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Characteristics of Waterpipe Health Warning Labels in the United States

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Objectives: In this paper, we assess characteristics of health warning labels (HWLs) on water-pipe tobacco packages sold in the US and changes after the FDA's minimum required warning statement went into effect in August 2018. Methods: We sampled 16 brands and 45 sub-brands/flavors of the most popular waterpipe tobaccos 6 months before and 4 months after the FDA's compliance deadline. HWL characteristics assessed included type (pictorial or text), message theme, location, and relative size. Results: Before the deadline, all packages had at least one text-only HWL that covered <25% of the surface, with most inconspicuously placed (such as side panel), and focusing on general health risks of tobacco rather than waterpipe-specific risks. After the deadline, only 1 of 10 brands had adopted the new required HWL, adding it to the existing one. Conclusions: HWLs were common on waterpipe tobacco packages in the US prior to the FDA mandate, but did not adhere to recommended standards of being pictorial, large (least 50% of the package), conspicuously placed, and using relevant, rotating message themes. The FDA's required warning has not yet been adopted by most brands. Doing so may improve the efficacy of HWLs to reduce smoking.
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Document Type: Research Article

Affiliations: 1: Professor and Director, Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis TN;, Email: kdw[email protected] 2: Doctoral Candidate, Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis TN 3: Graduate Student, Division of Health Systems Management and Policy, School of Public Health, The University of Memphis, Memphis, TN 4: Assistant Professor, Division of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, The University of Memphis, Memphis TN

Publication date: July 1, 2019

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

    The Journal aims to provide a comprehensive understanding of the impact of personal attributes, personality characteristics, behavior patterns, social structure, and processes on health maintenance, health restoration, and health improvement; to disseminate knowledge of holistic, multidisciplinary approaches to designing and implementing effective health programs; and to showcase health behavior analysis skills that have been proven to affect health improvement and recovery.

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