Consumer Perceptions of Waterpipe Tobacco Packaging and Digital Marketing Claims

Not Applicable

Completed

Conditions: Waterpipe Tobacco Smoking

Interventions: Behavioral: Package/Advertisement Without Claim
Behavioral: Package/Advertisement With Claim

Registration Number: NCT05439421

Lead Sponsor: Wake Forest University Health Sciences

Brief Summary: The purpose of the study is to evaluate the impact of marketing claims commonly found on waterpipe, also known as hookah, tobacco packages and in digital marketing on young adults' willingness to try hookah tobacco. Participants will complete two tasks, in random order. Participants will view six sample waterpipe tobacco packages, randomized at the package level to contain a prohibited or potentially-prohibited claim or not (Packaging Task). In the other task, they will view 10 digital marketing advertisements (i.e. Instagram posts or website pages) either with or without prohibited or potentially-prohibited claim, randomized at the advertisements level (Digital Marketing Task).

Detailed Description: Background/Objectives The Food and Drug Administration (FDA) has begun to prohibit certain claims on Waterpipe Tobacco (WT) packaging and advertising. Under Section 911 of the Family Smoking Prevention and Tobacco Control Act, manufacturers and retailers are prohibited from making unauthorized modified risk tobacco product (MRTP) claims, including statements that the product or its smoke: (1) results in reduced harm; (2) contains a reduced level of a substance or presents a reduced exposure to a substance; (3) does not contain or is free of a substance; and (4) statements that use modified risk descriptors such as light, mild, low, or similar descriptors. Some prohibited claims are easily identifiable, but others are more difficult to identify due to lack of specificity in the law and the implicit nature of some claims. Evidence is needed specific to WT packaging and marketing to determine which claims may be associated with consumer harm misperceptions to inform future regulatory actions. The study will address this gap by assessing how such claims influence consumer perceptions and behavioral intentions.

Recruitment & Eligibility

Status: COMPLETED

Sex: All

Target Recruitment: 1507

Inclusion Criteria

United States (U.S.) Resident
Has used waterpipe tobacco within the past year (self-report)
Has not used waterpipe tobacco within the past year but it susceptible to use (self- report)

Exclusion Criteria

Younger than 18 or older than 29
Non U.S. Resident
Has not used waterpipe tobacco within in the past year and is not susceptible to use (self-report)

Study & Design

Study Type: INTERVENTIONAL

Study Design: CROSSOVER

Arm && Interventions

Group	Intervention	Description
Without Claim No Chemicals	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
With Claim Apple Image	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim Fresh Hookah Tobacco	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim Premium Shisha Tobacco	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim Contains natural, unwashed tobacco leaf	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
Without Claim Shisha or hookah tobacco is unique and completely unlike that found in cigarettes	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
With Claim water in the shisha effectively cools and filters the smoke, making smooth and light	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim No Chemicals	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
Without Claim Apple Image	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim 100% Food Grade Glycerin	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim Ultra Light	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim Don't blow smoke - blow clouds	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim Contains natural, unwashed tobacco leaf	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim 0% Tar	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim Lower Nicotine Tobacco	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
With Claim High Quality Shisha Tobacco	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim Don't blow smoke - blow clouds	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
Without Claim Natural flavor	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
With Claim 0% Tar	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim 100% Food Grade Glycerin	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim Ultra Light	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
Without Claim Fresh Hookah Tobacco	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
With Claim Lower Nicotine Tobacco	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
Without Claim Premium Shisha Tobacco	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim High Quality Shisha Tobacco	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
Without Claim We only use ingredients which are FDA approved	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
With Claim Shisha or hookah tobacco is unique and completely unlike that found in cigarettes	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
Without Claim water in the shisha effectively cools and filters the smoke, making smooth and light	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest
With Claim We only use ingredients which are FDA approved	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim Natural flavor	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
With Claim Passing flavored tobacco smoke through water cools and purifies it	Package/Advertisement With Claim	Package or digital marketing advertisement containing claim of interest
Without Claim Passing flavored tobacco smoke through water cools and purifies it	Package/Advertisement Without Claim	Package or digital marketing advertisement without claim of interest

Primary Outcome Measures

Name	Time	Method
Willingness to Smoke Hookah Tobacco (Digital Marketing Task )	minute 5	One item to assess the extent to which young adults want to try smoking hookah: How much does this advertisement make you want to smoke hookah? Response scale: (1) Not at all to (4) A lot
Willingness to Try Hookah Tobacco (Packaging Task )	minute 5	One item to assess the extent to which young adults are willing to try the waterpipe tobacco product: How likely would you be to try this specific product? Response scale: (1) Not at all likely to (4) Very likely