Building consensus on a set of ENDS-specific pictorial health warnings: a Delphi study among a tobacco control expert panel.

Autor:	Asfar T; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA tasfar@med.miami.edu.; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA., Schmidt M; Department of Art, The University of Memphis, Memphis, Tennessee, USA., Oluwole OJ; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA., Casas A; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA., Friedman L; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA., Ferdous T; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA., Noar SM; Husssman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Eissenberg T; Psychology and Inst. for Drug/Alc. Studies, Virginia Commonwealth University, Richmond, Virginia, USA., Maziak W; Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, Florida, USA.
Jazyk:	angličtina
Zdroj:	Tobacco control [Tob Control] 2024 Feb 12. Date of Electronic Publication: 2024 Feb 12.
DOI:	10.1136/tc-2023-058384
Abstrakt:	Background: This study reports on the development of pictorial health warning labels for electronic nicotine delivery system (ENDS) using the Delphi approach with a panel of tobacco control experts. Twenty-four evidence-based ENDS-specific warnings corresponding to three themes (toxicity, health risks and specific harm) were developed and used in the Delphi study. Methods: We conducted a three-round online Delphi study among 60 experts (55% female) between June 2022 and April 2023. We balanced the panel in areas of expertise and positions relevant to ENDS (risks, benefits). In round 1, participants rated the warnings on attention, relevance to evidence and perceived effectiveness (harm perception, motivation to quit) and provided suggestions for improvement. In rounds 2 and 3, participants ranked the revised warnings based on importance in each theme. We assessed levels of agreement between participants using interquartile deviations and medians. Results: Warnings in theme 1, toxicity, received the highest ratings for perceived effectiveness on harm perception and encouraging quitting ENDS (p<0.05). Experts recommended using clear and affirmative text paired with emotion-provoking pictures and avoiding the rare side effects of ENDS. Most of the top-ranked warnings were from theme 3, ENDS-specific harm, pertained to lung damage, dual use of ENDS and cigarettes, nicotine addiction among youth, anti-ENDS industry sentiment and toxicity. Discussion: This study developed 24 evidence-based ENDS health warning labels using a systematic process that included several rounds of expert panel feedback. These warnings can be used to advance ENDS prevention and tobacco control policies and further target different populations. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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