Clinical Trial Summary
This project aims to evaluate the effectiveness of aversive visual health warnings on
e-cigarette cessation among young adults through a randomized controlled trial, as
e-cigarette use among this population has been steadily increasing, posing significant public
health concerns. While traditional tobacco products have long featured health warnings,
e-cigarettes lack similarly aversive visual warnings, and this study seeks to inform the
development of targeted e-cigarette cessation strategies and contribute to a deeper
understanding of how visual health warnings can be utilized to reduce e-cigarette use and
ultimately improve public health. The project has three main aims, which include a rigorous
assessment of the academic literature on e-cigarette risks and adverse effects to develop
evidence-based mock visual health warnings for e-cigarettes; assessing the effectiveness of
aversive visual health warnings in increasing intent to cessate e-cigarettes, with a
particular focus on individuals who have experienced adverse events; and examining the
long-term impacts of visual health warnings on e-cigarette cessation. This study will also
investigate the underlying mechanisms that may explain the relationship of the intervention
on cessation. To generate visual warnings, the research team will conduct a thorough review
of the scientific literature on e-cigarette risks and adverse effects and collaborate with a
graphic designer. Experimental warnings will be annotated and categorized in order to
understand the influence of different imagery on variations in participant response. The
study will be conducted as a randomized controlled trial, recruiting participants through
market research firms that will distribute an online survey to their panels of e-cigarette
users. Participants will be eligible for inclusion if they are 18-29 years old and currently
use e-cigarettes at least once per week. A quota will be included to ensure sufficient
responses from individuals who have experienced at least one adverse event related to
e-cigarette use in the past 12 months. The intervention group will be exposed to a series of
aversive visual health warnings about the potential health risks of e-cigarette use,
delivered through the online survey platform, while the control group will not receive any
intervention and will complete the same survey as the intervention group. Data will be
analyzed using appropriate statistical techniques, including logistic regression and
mediation/moderation analysis, to assess the effectiveness of the aversive visual health
warnings in reducing e-cigarette use and the moderating effects of prior adverse event
experience. Participants will be contacted for follow-up assessments at 3-months
post-intervention to investigate the impact of aversive visual health warnings on e-cigarette
cessation among young adults, including the moderating effects of prior adverse event
experience, and assess the underlying mechanisms that may explain the relationship between
the intervention and e-cigarette cessation.
