title: Believability of Cigar Warning Labels Among Adolescents.
abstract: OBJECTIVE
  Despite high rates of cigar use among youth, little information exists about how cigar warnings are received by youth. We examined believability of different cigar warning messages with different sources among adolescents in a national phone survey.
  
  
  METHODS
  Adolescents (aged 13-17 years) in the US (N = 1,125; total response rate, 66%) were randomized to receive one of three health messages ("cigar smoking can cause cancers of the mouth and throat, even if you do not inhale," "cigar smoking can cause lung cancer and heart disease," and "cigars are not a safe alternative to cigarettes") and one of four warning sources (Food and Drug Administration, Surgeon General, Centers for Disease Control and Prevention, and no source). Believability was assessed with "how believable is this warning," and responses were dichotomized for "not at all or somewhat" versus "very."
  
  
  RESULTS
  Weighted logistic regression results indicated that most youth found the cigar warnings very believable (60.5%). Messages about mouth and throat cancer (regardless of inhalation) and the safety of cigars in comparison to cigarettes were rated as significantly less believable than messages about lung cancer and heart disease related to cigars. There were no significant differences by source or other demographics. However, youth susceptible to using cigarettes were less likely to report the cigar warnings to be very believable.
  
  
  CONCLUSIONS
  The messages of cigar warning labels are not viewed as equally believable among adolescents. Future studies should examine how youth process messages about health effects of cigars and the impact of different cigar warnings on youth experimentation with and use of cigars.
authors.affiliation: Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina. Electronic address: kowitt@email.unc.edu.
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Kowitt
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Kristen
authors.initials: K
authors.lastname: Jarman
authors.affiliation: Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Ranney
authors.affiliation: Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
authors.forename: Adam O
authors.initials: AO
authors.lastname: Goldstein
mesh_terms: D000293:Adolescent; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D011356:Product Labeling / Q000379:methods* / Q000706:statistics & numerical data; D062789:Tobacco Products; D014481:United States
keywords: Adolescents; Cigars; Smoking; Tobacco prevention and control; Warning labels