Assessing the Impact of Conflicting Health Warning Information on Intentions to Use E-Cigarettes -An Application of the Heuristic-Systematic Model.

The purpose of this study is to determine how nonsmokers perceive conflicting information when a modified risk statement is included along with a warning label on e-cigarette packages. We propose an application of the heuristic-systematic model to test whether this conflicting information leads to more or less active processing. As part of a larger inquiry into e-cigarette labeling, we present an experiment (n = 303) in which we test this model with nonsmokers, measuring ambiguity perceptions, counter-arguing, reduced effectiveness of the message, and behavioral intentions. Results demonstrate that the addition of a modified risk statement on the package with the warning label increases ambiguity perceptions which can lead to reduced effectiveness of warning labels and reduced behavioral intentions to avoid using e-cigarettes among nonsmokers. While the systematic and heuristic pathways are both explanatory, heuristic processing provides the better fit.

High School Youth and E-cigarettes: The Influence of Modified Risk Statements and Flavors on E-cigarette Packaging.

Objectives: In this paper, we test variations of e-cigarette warning labels on high school youth, alone, and alongside modified risk statements (MRS) and/or flavors, to determine how perceptions of and intentions toward use of e-cigarettes are influenced by these package elements. Methods: An experiment (N = 715 high school youth) varied the warning label participants viewed (FDA warning label/ MarkTen warning label/ abstract warning label) and whether they viewed the label alone or alongside MRS and/or flavors. Results: Drawing upon the Heuristic Systematic Model, we found that youth who view an MRS with any of the warning labels are more likely to engage in counterarguing (compared to the FDA warning label alone), which increases risk perceptions. Additionally, the greater youth perceive the risks associated with e-cigarettes, the lower their intentions of using them, even if they have tried an e-cigarette in the past. Conclusions: Tobacco education and public health messages should encourage youth to evaluate the tobacco industry messages they receive, as counterarguing is associated with higher risk perceptions. Furthermore, fostering increased awareness of the risks associated with e-cigarette use by youth can reduce intentions to use them.