Health Warning Labels (HWLs) represent one of the most successful tobacco control strategies to communicate smoking-related risks, and studies have consistently shown that HWLs are associated with a decrease in smoking rates and smoking-related morbidity and mortality.
Communicating hookah and e-cigarette risks to young individuals through health warning labels has been identified as a priority by major health bodies in the US including the FDA. Currently, the FDA requires that hookah and e-cigarette tobacco packages have a textual health warning label: “WARNING: This product contains nicotine. Nicotine is an addictive chemical.”
Although this is a good first step, it is inadequate given the; 1- limited contact hookah smokers have with tobacco packaging, 2- the established harm of hookah smoking beyond tobacco (e.g., charcoal), and 3- the superior performance of pictorial health warning labels over text-only ones. Therefore, pictorial hookah-specific health warning labels involving other hookah components (e.g. device) are expected to be more effective in communicating risks to hookah smokers.
Similarly with e-cigarettes, the application of pictorial health warning labels on the actual device is a promising and feasible strategy to communicate e-cigarette risks since users have way more contact to the device than cigarettes.
Given the information that exists, our three projects highlight the importance of developing new health warning labels for both hookah and e-cigarettes to increase awareness not only at the local level, but at a national and international level as well. Studying the effects of health warning labels can allow us to advance risk communication and suggest innovative ideas to policymakers.
