Effects of E-Cigarette Warning Labels About Mental Health Consequences of Nicotine Addiction Among Young Adults in the USA: Results From a Randomized Controlled Experiment

Introduction:
This text presents the results of a randomized controlled experiment investigating the effects of e-cigarette package labels bearing text-only messages about the psychological consequences of nicotine withdrawal, the current addictiveness warning, and a no-message control condition on young adults' intentions to use or quit e-cigarettes and perceived message effectiveness.

Key Points:

* The study randomized 1919 young adults aged 18-24 years to view one of four warning label conditions.
* The messages tested focused on different mental health constructs to allow for comparison and potentially inform multiple labels for rotation.
* The study found that brief exposure to the mental health-related warning messages did not impact use or quit intentions more than the current FDA message.
* The FDA warning label produced no greater impact on intentions than a no-label blank message, which may reflect message fatigue.
* Young adults perceived messages articulating the negative consequences of nicotine addiction for mental health as more effective than an addictiveness-only message.
* The post-hoc analysis suggested that NH Black respondents had higher odds of reporting that the FDA label discouraged use or provoked concern than NH White young adults.
* The depression and anxiety label was more motivating for young adults with higher versus lower levels of education.

Main Message:
The study suggests that warnings about the mental health consequences of nicotine addiction might be one type of message to consider including in a suite of required warnings as part of a comprehensive tobacco prevention and control strategy. Race and ethnicity, education, and tobacco use appear to be associated with PME, suggesting the importance of requiring multiple warning label messages that may motivate diverse groups. Given the introduction of additional, noncombustible commercial tobacco products onto the market, it is increasingly important to understand how best to communicate nicotine's harms.

Kristy L Marynak, Joanna E Cohen, Johannes Thrul, Ryan D Kennedy, Rupali Limaye, Meghan B Moran, Effects of E-Cigarette Warning Labels About Mental Health Consequences of Nicotine Addiction Among Young Adults in the USA: Results From a Randomized Controlled Experiment, Nicotine & Tobacco Research, Volume 27, Issue 6, June 2025, Pages 1006–1015, https://doi.org/10.1093/ntr/ntae298