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Some teens just don’t buy warnings about cigars

Specific warnings about cigars aren’t striking some teens as believable, report researchers.

Overall, a majority of adolescents in the United States report current cigar warning labels to be very believable, according to the new study from the UNC School of Medicine. But the results suggest more work is needed to establish the best warnings to dissuade young people from smoking cigars.

The study, published in the Journal of Adolescent Health, included a national phone survey of 1,125 adolescents from ages 13 to 17. The survey presented people with one of three current cigar health warnings that specifically isolate the risk of cigar smoke:

  • 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.
  • Cigars are not a safe alternative to cigarettes.

The surveyors then asked a number of questions about the believability of the warnings. Three quarters (76.7 percent) of all respondents found it very believable that “cigar smoking can cause lung cancer and heart disease,” while just 53.4 percent found it very believable that “cigar smoking can cause cancers of the mouth and throat, even if you do not inhale,” and only 49.8 percent found it very believable that “cigars are not a safe alternative to cigarettes.”

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Respondents were classified as either susceptible—meaning they had used a cigarette or expressed interest in trying one—or non-susceptible. About 17 percent of those surveyed were classified as “susceptible.” Adolescents susceptible to using cigarettes were significantly less likely to report the cigar warnings to be very believable. The potential source of the cigar warning (FDA, CDC, the Surgeon General, or none) did not impact the answers, nor did race, age, or sex.

Studies have shown that cigars are one of the most common tobacco products among adolescents in the US, with one in 12 adolescents reporting current use of a cigar product.

“This is the first research that has been done to track how young people perceive cigars warning labels,” says Sarah Kowitt, doctoral candidate at the UNC Gillings School of Global Public Health and lead author of the study.

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“Adolescents may be misguided about the safety of cigar use,” says coauthor Adam O. Goldstein, a professor of family medicine and member of the UNC Lineberger Comprehensive Cancer Center. “Many still believe that risks of cigars can be mitigated by not inhaling or inhaling less. But we know that cigar smoking can cause serious harm, including cancer and heart disease.”

Historically, most tobacco prevention campaigns aimed at cigarettes. Some states, such as Maryland, have rolled out cigar-specific campaigns that may help dismantle cigar myths among youth.

While the current cigar warnings were mostly seen as believable, Goldstein says that further study is needed, especially on the impact of graphic cigar warnings in addition to text. Also, the researchers suggest continued study to develop warnings that have the maximum impact on susceptible adolescents.

Some countries, such as Australia, have begun this work. “In Australia, warnings include pictorial representations, which may engage adolescents more effectively,” Goldstein says.

The National Cancer Institute and FDA Center for Tobacco Products supported the work.

Source: UNC Chapel Hill

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