Warning Size Affects What Adolescents Recall From Tobacco Advertisements.

Objectives: In the U.S., print advertisements for smokeless tobacco (SLT) feature a large black-and-white text warning covering 20% of the advertisement space. Cigarette and e-cigarette advertisements feature a small warning covering approximately 4% of advertisement space. We explored how warning size affects adolescent boys' spontaneous recollection of the warning, brand-relevant advertisement features, and product risks.

Methods: 1,220 adolescent males (ages 11-16) viewed SLT, cigarette, and e-cigarette advertisements. After each advertisement, boys were asked to recall what they remembered most. Coders identified recalls of the warning label, brand-relevant advertisement features, and risks associated with the product in responses.

Results: Participants were less likely to recall warnings in the cigarette vs. SLT (OR=0.30, p<0.001) and e-cigarette vs. SLT (OR=0.15, p<0.001) ads. Separate GEEs revealed that boys who recalled warnings were less likely to mention brand-relevant advertisement features (OR's<0.32, p's<0.001). Logistic regressions revealed that boys who recalled the warnings were more likely to mention risks associated with the products (OR's>3.50, p's<0.001).

Conclusions: Youth are more likely to recall large SLT warnings than small cigarette and e-cigarette warnings. Warning recall is associated with lower likelihood of recalling brand-relevant advertisement features and greater likelihood of mentioning product risks.