Developing and testing health warning labels on the ENDS device

开发和测试用于ENDS的健康测试 项目摘要 电子尼古丁输送系统（ENDS或电子烟）的使用已达到流行水平， 美国的年轻人（US）。ENDS会释放出有毒物质，包括尼古丁， 青少年大脑发育导致依赖性和吸烟风险增加，但 对他们安全的误解很普遍。因此，ENDS相关风险的健康沟通 通过健康警告标签（HWL），已被认为是一个优先事项，由领先的健康和监管 在美国的机构，以减少在年轻人中使用ENDS。我们已经开发和试点测试了一个临床实验室 模型，以研究图形HWL对年轻（21-29岁）ENDS用户体验的潜在影响。在这 建议，我们将使用这个模型，再加上一个系统的发展，ENDS图形HWL测试他们的 当它们被放置在设备上时，对各种主观（例如满意度、伤害感知、尼古丁）的影响 依赖性、戒烟意图）和客观结果（例如，血浆尼古丁、抽吸地形图）。这将是 分三个阶段进行。首先，我们将回顾文献，并开发候选消息及其相关的 HWL的图片（n=45）。然后，将通过德尔菲研究对这组初始HWL进行修订和排名 在烟草控制、监管和健康传播专家中。第二，我们会进行专题小组讨论， 年轻的ENDS（21-29岁）用户，以使候选HWL适应我们的目标人群和器械本身。 第三，我们将在临床实验室交叉研究中测试ENDS器械上的HWL，其中每个受试者使用ENDS 在2个阶段中; 1）他们的首选产品没有HWL（对照），和2）他们的首选产品有图案 ENDS设备上的HWL。这个设计将允许我们测试我们的主要假设;与对照相比，使用 与HWL相关的ENDS与满意度降低，依赖抑制和抽吸相关 行为，但增加了有关伤害和意图戒烟的知识。该项目将指导决策者 将有效的HWL应用于ENDS，并将制定警告信息和图片， 国家利益攸关方可以通过不同方式开展反推销运动， 人和劝阻有害的结束使用。

Developing and Testing Health Warnings for ENDS PROJECT SUMMARY The use of electronic nicotine delivery systems (ENDS or e-cigarettes) has reached epidemic levels among young people in the United States (US). ENDS emit toxic substances, including nicotine that irreversibly affects youth’s developing brain leading to dependence and increased risk of cigarette smoking initiation, yet misperceptions about their safety are widespread. Therefore, health communication of ENDS-related risks through Health Warning Labels (HWLs) has been considered as a priority by leading health and regulatory bodies in the US to reduce ENDS use among young people. We have developed and pilot-tested a clinical lab model to examine the potential effects of pictorial HWLs on young (21-29 yrs) ENDS users’ experiences. In this proposal, we will use this model coupled with a systematic development of ENDS pictorial HWLs to test their effect when they are placed on the device on a variety of subjective (e.g. satisfaction, harm perception, nicotine dependence, intention to quit) and objective outcomes (e.g. plasma nicotine, puff topography). This will be done in three stages. First, we will review the literature and develop candidate messages and their associated pictures for the HWLs (n=45). This initial set of HWLs will then be revised and ranked through a Delphi study among tobacco control, regulation, and health communication experts. Second, we will conduct focus groups with young ENDS (21-29 yrs) users to adapt the candidate HWLs to our target population and device itself. Third, we will test HWLs on the ENDS device in a clinical lab cross-over study, where each subject uses ENDS in 2 sessions; 1) their preferred product without HWL (control), and 2) their preferred product with pictorial HWL on the ENDS device. This design will allow us to test our main hypothesis; compared to control, using ENDS with the HWLs is associated with decreased satisfaction, dependence suppression, and puffing behavior, but increased knowledge about harm and intention to quit. This project will guide policymakers into the application of effective HWLs for ENDS and will develop warning messages and pictorials that national and state stakeholders can use through different modalities in counter-marketing campaigns to protect young people and discourage harmful ENDS use.