Evidence map›Paper›PMID 37344191›Full record

Trial reportTobacco control2025

Optimising messages and images for e-cigarette warnings.

Allison J Lazard, Mohammad Ebrahimi Kalan, Sydney Nicolla, Marissa G Hall, Kurt M Ribisl, Jennifer Mendel Sheldon, Callie Whitesell, Tara L Queen, Noel T Brewer

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Tobacco control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. Trial
  2. Sharing Antivaping Social Media Messages.The Journal of adolescent health : official publication of the Society for Adolescent Medicine · 2025
    Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. The Role of e-Cigarette Packaging as a Health Communications Tool: A Focus Group Study With Adolescents and Adults in England and Scotland.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025
    Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Allison J LazardHussman School of Journalism and Media, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA lazard@unc.edu.ORCID 0000-0002-2502-2850
Mohammad Ebrahimi KalanLineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Sydney NicollaHussman School of Journalism and Media, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Marissa G HallLineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Kurt M RibislLineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID 0000-0003-3318-8524
Jennifer Mendel SheldonLineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Callie WhitesellDepartment of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID 0000-0001-7793-3894
Tara L QueenDepartment of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Noel T BrewerLineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Funding

Informing ENDS policies: Studying the impact of e-cigarette warnings on behaviorR01DA048390 · NIDA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BREWER, NOEL TODD · 2020 to 2025
$2.5M
Designing and Evaluating High-Impact Pictorial Health Warnings for Food ProductsK01HL147713 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI HALL, MARISSA · 2019 to 2023
$738k
NHLBI NIH HHS K01 HL147713NIDA NIH HHS R01 DA048390
6 · The paper itself

Abstract

backgroundThe US Food and Drug Administration (FDA) requires electronic cigarettes (e-cigarettes) to have a single addiction warning, but many other health harms are associated with vaping and warnings grow stale over time. We aimed to develop new warning messages and images to discourage e-cigarette use.

methodsParticipants were 1629 US adults who vaped or smoked. We randomised each participant to evaluate 7 of 28 messages on newly developed

resultsRegarding intended effects, new warning themes all discouraged vaping more than the current FDA-required warning (all p<0.001), led to greater negative affect (all p<0.001) and led to more anticipated social interactions (all p<0.001). The most discouraging warnings were about toxic metals exposure. Regarding unintended effects, the new themes led to more stigma against people who vape (6 of 7 themes, p<0.001) and led to a greater likelihood of thinking vaping is more harmful than smoking (all 7 themes, p<0.001), although unintended effects were smaller than intended effects. Images of harms (internal or people experiencing) discouraged vaping more than images of hazards (all p<0.001). DISCUSSION: Vaping warning policies should communicate a broader range of hazards and harms, beyond addiction, to potentially increase awareness of health harms. Images of internal harm or people experiencing harms may be particularly effective at discouraging vaping.

Indexed as

Electronic Nicotine Delivery SystemsProduct LabelingVapingAdultFemaleHumansMaleMiddle AgedUnited StatesUnited States Food and Drug AdministrationYoung Adultaddictionelectronic nicotine delivery devicespackaging and labelling

Identifiers

PMID37344191
PMCPMC10733543

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.