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Keller-Hamilton B, Fioritto M, Klein EG, Brinkman MC, Pennell ML, Nini P, Patterson JG, Ferketich AK. Visual attention to blu's parody warnings and the FDA's warning on e-cigarette advertisements. Addict Behav 2022; 125:107169. [PMID: 34768058 PMCID: PMC8629956 DOI: 10.1016/j.addbeh.2021.107169] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/06/2021] [Accepted: 10/26/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES In 2017, the e-cigarette brand, blu, released advertisements featuring large, boxed, positively-framed messages. These messages mimicked the format of FDA-mandated warnings that would appear on e-cigarette advertisements in the United States in 2018. We compared attention to blu's parody warnings and FDA-mandated warning appearing on blu advertisements. METHODS N = 73 young adults who had used tobacco participated in an eye-tracking study. Participants viewed three blu e-cigarette advertisements in random order: one with a parody warning and two with the FDA-mandated warning (one with a model's face and one without). Areas of interest (AOIs) were the parody or FDA-mandated warning. We compared dwell time on AOIs between the three advertisements. RESULTS Participants viewed parody warnings longer than each FDA-mandated warning on average (254 and 608 ms longer; p's < 0.02). Comparing the advertisements with FDA-mandated warnings revealed that participants spent less time looking at the warning in the advertisement with a model's face (354 fewer milliseconds; p = 0.001). CONCLUSIONS Parody warnings attracted more visual attention than FDA-mandated warnings, and the presence of a face in the advertisement drew attention away from the FDA-mandated warning. Results underscore the need for advertisement regulations that support increased attention to health warnings.
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Affiliation(s)
- Brittney Keller-Hamilton
- College of Medicine, The Ohio State University, Columbus, OH, USA; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
| | - Makala Fioritto
- Environmental, Health, and Safety, Textron Inc., Providence, RI, USA
| | - Elizabeth G Klein
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Marielle C Brinkman
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA; College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Michael L Pennell
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Paul Nini
- College of Arts and Sciences, The Ohio State University, Columbus, OH, USA
| | | | - Amy K Ferketich
- College of Public Health, The Ohio State University, Columbus, OH, USA
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Keller-Hamilton B, Curran H, Stevens EM, Slater MD, Lu B, Roberts ME, Ferketich AK. Associations between Cognitive and Affective Responses to Tobacco Advertisements and Tobacco Use Incidence: A Four-Year Prospective Study among Adolescent Boys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:11666. [PMID: 34770180 PMCID: PMC8582641 DOI: 10.3390/ijerph182111666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/01/2021] [Accepted: 11/03/2021] [Indexed: 11/16/2022]
Abstract
Exposure to tobacco advertisements is associated with initiation of tobacco use among youth. The mechanisms underlying this association are less clear. We estimated longitudinal associations between youths' cognitive and affective responses to advertisements for cigarettes, e-cigarettes, and smokeless tobacco (SLT) and initiation of these products. N = 1220 Ohio-residing boys of ages 11-16 were recruited into a cohort in 2015 and 2016. Participants completed surveys every six months for four years. Surveys assessed cognitive and affective responses to tobacco advertisements (which included health warnings) and tobacco use after an advertisement viewing activity. We used mixed-effects Poisson regression models with robust standard errors to estimate risk of initiating use of each tobacco product according to participants' cognitive (i.e., memorability of health risks) and affective (i.e., likability of advertisement) responses to advertisements for that product. No associations between affective responses to advertisements and tobacco use outcomes were detected in adjusted models. However, finding health risks memorable was associated with reduced risk of ever smoking initiation (aRR = 0.57; 95% CI: 0.34, 0.95) and a reduced risk of ever SLT initiation that approached statistical significance (aRR = 0.61; 95% CI: 0.36, 1.05). Measures to increase saliency of health risks on cigarette and SLT advertisements might reduce use among youth.
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Affiliation(s)
- Brittney Keller-Hamilton
- Division of Medical Oncology, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus, OH 43214, USA
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH 43214, USA
| | - Hayley Curran
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA; (H.C.); (A.K.F.)
| | - Elise M. Stevens
- Division of Preventive and Behavioral Medicine, Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA 01605, USA;
| | - Michael D. Slater
- School of Communication, The Ohio State University College of Arts and Sciences, Columbus, OH 43210, USA;
| | - Bo Lu
- Division of Biostatistics, The Ohio State University College of Public Health, Columbus, OH 43210, USA;
| | - Megan E. Roberts
- Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, OH 43210, USA;
| | - Amy K. Ferketich
- Division of Epidemiology, The Ohio State University College of Public Health, Columbus, OH 43210, USA; (H.C.); (A.K.F.)
