Evidence map›Paper›PMID 40523793›Full record

Trial reportBMJ open2025

Campaign messages to support pictorial health warning labels for little cigars and cigarillos: an online survey-based experiment.

Chineme Enyioha, Sonia Clark, Remi Philips, Olivia Hodgson, Kristen Jarman, James F Thrasher, Adam Goldstein

Abstract readRandomized Controlled Trial
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. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Chineme EnyiohaDepartment of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA chineme_enyioha@med.unc.edu.ORCID http://orcid.org/0000-0001-9583-0223
Sonia ClarkThe University of North Carolina at Chapel Hill Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, USA.
Remi PhilipsDepartment of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0009-0007-4757-2945
Olivia HodgsonDepartment of Biostatistics, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
Kristen JarmanDepartment of Family Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0002-6707-3058
James F ThrasherDepartment of Health Promotion, Education & Behavior, University of South Carolina, Columbia, South Carolina, USA.ORCID http://orcid.org/0000-0001-6418-4863
Adam GoldsteinDepartment of Family Medicine, The 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

objectivesCampaigns to support pictorial health warning labels (HWLs) for cigarettes have enhanced their effectiveness, but little to no research on campaign messages to support little cigars and cigarillos (LCC) pictorial HWLs exists. The goal of this study was to examine the effectiveness of messages to augment pictorial HWLs on LCCs among priority populations.

designOnline survey-based experiment.

settingQualtrics research panel online of US adults, recruited between January and February 2023.

participantsAdults ages 21-29 who reported current cigar use and reside in the USA.

interventionsParticipants (n=315) were randomly assigned to one of three conditions: (1) messages designed to elaborate pictorial HWLs, (2) pictorial HWLs alone and (3) messages and pictorial HWLs paired together. PROCEDURES AND OUTCOME MEASURES: Within conditions, participants were shown six negative health effects of LCCs and answered questions about perceived message effectiveness (PME), negative affect, thinking about risks (TAR) and self-reported learning (SRL) as well as questions on quit intention, concern about their health and reactance. Using mixed-effects models and ANOVA, we evaluated for differences across conditions.

resultsMost participants identified as male (60%) and either Black (45%) or White (45%). PME was very high across all three conditions (≥ 3.85) but no difference between conditions in a statistically significant manner (p=0.18). Mixed-effects models indicated that negative affect varied across conditions, highest in condition 2 (3.76; 95% CI 3.58, 3.94) and lowest in condition 3 (3.44; 95% CI 3.27, 3.61) (p=0.01), and showed no statistically significant difference between conditions for SRL (p=0.31) or TAR (p=0.43). No statistically significant difference was noted for quit intentions (p=0.16), health concern (p=0.28) or reactance (p=0.84).

conclusionsPictorial HWLs, campaign messages and the combination of the conditions were all perceived as very effective, with little differences in PME. Such findings indicate that pictorial HWLs on LCCs and communication messages about LCCs both appear as promising approaches to reducing LCC use among target populations. Longitudinal studies with ongoing exposure may identify factors that can enhance the effectiveness of campaign messages to enhance pictorial HWLs for LCCs.

Indexed as

Health PromotionProduct LabelingSmoking CessationTobacco ProductsAdultFemaleHumansMaleSurveys and QuestionnairesUnited StatesYoung AdultPUBLIC HEALTHSmoking ReductionTobacco Use

Identifiers

PMID40523793
PMCPMC12314825

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Registered trials

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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.