Youth Exposure and Response to the FDA Health Warning Label on Electronic Cigarettes Packaging: Policy Implications.
Youth Exposure and Response to the FDA Health Warning Label on Electronic Cigarettes Packaging: Policy Implications.
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青少年对电子烟包装上 FDA 健康警告标签的接触和反应：政策影响。
DOI：
10.1093/ntr/ntad175
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发表时间：
2024
期刊：
影响因子：
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通讯作者：
Noar,SethM
中科院分区：
文献类型：
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作者：
Asfar,Taghrid;Oluwole,OlusanyaJ;Pan,Yue;Casas,Alejandra;Garayua,AdrianaMaiteHernandez;Schmidt,Michael;Noar,SethM
青少年是电子烟健康传播的重点群体。本研究调查了青少年在4年内接触美国食品和药物管理局（FDA）电子烟警告标签的情况，以及它与青少年危害认知和意图变化的关系。目的和方法我们汇集了2018-2021年全国青少年烟草调查（10-17岁；n= 67 159）的数据。参与者分为四组：从不使用者（58.5%）、易受影响的非使用者（16.3%）、以前使用者（12.7%）和现在使用者（12.5%）。我们研究了青少年接触警告与成瘾性和危害认知、使用电子烟的意图和戒烟的意图之间的患病率、时间趋势、相关性和关联。结果仅有24.5%的青少年接触到警示语。风险敞口从2018年的14.9%上升到2019年的30.8%，然后在2021年下降到25.2%。西班牙裔（校正优势比(aOR) = 0.76 [95% CI = 0.641至0.89]）和非西班牙裔黑人当前使用者（0.53[0.40至0.69]）比白人当前使用者更不可能接触到警告。青少年接触电子烟与更高的电子烟成瘾感知（1.12[1.04至1.19]）和戒烟意愿（1.28[1.13至1.46]）呈正相关。然而，电子烟暴露与危害感知（0.91[0.85至0.96]）和非电子烟使用者使用电子烟的意愿（2.38[1.99至2.84]）呈负相关。结论青少年接触警示语的减少表明警示语的损耗效应。通过使用引人注目的设计、增加电子烟对青少年危害的主题、定期轮换警告内容以及使用符合文化的信息传递来加强标签，可能会改善其对青少年的影响，并解决种族/民族差异问题。FDA的电子烟标签仅触及24.5%的年轻人，并且接触警告并没有显示出磨损效应。少数民族的接触率明显较低。接触电子烟与更高的电子烟成瘾性和戒掉所有烟草产品的意图有关。尽管如此，它并没有增加非用户对电子烟的危害认知，也没有降低他们使用电子烟的意愿。通过使用更引人注目的设计来加强标签，包括关注与青少年相关的电子烟危害的不同主题，并定期轮换警告内容，可能会改善其对青少年的影响。需要继续监测电子烟政策的实施情况，以确保它们对不同种族/族裔亚人群的青年产生同样的影响。
IntroductionYouth represent a high-priority group for e-cigarette health communication. This study examined youth exposure to the Food and Drug Administration (FDA) e-cigarette warning label over 4 years and its association with change in youth harm perception and intention.Aims and MethodsWe pooled data from the 2018–2021 National Youth Tobacco Survey (age 10–17;n= 67 159). Participants were divided into four groups: never users (58.5%), susceptible nonusers (16.3%), former users (12.7%), and current users (12.5%). We examined the prevalence, time-trend, correlates, and association of youth exposure to the warning with addictiveness and harm perception, intention to use e-cigarettes, and intention to quit all tobacco products.ResultsOnly 24.5% of youth were exposed to the warning. Exposure increased from 14.9% in 2018 to 30.8% in 2019, then declined to 25.2% in 2021. Hispanic (adjusted odds ratio (aOR) = 0.76 [95% CI = 0.641 to 0.89]) and non-Hispanic black current users (0.53 [0.40 to 0.69]) were less likely to be exposed to the warning than white current users. Youth exposure was positively associated with a higher perception of e-cigarette addictiveness (1.12 [1.04 to 1.19]) and intention to quit all tobacco products (1.28 [1.13 to 1.46]). However, exposure was negatively associated with harm perception (0.91 [0.85 to 0.96]) and the intention to use e-cigarettes among e-cigarette nonusers (2.38 [1.99 to 2.84]).ConclusionsThe decline in youth exposure to the warning indicates wear-out effects. Strengthening the label by using compelling designs, adding themes on e-cigarette harm to youth, periodically rotating warning content, and using culturally tailored messaging may improve its impact on youth and address racial/ethnic disparities.ImplicationsThe FDA e-cigarette label reached only 24.5% of youth, and exposure to the warning declined to indicate wear-out effects. Exposure was significantly lower among minorities. Exposure was associated with a higher perception of e-cigarette addictiveness and intention to quit all tobacco products. Still, it did not increase harm perception or reduce intention to use e-cigarettes among nonusers. Strengthening the label by using more compelling designs, including diverse themes focusing on e-cigarette harm relevant to youth, and periodically rotating warning content may improve its impact on youth. Continued surveillance of the implementation of e-cigarette policies is needed to ensure that they equally affect youth across racial/ethnic subpopulations.