Pack Modifications Influence Perceptions of Menthol E-cigarettes

Objectives: Tobacco package colors and descriptors influence attitudes and intentions to use. This study examined the impact of flavor, color, and descriptors on electronic cigarette (e-cigarette) packages young adults' perceptions of e-cigarettes. Methods: We recruited 2872 US participants ages 18-24 from Amazon Mechanical Turk (2018-2019) and randomized them to view one of 7 e-cigarette package images that varied by flavor (menthol vs tobacco), color (green or brown vs black and white), and descriptor (present vs absent). Models examined main and interactive effects of flavor, color, and descriptor on perceptions of appeal, harm, and addictiveness, and the moderating effects of product appeal. Results: Menthol e-cigarette packages were rated as more "attention grabbing," "appetizing," and "fun to use." Perceptions of harm and addictiveness did not vary across package conditions. Interactions of menthol pack conditions with appeal emerged. Specifically, participants exposed to the green package with the menthol descriptor reported low e-cigarette harm perceptions across all levels of "attention grabbing" and "discourages use," while those exposed to the green package without the menthol descriptor or the brown package with the tobacco descriptor reported lower harm perceptions as ratings of product appeal increased. Conclusions: Colors and descriptors on e-cigarette packaging influence product appeal and harm perceptions.