Leah Ranney - Academia.edu (original) (raw)

Papers by Leah Ranney

PLOS ONE, 2018

Introduction Product packaging has long been used by the tobacco industry to target consumers and... more Introduction Product packaging has long been used by the tobacco industry to target consumers and manipulate product perceptions. This study examines the extent to which cigarillo packaging influences perceptions of product flavor, taste, smell, and appeal. Methods A web-based experiment was conducted among young adults. Participants viewed three randomly selected cigarillo packs, varying on pack flavor descriptor, color, type, branding, and warning-totaling 180 pack images. Mixed-effects models were used to estimate the effect of pack elements on product perceptions. Results A total of 2,664 current, ever, and never little cigar and cigarillo users participated. Cigarillo packs with a flavor descriptor were perceived as having a more favorable taste (β = 0.21, p < .001) and smell (β = 0.14, p < .001) compared to packs with no flavor descriptor. Compared to packs with no color, pink and purple packs were more likely to be perceived as containing a flavor (β = 0.11, p < .001), and were rated more favorably on taste (β = 0.17, p < .001), smell (β = 0.15, p < .001), and appeal (β = 0.16, p < .001). While warnings on packs decreased favorable perceptions of product taste (pictorial: β =-0.07, p = .03) and smell (text-only: β =-0.08, p = .01; pictorial: β =-0.09, p = .007), warnings did not moderate the effects of flavor descriptor or color. Conclusions To our knowledge, this study provides the first quantitative evidence that cigarillo packaging alters consumers' cognitive responses, and warnings on packs do not suffice to overcome

Md. L. Rev., 2006

2006] Justice Disparities: The ADA Enforcement System 95 bilities and n=222 persons with non-psyc... more 2006] Justice Disparities: The ADA Enforcement System 95 bilities and n=222 persons with non-psychiatric disabilities. The pri-mary outcome was receiving a benefit from filing an ADA Title I lawsuit, defined as a court ruling in favor of the plaintiff or a settle-ment between the ...

Journal of Adolescent Health, 2017

Purpose-Despite high rates of cigar use among youth, little information exists about how cigar wa... more Purpose-Despite high rates of cigar use among youth, little information exists about how cigar warnings are received by youth. We examined believability of different cigar warning messages with different sources among adolescents in a national phone survey. Methods-Adolescents (age 13-17) in the US (N = 1,125; total response rate, 66%) were randomized to receive one of three health messages ("cigar smoking can cause cancers of the mouth and throat, even if you do not inhale", "cigar smoking can cause lung cancer and heart disease", "cigars are not a safe alternative to cigarettes") and one of four warning sources (FDA, Surgeon General, CDC, no source). Believability was assessed with "how believable is this warning" and responses were dichotomized for "not at all or somewhat" vs. "very". Results-Weighted logistic regression results indicated that most youth found the cigar warnings very believable (60.5%). Messages about mouth and throat cancer (regardless of inhalation) and the safety of cigars in comparison to cigarettes were rated as significantly less believable than messages about lung cancer and heart disease related to cigars. There were no significant differences by source or other demographics. However, youth susceptible to using cigarettes were less likely to report the cigar warnings to be very believable. Conclusions-The messages of cigar warning labels are not viewed as equally believable among adolescents. Future studies should examine how youth process messages about health effects of cigars and the impact of different cigar warnings on youth experimentation with and use of cigars.

