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

Eve Taylor; Ann McNeill; Katherine East; Sarah Aleyan; Sara Hitchman; Mairtin McDermott; K Michael Cummings; Geoffrey T Fong; James F Thrasher; Anne C K Quah; Grace Y Li; Ron Borland; David Hammond

doi:10.1136/tobaccocontrol-2020-055739

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

Eve Taylor, Ann McNeill, Katherine East, Sarah Aleyan, Sara Hitchman, Mairtin McDermott, K Michael Cummings, Geoffrey T Fong, James F Thrasher, Anne C K Quah, Grace Y Li, Ron Borland, David Hammond

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Abstract

Background and aims: 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. Design: 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. Findings: 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). Conclusions: 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.

Original language	English
Article number	tobaccocontrol-2020-055739
Journal	Tobacco Control
DOIs	https://doi.org/10.1136/tobaccocontrol-2020-055739
Publication status	Published - 1 Sept 2020

Keywords

electronic nicotine delivery devices
packaging and labelling
public policy

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1136/tobaccocontrol-2020-055739

10092020 Changes in responses to nicotine vaping product warnings and leaflets

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Taylor, E., McNeill, A., East, K., Aleyan, S., Hitchman, S., McDermott, M., Cummings, K. M., Fong, G. T., Thrasher, J. F., Quah, A. C. K., Li, G. Y., Borland, R., & Hammond, D. (2020). 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. Tobacco Control, Article tobaccocontrol-2020-055739. https://doi.org/10.1136/tobaccocontrol-2020-055739

@article{20b8dd3ac56a4df990e1dede9ca522f5,

title = "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",

abstract = "Background and aims: 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. Design: 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. Findings: 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). Conclusions: 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.",

keywords = "electronic nicotine delivery devices, packaging and labelling, public policy",

author = "Eve Taylor and Ann McNeill and Katherine East and Sarah Aleyan and Sara Hitchman and Mairtin McDermott and Cummings, {K Michael} and Fong, {Geoffrey T} and Thrasher, {James F} and Quah, {Anne C K} and Li, {Grace Y} and Ron Borland and David Hammond",

year = "2020",

month = sep,

day = "1",

doi = "10.1136/tobaccocontrol-2020-055739",

language = "English",

journal = "Tobacco Control",

issn = "0964-4563",

publisher = "BMJ Publishing Group",

}

Taylor, E , McNeill, A , East, K , Aleyan, S , Hitchman, S , McDermott, M, Cummings, KM, Fong, GT, Thrasher, JF, Quah, ACK, Li, GY, Borland, R & Hammond, D 2020, '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', Tobacco Control. https://doi.org/10.1136/tobaccocontrol-2020-055739

TY - JOUR

T1 - Changes in responses to nicotine vaping product warnings and leaflets in England compared with Canada, the US, and Australia

T2 - Findings from the 2016-2018 ITC Four Country Smoking and Vaping Surveys

AU - Taylor, Eve

AU - McNeill, Ann

AU - East, Katherine

AU - Aleyan, Sarah

AU - Hitchman, Sara

AU - McDermott, Mairtin

AU - Cummings, K Michael

AU - Fong, Geoffrey T

AU - Thrasher, James F

AU - Quah, Anne C K

AU - Li, Grace Y

AU - Borland, Ron

AU - Hammond, David

PY - 2020/9/1

Y1 - 2020/9/1

N2 - Background and aims: 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. Design: 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. Findings: 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). Conclusions: 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.

AB - Background and aims: 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. Design: 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. Findings: 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). Conclusions: 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.

KW - electronic nicotine delivery devices

KW - packaging and labelling

KW - public policy

UR - http://www.scopus.com/inward/record.url?scp=85095136625&partnerID=8YFLogxK

U2 - 10.1136/tobaccocontrol-2020-055739

DO - 10.1136/tobaccocontrol-2020-055739

M3 - Article

SN - 0964-4563

JO - Tobacco Control

JF - Tobacco Control

M1 - tobaccocontrol-2020-055739

ER -

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

Abstract

Keywords

UN SDGs

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