Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2020 Apr 21;22(5):630-637.
doi: 10.1093/ntr/ntz091.

Optimizing Warnings on E-Cigarette Advertisements

Jessica L King  1 , Allison Lazard  2   3 , Beth A Reboussin  4 , Leah Ranney  3 , Jennifer Cornacchione Ross  1 , Kimberly G Wagoner  1 , Erin L Sutfin  1
Affiliations
Randomized Controlled Trial

Optimizing Warnings on E-Cigarette Advertisements

Jessica L King et al. Nicotine Tob Res. .

Abstract

Introduction: We examined the effect of visual optimizations on warning text recall.

Methods: We used Amazon's Mechanical Turk to recruit 1854 young adult (18-34 years) electronic cigarette (e-cigarette) users or susceptible nonusers. We conducted a between-subjects 3 × 2 × 2 experiment to examine the influence of color (black text on white background [BW] vs. black on yellow [BY] vs. yellow on black [YB]), shape (rectangle vs. novel), and signal word (presence vs. absence of the word "warning"). We randomized participants to view one of 12 warnings on a fictional e-cigarette advertisement. We coded open-ended recall responses into three categories: (1) recalled nothing, (2) recalled something, (3) recalled the concept. We examined main effects on warning text recall using multinomial regression. We examined differences in attention, perceived message effectiveness, and appeal.

Results: Those exposed to BW or BY warnings were more likely than those exposed to YB to recall something (AOR = 1.6, AOR = 1.5, respectively) or the concept (OR = 1.4, BW). Those exposed to novel shape (44.7% novel vs. 37.9% rectangle; p = .003) or color (44.5% BY vs. 41.9% YB vs. 37.5% BW; p = .04) warnings were more likely to report attention to the warning. In aided recall, those exposed to the signal word were more likely than those not exposed to select the correct response (64.0% vs. 31.3%; p < .0001). We did not find differences for message effectiveness or appeal.

Conclusions: Visual optimizations such as color may influence warning text recall and should be considered for new warnings. Research should continue exploring variations for advertisement warnings to maximize attention to warning text.

Implications: This study examines the impact of visual optimizations on recall of the US Food and Drug Administration-mandated e-cigarette advertisement warning text. We found that color might influence warning text recall, but we did not find effects for shape or signal word. It is possible the newly mandated e-cigarette advertisement warnings, which are required to occupy at least 20% of the advertisement, are currently novel enough to attract attention. Future research should examine optimizations following implementation of the new advertisement warnings.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Twelve warning conditions from full experiment.
See this image and copyright information in PMC

References

    1. Family Smoking Prevention and Tobacco Control Act; 2009.https://www.fda.gov/tobacco-products/rules-regulations-and-guidance/fami.... Accessed August 18, 2018.
    1. Popper ET, Murray KB. Communication effectiveness and format effects on in-ad disclosure of health warnings. J Public Policy Mark. 1989;8(1):109–123.
    1. Fischer PM, Krugman DM, Fletcher JE, Fox RJ, Rojas TH. An evaluation of health warnings in cigarette advertisements using standard market research methods: what does it mean to warn? Tob Control. 1993;2(4):279–285.
    1. Food and Drug Administration, HHS. Deeming tobacco products to be subject to the federal food, drug, and cosmetic act, as amended by the family smoking prevention and tobacco control act; restrictions on the sale and distribution of tobacco products and required warning statements for tobacco products final rule. Fed Regist. 2016;81(90):28973–29106. - PubMed
    1. Rutgers School of Public Health. Trinkets & Trash: Artifacts of the Tobacco Epidemic https://www.trinketsandtrash.org/detail.php?artifactid=12286&page=1. Accessed August 13, 2018.

Publication types

LinkOut - more resources