The Impact of Cigarillo Warnings on Purchasing and Smoking Behaviors Among Young Adult Cigarillo Users

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Project Summary Cigarillo use remains a public health concern, particularly among vulnerable populations. Young adults, including those who are Black or African American, have the highest rates of cigarillo use. Cigarillo smoking has many negative health effects, is associated with using other tobacco products, such as cigarettes, and cigarillo smoke contains many toxic chemicals. Additionally, some young adults believe cigarillos to be less harmful and less addictive than cigarettes, encouraging uptake and continued use. Significant knowledge gaps exist in our understanding of how to effectively communicate the risks of cigarillo smoking , but one effective strategy is through warning labels. Cigarillos are under the regulatory authority of the Food and Drug Administration (FDA), and the FDA has mandated the implementation of six text-only warnings for cigarillos. This R01 application will address gaps in the literature about the effectiveness of cigarillo warnings by extending our previous research where we developed pictorial warnings for cigarillos. The specific aims of the proposed study are to: (1) Examine the impact of a pictorial cigarillo warning policy among young adult cigarillo smokers’ purchasing behaviors using a behavioral economics framework; and (2) examine the impact of repeated exposure to pictorial versus cigarillo warnings on cigarillo smoking intentions and behaviors. Our study focuses on young adult and Black/African American frequent cigarillo users ages 21-34 because they have the highest rates of cigarillo use. We will first develop an online shopping task using the Experimental Tobacco Marketplace and examine the impact of different cigarillo warning manipulations (pictorial, FDA text- only, Surgeon General text-only) on cigarillo purchasing, cigarillo demand, and substitution of other tobacco products. We will then recruit another sample of young adult and Black/African American frequent cigarillo users to participate in a 6-week randomized control trial where they will be exposed to cigarillo warnings weekly to examine the impact of the warnings on cigarillo smoking intentions and behaviors. The goal of this research is to increase the effectiveness of warning labels to discourage cigarillo use among young adults, including those who are Black or African American. The results of this timely project could inform the FDA’s rulemaking for cigarillo warnings, thereby reducing tobacco-related morbidity and mortality.