Kudos to Isaac Lipkus and his entire team for the submission of their NIH R21 application entitled: "Exploring Reactions to Health Warnings on Waterpipe Tobacco Ads." This proposal requests funding for a 16-month period with a start date of July 1, 2018.

Waterpipe tobacco smoking (WTS) is increasing in the United States among young adults exposing them to its many health risks. This increase is partly to due to product and social allure advertisements from commercial entities (e.g., waterpipe bars, cafes) that portray WTS as a fun social activity while masking its harmful effects. The positive feelings these advertisements likely elicit may reduce worry and perceived health risks and increase the appeal of WTS. Advertisement appeal may be curbed by placing health warnings. Thus, we address the extent to which the addition of text only and text plus graphic health warnings influence reactions to waterpipe tobacco advertisements as well as risk appraisals, attitudes toward WTS, and intention to engage in WTS.

The primary aims are: 1) develop, pilot test and select health warnings in four domains as well as product and social allure ads to be used in (Phase 2); 2) explore whether reactions to ads as well as risk appraisals, attitudes toward WTS, and intentions to engage WTS vary by advertisements with or without health warnings; 3) explore whether effects of warnings on risk appraisals, attitudes toward WTS, and intention to engage in  WTS are mediated by reactions to the advertisements; and 4) examine how attentional processes as assessed using eye-tracking mediate reactions to health warnings. Findings will inform messaging strategies to curb WTS and potentially the FDA’s regulation of WTS advertisements.