Attentional allocation to e-cigarette warning levels amongst smokers and never-smokers
Creators: name: Cox, Sharon
Publisher: name: Open Science Framework
Year: 2021
Subjects: subject: Social and Behavioral Sciences

description: Tobacco health warning labels on cigarette packs have been the cornerstone of a comprehensive tobacco control plan aimed at both deterring never-smokers wanting to try smoking whilst communicating the health risks to smokers. The high risk of smoking means that a complete deterrent message is required. However, messaging for reduced risk products such as e-cigarettes require different labelling, because while never nicotine users should be dissuaded from use, smokers who could benefit from quitting should not be dissuaded. The current EU Tobacco Products Directive (TPD) e-cigarette health warning label highlights as its key message the addictive potential of e-cigarette products. The current label may dissuade smokers from trying e-cigarettes as findings from a national survey indicate that one key reason cited by smokers for not switching to e-cigarettes is fear of swapping one addiction for another (ASH 2018). Given that around one-third of smokers have not yet tried an e-cigarette (ASH, 2019) and e- cigarettes are now accepted to be considerably less harmful than smoking (Shahab et al., 2017), development of warning labels that may encourage use of e-cigarettes is needed. Cox et al., (2019) established that the current TPD warning label may maintain smokers’ negative harm perceptions of e-cigarettes, and Kimber et al., (2020) extended this by showing that an alternative (reduced risk) message may minimise risk perceptions and increase intentions to use in smokers whilst having no unintended consequences for never-smokers. The aim of the current study is to extend this work and to apply eye-movement tracking to further our understanding of how the TPD and the alternative messages (developed and published by Kimber et al., 2020) attract attention and how the amount of attention paid to each message may be associated with measures of perceived harm, effectiveness and intention to purchase and use. Eye movements are very closely linked to attention (Hoffman and Subramaniam, 1995) and eye-tracking technology has already informed our understanding of the impact of plain cigarette and tobacco packaging and written vs. pictorial health warnings on cigarette packets and advertising (Meernik at el. 2016). To our knowledge, however, eye-movement tracking has not yet been applied to a direct comparison of two types of warning message on e-cigarette packaging. Specifically in this study, we intend to ask smokers (n=20) and never-smokers (n=20) to attend one session at the laboratory where they will be asked to complete a dot-probe task. Differences between smokers’ (n=14) and non-smokers’ (n=15) eye movements when viewing warnings on plain and branded packages were detected by Munafo et al., (2011) so we anticipate a similar sample size may be sufficient here. The TPD health warning will be displayed simultaneously with the alternative reduced risk message, or a neutral control message. Dwell time and saccade latency will provide measures of attentional focus on each message. The data can then be used to explore associations between attention to the message and perceptions of harm and/or intentions to use e-cigarettes.