Trial Outcomes & Findings for Comparison of Text and Pictorial Waterpipe Tobacco Warnings Among Young Adults (NCT NCT05783843)

NCT ID: NCT05783843

Last Updated: 2024-05-21

Results Overview

The primary outcome is intention to smoke tobacco in a waterpipe within the next year, measured by averaging three items to create a composite score (adapted from research on cigarette smoking). The primary outcome will be measured after the exposure to waterpipe packages. Score ranges from 1-5 with higher score indicating greater intention to smoke hookah. 1. How interested are you in smoking hookah in the next year? 2. How likely are you to smoke hookah in the next year? 3. How much do you plan to smoke hookah in the next year? Response scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) Very interested/likely/much

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

1215 participants

Primary outcome timeframe

Minute 2

Results posted on

2024-05-21

Participant Flow

Participant milestones

Participant milestones
Measure
Text Warnings
Waterpipe tobacco packages shown with text-only warning about health harms of waterpipe smoking Text Warnings: Participants will be shown 6 waterpipe tobacco packages with 6 different text-only warnings about the health harms of waterpipe smoking. The order of the 6 packages within this trial arm will be randomized. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study and designed the warnings for this arm.
Pictorial Warnings
Waterpipe tobacco packages shown with pictorial warnings about health harms of waterpipe smoking Pictorial Warnings: Participants will be shown 6 waterpipe tobacco packages with 6 different pictorial warnings about the health harms of waterpipe smoking. The order of the 6 packages within this trial arm will be randomized. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study and designed the warnings for this arm.
No Warnings (Control)
Waterpipe tobacco package shown without a warning No Warnings (Control): Participants will be shown a single package without a warning. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study.
Overall Study
STARTED
396
402
417
Overall Study
COMPLETED
396
402
417
Overall Study
NOT COMPLETED
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Comparison of Text and Pictorial Waterpipe Tobacco Warnings Among Young Adults

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Text Warnings
n=396 Participants
Waterpipe tobacco packages shown with text-only warning about health harms of waterpipe smoking Text Warnings: Participants will be shown 6 waterpipe tobacco packages with 6 different text-only warnings about the health harms of waterpipe smoking. The order of the 6 packages within this trial arm will be randomized. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study and designed the warnings for this arm.
Pictorial Warnings
n=402 Participants
Waterpipe tobacco packages shown with pictorial warnings about health harms of waterpipe smoking Pictorial Warnings: Participants will be shown 6 waterpipe tobacco packages with 6 different pictorial warnings about the health harms of waterpipe smoking. The order of the 6 packages within this trial arm will be randomized. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study and designed the warnings for this arm.
No Warnings (Control)
n=417 Participants
Waterpipe tobacco package shown without a warning No Warnings (Control): Participants will be shown a single package without a warning. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study.
Total
n=1215 Participants
Total of all reporting groups
Age, Continuous
25 years
STANDARD_DEVIATION 3.2 • n=5 Participants
24.9 years
STANDARD_DEVIATION 3.4 • n=7 Participants
25 years
STANDARD_DEVIATION 3.3 • n=5 Participants
25 years
STANDARD_DEVIATION 3.3 • n=4 Participants
Sex/Gender, Customized
Female
253 Participants
n=5 Participants
270 Participants
n=7 Participants
266 Participants
n=5 Participants
789 Participants
n=4 Participants
Sex/Gender, Customized
Male
143 Participants
n=5 Participants
131 Participants
n=7 Participants
151 Participants
n=5 Participants
425 Participants
n=4 Participants
Sex/Gender, Customized
Unknown/Not Reported
0 Participants
n=5 Participants
1 Participants
n=7 Participants
0 Participants
n=5 Participants
1 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
101 Participants
n=5 Participants
86 Participants
n=7 Participants
77 Participants
n=5 Participants
264 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
295 Participants
n=5 Participants
316 Participants
n=7 Participants
340 Participants
n=5 Participants
951 Participants
n=4 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
Race (NIH/OMB)
American Indian or Alaska Native
4 Participants
n=5 Participants
1 Participants
n=7 Participants
6 Participants
n=5 Participants
11 Participants
n=4 Participants
Race (NIH/OMB)
Asian
25 Participants
n=5 Participants
33 Participants
n=7 Participants
26 Participants
n=5 Participants
84 Participants
n=4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
2 Participants
n=4 Participants
Race (NIH/OMB)
Black or African American
82 Participants
n=5 Participants
92 Participants
n=7 Participants
97 Participants
n=5 Participants
271 Participants
n=4 Participants
Race (NIH/OMB)
White
219 Participants
n=5 Participants
236 Participants
n=7 Participants
234 Participants
n=5 Participants
689 Participants
n=4 Participants
Race (NIH/OMB)
More than one race
34 Participants
n=5 Participants
18 Participants
n=7 Participants
30 Participants
n=5 Participants
82 Participants
n=4 Participants
Race (NIH/OMB)
Unknown or Not Reported
32 Participants
n=5 Participants
21 Participants
n=7 Participants
23 Participants
n=5 Participants
76 Participants
n=4 Participants
Region of Enrollment
United States
396 participants
n=5 Participants
402 participants
n=7 Participants
417 participants
n=5 Participants
1215 participants
n=4 Participants

