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Adolescent males’ responses to blu’s fake warnings
  1. Brittney Keller-Hamilton1,
  2. Megan E Roberts2,
  3. Michael D Slater3,
  4. Micah Berman4,5,
  5. Amy K Ferketich1
  1. 1 Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
  2. 2 Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, Columbus, Ohio, United States
  3. 3 School of Communication, The Ohio State University, Columbus, Ohio, USA
  4. 4 Division of Health Services Management and Policy, College of Public Health, The Ohio State University, Columbus, Ohio, United States
  5. 5 Moritz College of Law, The Ohio State University, Columbus, Ohio, United States
  1. Correspondence to Brittney Keller-Hamilton, College of Public Health, Ohio State University, Columbus, OH 43210, USA; keller-hamilton.1{at}


Objective Blu’s ‘Something Better’ advertising campaign ran in popular print magazines in 2017. The campaign included advertisements with fake warnings conveying positive messages, which mimicked the Food and Drug Administration (FDA)’s warning requirements for electronic cigarette (e-cigarette) advertisements that took effect in 2018. We report adolescent males’ recall of these fake warnings and how exposure to fake warnings affected recall of other advertisement components, including the actual warning or health risks, brand and product.

Methods Ohio males ages 12–19 years (N = 775; 73.8 % white non-Hispanic) were randomly assigned to view an e-cigarette advertisement with or without a fake warning. Afterward, they were asked what they remembered most about the advertisement. Responses were qualitatively coded. Statistical analyses included survey-weighted descriptive statistics and logistic regression.

Results Of participants who viewed an e-cigarette advertisement with a fake warning, 27.0 % reported the fake warning was what they remembered most, and 18.8 % repeated the fake warning message. Participants viewing advertisements with a fake warning had lower odds of recalling the actual warning or health risks (OR = 0.29; 95% CI: 0.11 to 0.77) or brand (OR = 0.43; 95% CI: 0.22 to 0.85), compared with participants viewing other e-cigarette advertisements.

Conclusions Adolescents viewing an advertisement with a fake warning were less likely to recall the advertisement’s actual warning or health risks. Although e-cigarette advertisements now carry large FDA-mandated warnings, this tactic could be used for cigarette advertisements that continue to carry small warnings in the USA. Findings underscore the necessity of tobacco advertisement surveillance and study of advertisements’ effects on adolescents.

  • advertising and promotion
  • electronic nicotine delivery devices
  • tobacco industry

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  • Contributors All authors contributed to this manuscript and approved its final version.

  • Funding This study was funded by the National Cancer Institute and the Food and Drug Administration Center for Tobacco Products (P50CA180908).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.