Evidence map›Paper›PMID 41617163›Full record

Trial reportAmerican journal of preventive medicine2026

Perceived Effectiveness of Cigar Warnings Among Young People in the U.S.

Leah M Ranney, Rime Jebai, Micheal Jetsupphasuk, Sonia A Clark, Kristen L Jarman, Sarah D Kowitt, James F Thrasher, Adam O Goldstein, Jennifer Ross Cornacchione

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in American journal of preventive medicine, 2026. 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

9 authors.

Leah M RanneyDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: Leah_ranney@unc.edu.
Rime JebaiDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts.
Micheal JetsupphasukDepartment of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Sonia A ClarkLineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Kristen L JarmanDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Sarah D KowittDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
James F ThrasherDepartment of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina.
Adam O GoldsteinDepartment of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Jennifer Ross CornacchioneDepartment of Health Law, Policy and Management, Boston University School of Public Health, Boston, Massachusetts.

Funding

Biostatstics for Research in Environmental HealthT32ES007018 · NIEHS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Stephanie Engel, Rebecca Fry · 1985 to 2026
$31.3M
Strengthening Cigar Warnings to Prevent Adolescent UseR01CA260822 · NCI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CORNACCHIONE ROSS, JENNIFER JANE, RANNEY, LEAH MARIE · 2021 to 2023
$1.2M
NCI NIH HHS R01 CA260822NIEHS NIH HHS T32 ES007018
6 · The paper itself

Abstract

introductionThe effectiveness of warning size and format on cigar packaging in influencing youth and young adult smoking behaviors is not well understood. This study tested these cigar warning characteristics among youth and young adults who use or are susceptible to using little cigars or cigarillos.

methodsThe study recruited 506 U.S. youth and young adults, aged 15-20 years, between April and June 2023. Participants reported ever or past 30-day use of little cigars or cigarillos or were susceptible to using little cigars or cigarillos. A 2 × 2 between-subjects online experiment was conducted where youth and young adults were randomized to 1 of 4 conditions, with manipulations for cigar warning size (30% or 50% of the package) and format (U.S. Food and Drug Administration-proposed text-only or pictorial). Youth and young adults viewed 6 warnings on a mock cigarillo package. The primary outcome was perceived message effectiveness. A mixed-effects regression model was fit to examine the effects of warning size and format on outcomes in September 2023.

resultsMost participants were female (50.0%), White (59.3%), and heterosexual (67.8%). Nearly half were susceptible to little cigars or cigarillos (47.4%), followed by past 30-day use (32%) and ever use (20.6%). Pictorial warnings significantly increased perceived message effectiveness compared with text-only warnings. Similar effects were found for risk perceptions, cognitive and emotional reactions, and recognition. Warning size had no statistically significant effect on outcomes.

conclusionsPictorial cigar warnings outperformed U.S. Food and Drug Administration-proposed text-only warnings on perceived message effectiveness and secondary outcomes among youth and young adults who use or are susceptible to little cigars or cigarillos. These results suggest that a pictorial format will enhance the effectiveness of cigar warnings, as has been found for cigarettes.

Indexed as

Cigar SmokingProduct LabelingTobacco ProductsAdolescentFemaleHumansMaleUnited StatesUnited States Food and Drug AdministrationYoung Adult

Identifiers

PMID41617163
PMCPMC12991477

What OpenQuestion holds

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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.