number of ads still lacked the required warning. It is crucial for manufacturers to consistently present and display warning statements in a visually distinct manner in order to reach the broader population with information on tobacco-related risks, including addiction. Further research is needed to assess the impact of these warning statements on ENDS-related risk perceptions and product initiation among young people.

Czaplicki L, Marynak K, Kelley D, Moran MB, Trigger S, Kennedy RD. Presence of Nicotine Warning Statement on US Electronic Nicotine Delivery Systems (ENDS) Advertisements 6 Months Before and After the August 10, 2018 Effective Date. Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. 2022;24(11):1720-1726. doi:10.1093/ntr/ntac104