title: The Effects of Brief Waterpipe Tobacco Use Harm and Addiction Education Messages Among Young Adult Waterpipe Tobacco Users.
abstract: BACKGROUND
  This study investigated the immediate effects of brief education messages delivered online about harms and addictiveness of waterpipe tobacco use among young adult waterpipe users aged 18 to 30 years.
  
  
  METHODS
  Participants (n = 327, mean age 24.8 years, 62.1% male, 77.6% white, 67.8% used waterpipe monthly, 26.4% weekly, 5.8% daily) were recruited online and randomized to one of three experimental conditions: (1) Control condition viewing no messages; (2) Harms condition viewing messages about harms of waterpipe tobacco; (3) Harms and addiction condition viewing messages about harms and addictiveness of waterpipe tobacco. Outcomes included perceived harm and addictiveness of waterpipe, worry about harm and addiction, and desire to quit.
  
  
  RESULTS
  Compared to the control condition, participants in the harms condition reported significantly greater perceived harm and addictiveness of waterpipe relative to cigarettes, perceived risk of harm and addiction, worry about harm and addiction, and desire to quit. There were few significant differences in these outcomes between participants in the harms condition and the harms and addiction condition. Mediation analyses suggest waterpipe tobacco use harm messages may increase desire to quit by producing greater worry about harm and addiction.
  
  
  CONCLUSIONS
  Brief education messages about waterpipe tobacco use harm increased young adult's perceptions of harm and addictiveness of waterpipe tobacco use and generated stronger desire to quit. The waterpipe tobacco use addiction messages tested had little added impact. Studies should prospectively examine the real-world impact of waterpipe tobacco use harm messages and investigate more effective strategies for designing addiction messages.
  
  
  CONCLUSIONS
  This study demonstrates that brief education messages about waterpipe tobacco use harm can increase young adult waterpipe tobacco user's perceptions of harm and addictiveness of waterpipe tobacco use and generate stronger desire to quit. The findings indicate messages on addictiveness of waterpipe tobacco use have no added impact on these outcomes.
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC; dmm239@georgetown.edu.
authors.forename: Darren
authors.initials: D
authors.lastname: Mays
authors.affiliation: Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC;
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: Tercyak
authors.affiliation: Duke University School of Nursing, Durham, NC.
authors.forename: Isaac M
authors.initials: IM
authors.lastname: Lipkus
mesh_terms: D000293:Adolescent; D000328:Adult; D016739:Behavior, Addictive / Q000517:prevention & control* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010465:Perception; D011897:Random Allocation; D012907:Smoking / Q000009:adverse effects* / Q000523:psychology; D000074606:Smoking Prevention; D064424:Tobacco Use / Q000009:adverse effects* / Q000517:prevention & control* / Q000523:psychology; D014029:Tobacco Use Disorder / Q000517:prevention & control / Q000523:psychology; D055815:Young Adult