Evidence map›Paper›PMID 37952202›Full record

Trial reportNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2024

Effects of Pictorial Health Warning Labels on Intention to Quit Waterpipe in Lebanon: A Mediation Analysis.

Rime Jebai, Taghrid Asfar, Miguel Ángel Cano, Rima Nakkash, Michael Schmidt, Wensong Wu, Zoran Bursac, Wasim Maziak

Open access · greenAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.0field-weighted citation impact, top 22% of its field
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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. 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

8 authors at 6 institutions in 3 countries.

Rime JebaiDepartment of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.ORCID 0000-0002-9265-1323
Taghrid AsfarDepartment of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.ORCID 0000-0003-1133-9723
Miguel Ángel CanoPeter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Rima NakkashDepartment of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
Michael SchmidtSchool of Public Health and Department of Art, University of Memphis, Memphis, TN, USA.
Wensong WuDepartment of Mathematics and Statistics, Florida International University, Miami, FL, USA.
Zoran BursacDepartment of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
Wasim MaziakDepartment of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA.ORCID 0000-0001-6126-8420
Florida International University · USBoston University · USGeorge Mason University · USThe University of Texas Southwestern Medical Center · USUniversity of Memphis · USUniversity of Miami · US

Funding

Translating evidence and building capacity to support waterpipe control in the Eastern MediterraneanR01TW010654 · FIC · FLORIDA INTERNATIONAL UNIVERSITY · PI ASFAR, TAGHRID, MAZIAK, WASIM · 2017 to 2021
$1.8M
FIC NIH HHS R01 TW010654National Institute of Health and Fogarty International Center R01TW010654
6 · The paper itself

Abstract

introductionPictorial health warning labels (HWLs) on waterpipe (WP) tobacco packages represent a better strategy for communicating the health risks associated with WP use and promoting quit intention than text-only. However, the mechanism by which these warnings lead to higher intentions to quit remains unknown. AIMS AND

methodsThis study explores how pictorial warnings versus text-only induces higher quit intention among a sample of young adult WP smokers in Lebanon. An online randomized cross-over experimental study was conducted in August 2021 among 276 young adult WP smokers who were exposed to two conditions: pictorial HWLs and text-only warnings on WP tobacco packages in random order. After each image, participants completed post-exposure assessments of health communication outcomes (eg, attention and negative affect). Using serial and parallel mediation analysis, we examined the role of attention, negative affect, cognitive elaboration, and perceived harm in mediating the relationship between exposure to HWLs and intention to quit.

resultsUsing serial mediation, exposure to pictorial warnings versus text-only was found to affect intention to quit through the following pathways: attention and negative affect, which accounted for 17.28% of the total effect, and through negative affect and cognitive elaboration, which accounted for 21.53% of the total effect. Results of parallel mediation showed that the indirect effect pathways via negative affect (β = 0.063; [95% bootstrap CI = 0.004 to 0.149]) and cognitive elaboration (0.047; [0.001 to 0.114]) were statistically significant.

conclusionsThe findings call on designing and implementing attention-grabbing, emotionally evocative, and cognitively persuasive pictorial warnings in Lebanon and other countries to curb WP tobacco smoking. IMPLICATIONS: This is among the first experimental studies looking at multiple mediators underlying the effect of exposure to pictorial HWLs on intention to quit in a sample of current WP smokers in Lebanon. The findings showed that using attention-grabbing, emotionally evocative, and persuasive pictures with a clear textual warning is crucial to maximizing the impact of implementing WP-HWLs regulations in Lebanon and other countries to curb WP tobacco smoking.

Indexed as

IntentionMediation AnalysisProduct LabelingSmoking CessationAdolescentAdultCross-Over StudiesFemaleHumansLebanonMaleTobacco, WaterpipeWater Pipe SmokingYoung Adult

Identifiers

PMID37952202
PMCPMC12104537
OpenAlexW4388609939

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.