THE INFLUENCE OF WATERPIPE LOUNGE MENU LABELING ON INTENTION TO QUIT SMOKING AND PERCEIVED HARM, RISK AND ADDICTION AMONG YOUNG ADULT WATERPIPE TOBACCO SMOKERS IN THE UNITED STATES
Feldman, Robert H
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In the US, young adults 18 to 24 years of age have experienced the most notable decline in smoking rates from 24.4% in 2005 (Mariolis et al., 2006) to 7.8% in 2018 (Creamer, 2019). However, alternative tobacco products, such as waterpipes (also known as hookahs), are increasingly becoming the first product used by tobacco-naïve young adults and may be a gateway to nicotine addiction (Meier, Tackett, Miller, Grant, & Wagener, 2015). Tobacco surveillance measures show that among young adults in the US, 44.3% reported ever use (lifetime) and 10.7% current use (every day and someday) of waterpipe tobacco (Kasza et al., 2017). Although public health best practices for communicating the harms of tobacco use are well-established in traditional products, such as cigarettes, there is a critical knowledge gap on how to properly communicate the harms of waterpipe tobacco smoking (WTS) to current and potential consumers. In this dissertation, two independent studies were conducted to examine the effect of health-related information on waterpipe lounge menus on intention to quit smoking, as well as perceived relative harm, perceived risk of health consequences and perceived relative addiction.The overall results of Study 1 and Study 2 were consistent with prior research showing that brief health warning messages and nicotine content may increase intention to quit smoking, as well as perceived harm and risk of health consequences (Mays, Tercyak, et al., 2016). In addition, the research expands this evidence by demonstrating that the waterpipe lounge menu is a viable location for delivery of health education messages and product labeling. These findings may be used in future research to design further health communication experiments for WTS, as well as support practice and policy decisions for health warning messages and product labeling specific to waterpipe tobacco.