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Jang Y, Shaw J, Wackowski OA, Noar SM. Effectiveness of Text-Only E-Cigarette Warnings: A Meta-Analysis. JAMA Intern Med. Published online June 02, 2025. doi:10.1001/jamainternmed.2025.1380

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2834773

“Text-only e-cigarette warnings may enhance public understanding about the addictiveness and health harms of e-cigarettes and discourage e-cigarette use; these findings support adding warnings to e-cigarettes about health harms beyond nicotine addiction.”

Note: Research on messaging to young people in the US show that “themes about chemical exposures and health effects on organs with explanations for how health effects occurred led to higher perceived message effectiveness (PME) than most other themes (including health effects on organs without explanations), while the nicotine addiction theme led to lower PME than most other themes (p < .05).”

Kowitt SD, et al. Identifying Promising Message Themes for Youth Who Use Multiple Tobacco Products. Journal of Adolescent Health. 8/4/2025. https://doi.org/10.1016/j.jadohealth.2025.02.004

TRC Research Commentary

Kalan E, Osibogun O, Ben Taleb Z. The Future of e-Cigarette Health Warnings. JAMA Intern Med. Published online June 02, 2025. doi:10.1001/jamainternmed.2025.1388

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2834782

Journal Commentary: “In sum, the study by Jang et al. (in the recent TRC Research Summary) makes a compelling case for strengthening text-based e-cigarette (Health Warning Labels) HWLs, particularly by emphasizing health harms over nicotine addiction risks. However, its findings also reinforce the limitations of text-only messaging, highlighting the need to explore more engaging and persuasive warning formats. Given the success of pictorial cigarette warnings, policymakers should prioritize the adoption of pictorial health warnings (HWLs) for e-cigarettes, ensuring that clear, visually compelling warnings appear on both packaging and devices to maximize consumer awareness. ”

Note: The nature of Health Warning Labels (HWLs) is critical where e-cigarettes are legally permitted, but not in countries like Thailand, where they are banned. The kind of messages that are effective with youth is of importance since the tobacco/vaping industry targets youth.

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Stephen Hamann