Objectives: In this paper, we test variations of e-cigarette warning labels on high school youth, alone, and alongside modified risk statements (MRS) and/or flavors, to determine how perceptions of and intentions toward use of e-cigarettes are influenced by these package elements.
Methods: An experiment (N = 715 high school youth) varied the warning label participants viewed (FDA warning label/ MarkTen warning label/ abstract warning label) and whether they viewed the label alone or alongside MRS and/or flavors. Results: Drawing upon the Heuristic Systematic
Model, we found that youth who view an MRS with any of the warning labels are more likely to engage in counterarguing (compared to the FDA warning label alone), which increases risk perceptions. Additionally, the greater youth perceive the risks associated with e-cigarettes, the lower their
intentions of using them, even if they have tried an e-cigarette in the past. Conclusions: Tobacco education and public health messages should encourage youth to evaluate the tobacco industry messages they receive, as counterarguing is associated with higher risk perceptions. Furthermore,
fostering increased awareness of the risks associated with e-cigarette use by youth can reduce intentions to use them.
Today's health information landscape is increasingly characterized by conflicting and often controversial messages about a range of health topics, including nutrition, cancer screening, e‐cigarettes, and medications. Content analyses of media coverage suggest that conflicting health information is widespread, and observational survey studies consistently show that the public notices such content – not only from media sources, but also from interpersonal and clinical information sources. Importantly, experimental and longitudinal survey studies provide evidence of media effects: greater exposure to conflicting health information has been shown to produce adverse affective, cognitive, and behavioral intentional responses, including negative emotional reactions, confusion about and backlash toward health research and recommendations, and lower intentions to adhere to healthy lifestyle recommendations. Moreover, there is even nascent evidence that exposure to conflicting health information reduces receptivity to subsequent
unrelated
health messages about behaviors for which there is broad scientific consensus, such as fruit and vegetable consumption and physical activity. Taken together, this growing body of research documenting the adverse consequences of exposure to conflicting health information signals the need for continued attention from health communication scholars. Future research should consider how best to intervene and mitigate the negative consequences of such exposure.
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