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Klein EG, Alalwan MA, Pennell ML, Angeles D, Brinkman MC, Keller-Hamilton B, Roberts ME, Nini P, Ferketich AK. Waterpipe Warning Placement and Risk Perceptions: An Eye Tracking Study. Am J Health Behav 2021; 45:186-194. [PMID: 33402248 PMCID: PMC7898276 DOI: 10.5993/ajhb.45.1.15] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objectives: The purpose of this study was to select a health warning message location on a waterpipe (WP) that both attracted visual attention and conveyed the risks associated with WP smoking. Methods: During June through November 2019, we conducted a within-subjects randomized experiment (N = 74) using eye tracking equipment to examine visual attention to 3 placements of a health warning on the WP (stem, water bowl, hose). We asked young adult ever WP users 3 questions about WP harm perceptions. We used generalized linear mixed models to examine the amount of fixation time spent on the placement locations; we used repeated measures ANOVA to model changes in harm perceptions. Results: There were statistically significant differences across all 3 placement locations; regardless of place, all HWLs attracted a comparable amount of visual attention. Absolute WP harm perceptions significantly increased following the experiment and remained significantly higher at the one-week follow-up, compared to baseline. Conclusions: Warnings on WPs attracted visual attention and increased harm perceptions, and those harm perceptions remained high one week after the experiment. Findings indicate the value of including a warning on the WP device, and underscore the necessity and effectiveness of those health warnings to combat WP harm misperceptions.
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Affiliation(s)
- Elizabeth G Klein
- Elizabeth G. Klein, Associate Professor, The Ohio State University College of Public Health, Columbus, OH, United States;,
| | - Mahmood A Alalwan
- Mahmood A. Alalwan, Student Research Assistant, The Ohio State University College of Public Health, Columbus, OH, United States
| | - Michael L Pennell
- Michael L. Pennell, Associate Professor, The Ohio State University College of Public Health, Columbus, OH, United States
| | - David Angeles
- David Angeles, Graduate Research Assistant, The Ohio State University, Columbus, OH, United States
| | - Marielle C Brinkman
- Marielle C. Brinkman, Senior Research Scientist, The Ohio State University College of Public Health, Columbus, OH, United States
| | - Brittney Keller-Hamilton
- Brittney Keller-Hamilton, Research Scientist, The Ohio State University Comprehensive Cancer Center, Columbus, OH, United States
| | - Megan E Roberts
- Megan E. Roberts, Assistant Professor, The Ohio State University College of Public Health, Columbus, OH, United States
| | - Paul Nini
- Paul Nini, Professor, The Ohio State University, Columbus, OH, United States
| | - Amy K Ferketich
- Amy K. Ferketich, United States, Professor, The Ohio State University College of Public Health, Columbus, OH, United States
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Stevens EM, Johnson AL, Leshner G, Sun F, Kim S, Leavens ELS, Tackett AP, Hébert ET, Wagener TL. People in E-Cigarette Ads Attract More Attention: An Eye-Tracking Study. TOB REGUL SCI 2020; 6:105-117. [PMID: 33816715 PMCID: PMC8018674 DOI: 10.18001/trs.6.2.3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Minimally regulated electronic cigarettes (e-cigarette) advertising may be one potential factor driving the increasing prevalence of young adult e-cigarette use. Using eye-tracking, the current study examined which e-cigarette advertising features were the most appealing to young adults as a first step to examine how e-cigarette advertising may be regulated. METHODS Using a within-subjects design, 30 young adults (M age = 20.0 years) viewed e-cigarette ads in a laboratory. Ad features or areas of interest (AOIs) included: 1) brand logo, 2) product descriptor, and 3) people. During ad viewing, eye-tracking measured participants' dwell time and time to first fixation for each AOI as well as each ad brand. Harm perceptions pre- and post-viewing were measured. RESULTS Participants spent the longest dwell time on people (M = 2701 ms), then product descriptors (M = 924 ms), then brand logos (M = 672 ms; ps < .001). They also fixated fastest on AOIs in that order. Participant sex significantly impacted dwell time of ad brand, and harm perceptions decreased after viewing the ads (ps < .05). CONCLUSIONS This study provides initial evidence about which e-cigarette ad features may appeal most to young adults and may be useful when designing evidence-based policy.
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Affiliation(s)
- Elise M Stevens
- Harvard T.H. Chan School of Public Health, Dana-Farber Cancer Institute, Harvard University, Boston, MA
| | - Amanda L Johnson
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Glenn Leshner
- Edward L. and Thelma Gaylord Chair in journalism, Gaylord College of Journalism and Mass Communication, University of Oklahoma, Norman, OK
| | - FuWei Sun
- Department of Journalism, Fu Hsing Kang College, National Defense University, Taiwan
| | - Seunghyun Kim
- Department of Marketing and Advertising, College of Business, University of Arkansas at Little Rock, Little Rock, AK
| | - Eleanor L S Leavens
- Department of Population Health, University of Kansas Medical Center, Kansas City, KS
| | - Alayna P Tackett
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Emily T Hébert
- Oklahoma Tobacco Research Center, Stephenson Cancer Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Theodore L Wagener
- Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Department of Internal Medicine, The Ohio State University, Columbus, OH
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