INTRODUCTION Many people remove the tobacco leaf from cigars and replace it with cannabis (i.e., blunts), but few studies have examined whether messages about the risks of cigars, like warnings on cigar packages, can affect blunt use. METHODS Participants were 438 US adults who reported past 30-day cigar use and ever blunt use, recruited from a probability-based national panel to take an online survey. In a 2x2 experiment with a between-subjects design, we manipulated two cigar warning characteristics: 1) warning type: text-only vs. pictorial (i.e., text + image) and 2) warning size: 30% (smaller) vs. 50% (larger) of the product package. Participants then viewed 6 different warnings on a fictious cigarillo package, within their randomly assigned condition. After evaluating all stimuli, participants were asked the extent to which the warnings discouraged them from wanting to use cigars to smoke cannabis (i.e., blunt perceived warning effectiveness). Response options ranged from "not at all" (1) to "a great deal" (5). RESULTS We observed no main effects of warning type or size on blunt perceived warning effectiveness. However, a significant interaction existed between the two experimental manipulations (p=0.009). Whereas adding images made no difference to blunt perceived warning effectiveness when warnings were smaller (simple effect: -0.22, p=0.28), images mattered for larger warnings. Specifically, adding images increased blunt perceived warning effectiveness when warnings were 50% of the product package (simple effect: 0.52, p=0.008). CONCLUSIONS This experiment provides preliminary evidence that larger pictorial cigar warnings may discourage blunt use relative to larger but text-only warnings. IMPLICATIONS Blunts, which are hollowed out cigars with tobacco leaf wrappers that are filled with cannabis leaf, are one of the most common ways in which tobacco and cannabis are used simultaneously, yet few studies have examined whether messages about the risks of cigars can affect blunt use. We conducted an online experiment concerning the perceived effectiveness of cigar warnings among people who use blunts recruited from a probability-based panel. Results provide novel, preliminary evidence that larger pictorial cigar warnings may discourage blunt use, relative to larger but text-only warnings. More research evaluating cigar warnings on blunt use is needed.

中文翻译：

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雪茄警告在阻止直接使用方面的有效性。

简介 许多人把雪茄中的烟叶去掉，用大麻代替（即钝烟），但很少有研究探讨有关雪茄风险的信息（如雪茄包装上的警告）是否会影响钝烟的使用。方法 参与者是 438 名美国成年人，他们报告过去 30 天吸过雪茄并曾经使用过雪茄，他们是从基于概率的国家小组中招募来进行在线调查的。在采用受试者间设计的 2x2 实验中，我们操纵了两个雪茄警告特征：1) 警告类型：纯文本与图片（即文本 + 图像）和 2) 警告大小：30%（较小）与 50产品包装的%（较大）。然后，参与者在随机分配的条件下查看虚构小雪茄包装上的 6 个不同警告。在评估所有刺激后，参与者被问及警告在多大程度上阻止他们使用雪茄吸食大麻（即钝化感知的警告有效性）。回答选项范围从“一点也不”(1) 到“很大”(5)。结果我们没有观察到警告类型或大小对直率感知警告有效性的主要影响。然而，两种实验操作之间存在显着的交互作用（p=0.009）。当警告较小时，添加图像对于减弱感知的警告有效性没有影响（简单效果：-0.22，p = 0.28），但图像对于较大的警告很重要。具体来说，当警告占产品包装的 50% 时，添加图像会提高直率感知警告的有效性（简单效应：0.52，p=0.008）。结论 该实验提供了初步证据，表明相对于较大但纯文本的警告，较大的图片雪茄警告可能会阻止生硬的使用。影响 钝烟是一种用烟叶包装纸挖空的雪茄，里面装满大麻叶，是同时使用烟草和大麻的最常见方式之一，但很少有研究探讨有关雪茄风险的信息是否会影响钝烟。使用。我们进行了一项在线实验，研究从基于概率的小组中招募的使用钝器的人对雪茄警告的感知有效性。结果提供了新颖的初步证据，表明相对于较大但纯文字的警告，较大的图片雪茄警告可能会阻止生硬的使用。需要更多的研究来评估雪茄关于钝用的警告。