Evidence map›Paper›PMID 39819948›Full record

Trial reportBMJ open2025

Impact of warning pictorials and size on perceived effectiveness of cigar warning labels in a nationally representative between-subjects experiment.

Adam O Goldstein, Michelle Z Yang, Kristen L Jarman, Tara L Queen, Sonia A Clark, Leah M Ranney, Jennifer Cornacchione Ross, Paschal Sheeran, Chineme Enyioha, James F Thrasher and 2 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. The Impact of Cigarillo Text Warning Presence and Size on Young Adults' Cigarillo Risk Beliefs, Knowledge, Appeal, and Use Intentions.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2025
    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

12 authors.

Adam O GoldsteinDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA adam_goldstein@med.unc.edu.
Michelle Z YangDepartment of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0002-4742-0753
Kristen L JarmanDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0002-6707-3058
Tara L QueenDepartment of Health Behavior, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Sonia A ClarkDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Leah M RanneyDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0001-9766-4767
Jennifer Cornacchione RossDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID http://orcid.org/0000-0001-5173-3130
Paschal SheeranLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Chineme EnyiohaDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0001-9583-0223
James F ThrasherDepartment of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA.
Desmond JensonPublic Health Law Center, Mitchell Hamline School of Law, Saint Paul, Minnesota, USA.ORCID http://orcid.org/0000-0002-7251-1737
Sarah D KowittDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Funding

Little Cigar and Cigarillo Warnings to Reduce Tobacco-Related Cancers and DiseaseR01CA240732 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI GOLDSTEIN, ADAM O · 2019 to 2023
$3.1M
NCI NIH HHS R01 CA240732
6 · The paper itself

Abstract

backgroundPeople who smoke cigars often have misperceptions about the associated risks, contributing to rises in smoking rates. This study investigates the perceived warning effectiveness (PWE) of health warning labels (HWLs) on cigar packages. We tested the impact of warning type and warning size in the HWLs on PWE and other health outcomes. DATA AND

methodsIn a between-subjects experimental design, participants (n=809) who used little cigars or cigarillos in the past 30 days were randomly assigned to one of four conditions: text-only at 30% size, pictorial+text warning at 30% size, text-only at 50% size and pictorial+text warning at 50% size. In each condition, participants rated six cigarillo HWLs on PWE, self-reported learning, thinking about risks, new knowledge, perceived enjoyment and negative affect. Reactance to the labels was also measured. Data were analysed with mixed-effects models.

resultsPictorial+text cigarillo HWLs were deemed more effective than text-only HWLs in PWE (

conclusionIncluding images with text warning statements for cigarillos can increase PWE. Our findings provide important insights for the US Food and Drug Administration and international regulatory agencies in designing new HWLs for cigars that can more effectively communicate smoking risks, address misinformation and potentially reduce cigar smoking.

Indexed as

Health Knowledge, Attitudes, PracticeProduct LabelingSmokingSmoking PreventionTobacco ProductsAdolescentAdultFemaleHumansMaleMiddle AgedYoung AdultPsychosocial InterventionPUBLIC HEALTHSmoking Reduction

Identifiers

PMID39819948
PMCPMC11752031

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.