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Changes in responses to nicotine vaping product warnings and leaflets in England compared with Canada, the US and Australia: findings from the 2016-2018 ITC Four Country Smoking and Vaping Surveys.

Authors
  • Taylor, Eve Violet1
  • East, Katherine A2, 3
  • McNeill, Ann2, 4
  • Cummings, Michael5, 6
  • Thrasher, James7, 8
  • Fong, Geoffrey T3, 9, 10
  • Quah, Anne C K9
  • McDermot, Máirtín2
  • Li, Grace9
  • Borland, Ron11, 12
  • Hammond, David3
  • Aleyan, Sarah2, 3
  • Hitchman, Sara C2
  • 1 Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK [email protected]
  • 2 Addictions Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
  • 3 School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada. , (Canada)
  • 4 Shaping Public Health Polices to Reduce Inequalities and Harm (SPECTRUM), London, UK.
  • 5 Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA.
  • 6 Hollings Cancer Centre, Medical University of South Carolina, Charleston, South Carolina, USA.
  • 7 Health Promotion, Education and Behavior, School of Public Health, University of South Carolina, Columbia, South Carolina, USA.
  • 8 Tobacco Research Department, Centre for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico. , (Mexico)
  • 9 Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada. , (Canada)
  • 10 Ontario Institute for Cancer Research, Toronto, Ontario, Canada. , (Canada)
  • 11 Melbourne Centre for Behaviour Change, School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia. , (Australia)
  • 12 Cancer Council Victoria, Melbourne, Victoria, Australia. , (Australia)
Type
Published Article
Journal
Tobacco control
Publication Date
Jan 01, 2022
Volume
31
Issue
1
Pages
107–111
Identifiers
DOI: 10.1136/tobaccocontrol-2020-055739
PMID: 33115961
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

In May 2017, black-and-white text nicotine addiction warning labels ('warnings') and health and safety leaflets ('leaflets') became mandatory for nicotine vaping products (NVPs) in England, in accordance with the European Union's Tobacco Products Directive. We compared changes over time in noticing warnings and leaflets, recall of warnings about nicotine and concerns about using NVP due to noticing warnings in England, compared with Canada, the US and Australia, where no warnings and leaflets were mandated. 19 005 adult (aged 18+) NVP users, smokers and quitters of cigarettes and NVP from the 2016 and 2018 International Tobacco Control Four Country Smoking and Vaping Surveys in England, Canada, the US and Australia, recruited via probability and non-probability sampling. Noticing warnings increased in England from 4.9% (2016) to 9.4% (2018) (adjusted OR/AOR=1.64, 95% CI=1.15-2.36); this change was larger than changes in Canada (AOR=2.51, 95% CI=1.71-3.69) and the US (AOR=2.22, 95% CI=1.45-3.39). Recall of a nicotine warning increased in England from 86% (2016) to 94.9% (2018) (AOR=5.50, 95% CI=1.57-19.27) but not significantly elsewhere. Noticing leaflets increased in England from 14.6% (2016) to 19.1% (2018) (AOR=1.42, 95% CI=1.15-1.74); this change was larger than in Canada (AOR=1.42, 95% CI=1.12-1.79), the US (AOR=1.55, 95% CI=1.17-2.06) and Australia (AOR=1.51, 95% CI=1.02-2.22). Among those noticing warnings, concern about NVP use did not change significantly between 2016 and 2018 (all countries p>0.081). Introduction of mandatory NVP warnings and leaflets in England was associated with small increases in noticing them but not with changes in concerns about NVP use. © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

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