Message development for a communication campaign to support health warning labels on cigars: a qualitative study

Background: Communication campaigns for health warning labels (HWLs) are an evidence-based strategy to reduce tobacco use. No research has examined campaign messages to support graphic HWLs for little cigars and cigarillos (LCCs).

Methods: We developed four message types for graphic LCC HWLs: (1) Explanatory (2) Testimonial (3) Inquisitive and (4) Recommendation, depicting colon, lung, and esophageal cancer. Online focus groups with Black and White young adults (18-25 years old) who reported current LCC use were conducted. Participants were shown graphic HWLs on LCCs and then four message types corresponding to the HWLs. Participants discussed persuasive communication features for each message type.

Results: Thirty-six young adults who use LCCs participated. Four central themes were revealed. (1) Perceived credibility of message and messenger impacted effectiveness. (2) Personally relevant messages were emotionally engaging and made people think about their health, (3) Succinct, factual messages with new information were perceived as believable, and (4) Language perceived to be "Marketing," was deemed insincere.

Conclusions: For communication campaigns to support graphic HWLs for LCCs, messages perceived as credible, relatable, and messages that convey new information are more likely to be received positively and may increase campaign effectiveness.