Disclosure Slide 1. Funding: Florida Department of Health, James & Esther King Biomedical Research Award Grant Number: 20K10 Grant Title: Developing and testing waterpipespecific health warning labels targeting young people in Florida
2. Industry funding: N/A 3. Off-label medication uses discussed: N/A
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“It is really gross, but in a good way, it gets the message across, this could be you” Evaluating Waterpipe-Specific Health Warning Labels Among Young People in the U.S: A Focus Group Study Taghrid Asfar MD, MSPH; Michael Schmidt, PhD; Alejandra Casas, BS; Olusanya J. Oluwole, MPH; Laura McClure L, MSPH; Richard J. Thurer, MD; Ian Abrams BA; Wei Li, MPH; Zoran Bursac, PhD, MPH; Wasim Maziak, MD, PhD Presenter: Alejandra Casas, BS, MPH Candidate Department of Public Health Sciences University of Miami Miller School of Medicine 3
SRNT 2022 Meeting March 17, 2022, 4:45 PM-6:15 PM Poster Session Number: POS4 Poster Number: 061
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Background
Waterpipe smoking has increased dramatically among young adults in the United States mainly due to the misperception that it is safer than cigarette smoking. Mounting evidence show that waterpipe smoking is addictive and harmful. Pictorial health warning labels are effective in communicating smoking-related risks. 5
Objectives § Aim 1: Adapt 24 waterpipe pictorial health warning labels to young adults in Florida using focus groups. The 24 labels were developed by an international expert panel in a Delphi study. Labels were stratified into six themes: ØTheme 1: Addiction ØTheme 2: Waterpipe harm compared to cigarettes ØTheme 3: Waterpipe harm to others ØTheme 4: Waterpipe health effects ØTheme 5: Quitting waterpipe ØTheme 6: Waterpipe specific harms
§ Aim 2: Test the top 4 labels in a clinical lab experiment. § Aim 3: Disseminate knowledge to stakeholders, policy makers, public health professionals, researchers, and community members. 6
Theme 1 Addiction
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Theme 2 Waterpipe Harm Compared to Cigarettes
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Theme 3 Waterpipe Harm to Others
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Theme 4 Waterpipe Health Risks
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Theme 5 Quitting Waterpipe Smoking
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Theme 6 Waterpipe Specific Harm
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Methods § Brief survey to rate and rank the 24 labels § Focus group sessions consisted of: Focus Groups N= 8 Ø10 min PowerPoint presentation to communicate health risks associated to waterpipe smoking and discuss common myths associated to waterpipe smoking. ØA group discussion for each label in terms of their design/content, attention, reaction, effectiveness, and improvement. ØSelecting the three top and three least labels in terms of effectiveness. ØDiscussing the optimal placement of labels.
Participants
N= 21
Gender
Females: 57% Males: 43%
Age
21-35 years old
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Results
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Results § Focus group discussions revealed that the ranking was mainly based on: ØEliciting shock ØFear ØDisgust ØConcern about the negative effects of waterpipe smoking “Well, what definitely catches my attention is that disgusting growth in the mouth……. This is something that is gross and catches your attention and gets the message across: this could be you.” (FG 1, male)
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Results § Suggestions for labels included: ØShorter text ØMore statistics ØAdding the source of information (e.g., CDC)
“Maybe it would be more effective if it has more stats or something like that. The picture is a lot more like shocking than the actual message.” (FG 5, female)
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Results § Preferred images were those that were: ØRealistic ØGraphic ØGross ØCongruent to the text
“There is a better balance between the text and picture. I think it’s really gross and in a good way: the tongue is brown, and I would relate that to smoke.” (FG4, female)
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Results § Recommendations for label placement included on the waterpipe device and using text-only waterpipe labels on café menus and entrances.
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Conclusion § This study attempted to advance waterpipe policy through developing an innovative set of waterpipe pictorial labels based on feedback from young waterpipe users. § Top ranked labels were those who provoked emotions.
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