PRIMARY outcome

Timeframe: Minute 2

The primary outcome is intention to smoke tobacco in a waterpipe within the next year, measured by averaging three items to create a composite score (adapted from research on cigarette smoking). The primary outcome will be measured after the exposure to waterpipe packages. Score ranges from 1-5 with higher score indicating greater intention to smoke hookah. 1. How interested are you in smoking hookah in the next year? 2. How likely are you to smoke hookah in the next year? 3. How much do you plan to smoke hookah in the next year? Response scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) Very interested/likely/much

Outcome measures

Outcome measures
Measure
Text Warnings
n=396 Participants
Waterpipe tobacco packages shown with text-only warning about health harms of waterpipe smoking Text Warnings: Participants will be shown 6 waterpipe tobacco packages with 6 different text-only warnings about the health harms of waterpipe smoking. The order of the 6 packages within this trial arm will be randomized. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study and designed the warnings for this arm.
Pictorial Warnings
n=402 Participants
Waterpipe tobacco packages shown with pictorial warnings about health harms of waterpipe smoking Pictorial Warnings: Participants will be shown 6 waterpipe tobacco packages with 6 different pictorial warnings about the health harms of waterpipe smoking. The order of the 6 packages within this trial arm will be randomized. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study and designed the warnings for this arm.
No Warnings (Control)
n=417 Participants
Waterpipe tobacco package shown without a warning No Warnings (Control): Participants will be shown a single package without a warning. Study investigators developed a fictitious waterpipe tobacco brand to be used in this study.
Behavioral Intentions
1.83 score on a scale
Standard Error 0.07
1.72 score on a scale
Standard Error 0.05
2.21 score on a scale
Standard Error 0.07

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 2

Three items will be used to measure how appealing each waterpipe tobacco package is to respondents, how likely they would be to try the product, and how much the packaging makes the respondent think that the product is harmful. 1. How appealing is this product to you? 2. How likely would you be to try this product? 3. How much does this packaging make you think this product is harmful? Response scale: (1) Not at all / (2) A little / (3) Somewhat / (4) A lot

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 2

This outcome will be measured using the 3-item Perceived Measured Effectiveness scale created by Noar and colleagues that includes items on attitudes, risk beliefs, and intentions. Mean scores will be calculated. 1. How much does this warning make smoking hookah seem unpleasant to you? 2. How much does this warning make you concerned about the health effects of smoking hookah? 3. How much does this warning discourage you from wanting to smoke hookah? Response scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) A great deal

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 1

One item to measure self-reported attention to the warning. 1\. How much does this warning grab your attention? Response scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) A great deal

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 2

Three items to measure negative emotional reactions to the warning that the participant saw. Mean scores will be calculated. 1. How much does this warning make you feel anxious? 2. How much does this warning make you feel disgusted? 3. How much does this warning make you feel scared? Response scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) A great deal

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 1

One item to measure the extent to which a participant reports the warning making them think about the risks of hookah smoking. 1\. How much does this warning make you think about the health effects of smoking hookah? Response scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) A great deal

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 1

One item to measure the extent to which respondents learned something new from the warning. 1\. To what extent did you learn something new from this warning that you did not already know? Response Scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) A great deal

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 1

One item to measure self-reported likelihood of discussing the warning shown with one's social contacts within the week following the survey. 1\. How likely are you to talk about this warning with others in the next week? Response Scale: (1) Not at all / (2) Very little / (3) Somewhat / (4) Quite a bit / (5) A great deal

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 3

Six items to measure knowledge of the potential health harms described by the warnings. 1. Hookah smoking causes heart damage. 2. Hookah smoking causes lung damage. 3. Hookah smoking causes mouth cancer. 4. Hookah smoking causes carbon monoxide poisoning. 5. Hookah smoking during pregnancy stunts fetal growth. 6. Hookah smoking causes nicotine addiction. Response scale: (1) True / (2) False / (3) I don't know

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 3

Five items to measure the respondent's belief of their own risk of experiencing each of the warning health harms. One item measures risk to pregnant people, rather than the self, since this item will be administered to all participants. 1. If I smoke hookah, I will damage my heart. 2. If I smoke hookah, I will damage my lungs. 3. If I smoke hookah, I will get mouth cancer. 4. If I smoke hookah, I will get carbon monoxide poisoning. 5. If a person smokes hookah during pregnancy, it will stunt fetal growth. 6. If I smoke hookah, I will become addicted. Response scale: (1) Strongly disagree / (2) Somewhat disagree / (3) Neither disagree nor agree / (4) Somewhat agree / (5) Strongly agree

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 3

Five/six items measuring a respondent's concern about their risk of warning health effects. Damage to fetuses will only be asked of respondents who report female sex at birth. 1. If you smoke hookah, how much would you worry about getting mouth cancer? 2. If you smoke hookah, how much would you worry about damaging your heart? 3. If you smoke hookah, how much would you worry about damaging your lungs? 4. If you smoke hookah, how much would you worry about getting carbon monoxide poisoning? 5. If you smoke hookah, how much would you worry about stunting fetal growth, if you were pregnant? 6. If you smoke hookah, how much would you worry about becoming addicted? Response scale: (1) Not at all / (2) A little / (3) Somewhat / (4) A lot

Outcome measures

Outcome data not reported

OTHER_PRE_SPECIFIED outcome

Timeframe: Minute 1

Participants who report past-year use will report, on a scale of 1-10, how motivated they are to quit smoking hookah.

Outcome measures

Outcome data not reported

Adverse Events

Text Warnings

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Pictorial Warnings

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

No Warnings (Control)

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Erin L. Sutfin, PhD

Wake Forest University School of Medicine

Phone: 336-713-5282

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place