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CTP Supplement to Parent Grant: Graphic and Text-Based Waterpipe Warning Labels to Combat Harm Misperceptions

Principal Investigator(s): Amy K. Ferketich and Marielle C. Brinkman
Funding Mechanism: NIH Grant

ID number: 3R01CA229306-02S2(Suppl)

Award Date: September 12, 2019

Institution: Ohio State University

This study is a supplement to a parent study that investigated the impact of the placement of text-only or graphic-and-text health warning labels on waterpipes on smoking behavior and toxicant exposure. The supplemental study will investigate warning label placement and whether changes in participants’ waterpipe smoking behavior due to warning labels result in measurable changes in biomarkers of potential harm and puffing behavior. The parent study aims are: (1) to determine the optimal message and placement of the health warning label on a waterpipe to attract user attention; (2) determine the effect of the presence of the optimal text vs. text/graphic vs. no health warning label on a carbon monoxide biomarker, waterpipe puffing behavior, and other behaviors, including perceptions of risk as measured by the social interaction among participants during the waterpipe smoking session; and (3) to explore the impact of the presence of a health warning label (text vs. text/graphic) on smoking behavior at 3 and 6 months post-experiment. For Aim 1, researchers will determine the optimal placement of heath warning labels on different waterpipes using focus group methods (n = up to 36) and eye tracking research (n=72) in samples of young adults ages 18-29 years. For Aim 2, researchers will randomize 246 young adults (ages 21-29 years) to view text-only labels, text/graphic labels, or no health warning label on waterpipes that they smoke ad libitum in a controlled laboratory setting; outcomes will include waterpipe puffing topography measures; subjective ratings of nicotine dependence, craving, and liking/disliking; exhaled carbon monoxide; and conversation topics related to fear, health risks, and the health warning label. For Aim 3, researchers will measure changes in smoking behavior at 3 and 6 months after the experiment. The supplement will add spirometry and genotoxicity measures to the laboratory experiment and the 3-month assessment in order to study lung function and biomarkers of harm, respectively. This study will provide new information about waterpipe health warning labels that may inform regulatory activities. 

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