Nicotine & Tobacco Research, 2016

Introduction: Little is known on how to communicate messages on tobacco constituents to tobacco u... more Introduction: Little is known on how to communicate messages on tobacco constituents to tobacco users. This study manipulated three elements of a message in the context of a theorybased communication campaign about tobacco constituents: (1) latency of response efficacy (how soon expected health benefits would accrue), (2) self-efficacy (confidence about quitting), and (3) interrogative cue ("Ready to be tobacco-free?"). Methods: Smokers (N = 1669, 55.4% women) were recruited via an online platform, and were randomized to a 3 (Latency of response efficacy) × 2 (Self-efficacy) × 2 (Interrogative cue) factorial design. The dependent variables were believability, credibility, perceived effectiveness of the communication message, and action expectancies (likelihood of seeking additional information and help with quitting). Results: Latency of response efficacy influenced believability, perceived effectiveness, credibility, and action expectancies. In each case, scores were higher when specific health benefits were said to accrue within 1 month, as compared to general health benefits occurring in a few hours. The interrogative cue had a marginal positive effect on perceived effectiveness. The selfefficacy manipulation had no reliable effects, and there were no significant interactions among conditions. Conclusions: Smokers appear less persuaded by a communication message on constituents where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month). Additionally, smokers appeared to be more persuaded by messages with an interrogative cue. Such findings may help design more effective communication campaigns on tobacco constituents to smokers. Implications: This paper describes, for the first time, how components of tobacco constituent messages are perceived. We now know that smokers appear to be less persuaded by communication messages where general health benefits accrue immediately (within a few hours) than specific benefits over a longer timeframe (1 month). Additionally, including an interrogative cue ("Ready to be tobacco free?") may make messages more effective, whereas the self-efficacy manipulation

JAMA Network Open

IMPORTANCE The US Food and Drug Administration (FDA) is required to communicate the risks of toba... more IMPORTANCE The US Food and Drug Administration (FDA) is required to communicate the risks of tobacco constituents to the public. Few studies have addressed how FDA media campaigns can effectively communicate about cigarette smoke constituents. OBJECTIVE To examine whether messages about cigarette smoke constituents are effective in reducing smoking intentions and behaviors among adults who smoke. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial enrolled participants who were aged between 18 and 65 years, were English speakers, were living in the United States, and who smoked at least 100 cigarettes during their lifetime and now smoked every day or some days. Participants received daily messages via email for 15 days. Participants were randomized to 1 of 2 message conditions or a control group and reported their previous-day smoking behaviors daily.

International Journal of Environmental Research and Public Health, 2019

The US Food and Drug Administration is tasked with communicating information to the public about ... more The US Food and Drug Administration is tasked with communicating information to the public about the harmful chemicals in cigarette smoke. Our study used eye tracking method to test the effectiveness of messages about the harmful chemicals in cigarettes smoke among adult smokers. A sample size of 211 current cigarette smokers viewed four communication messages that included: Health effects of a chemical in cigarette smoke and an image depicting the health effect. The messages focused on arsenic, formaldehyde, uranium, and general health. Eye tracking recorded the length of time participants viewed the text and the image. After each message, the participants were asked about the messages’ effectiveness in changing attitudes towards smoking. We analyzed the data using multilevel modeling, and of the 211 smokers, 59.7% were female, 36.5% were Black, and 21.3% had a high school degree or less. Compared to the general message, the messages about formaldehyde and uranium were more discour...

Tobacco Control, 2016

Objective This systematic review examines the impact of non-menthol flavours in tobacco products ... more Objective This systematic review examines the impact of non-menthol flavours in tobacco products on tobacco use perceptions and behaviours among youth, young adults and adults. Data sources English-language peer-reviewed publications indexed in 4 databases were searched through April 2016. Study selection A search strategy was developed related to tobacco products and flavours. Of 1688 articles identified, we excluded articles that were not English-language, were not peer-reviewed, were qualitative, assessed menthol-flavoured tobacco products only and did not contain original data on outcomes that assessed the impact of flavours in tobacco products on perceptions and use behaviour. Data extraction Outcome measures were identified and tabulated. 2 researchers extracted the data independently and used a validated quality assessment tool to assess study quality. Data synthesis 40 studies met the inclusion criteria. Data showed that tobacco product packaging with flavour descriptors tended to be rated as more appealing and as less harmful by tobacco users and non-users. Many tobacco product users, especially adolescents, reported experimenting, initiating and continuing to use flavoured products because of the taste and variety of the flavours. Users of many flavoured tobacco products also showed decreased likelihood of intentions to quit compared with non-flavoured tobacco product users. Conclusions Flavours in most tobacco products appear to play a key role in how users and non-users, especially youth, perceive, initiate, progress and continue using tobacco products. Banning non-menthol flavours from tobacco products may ultimately protect public health by reducing tobacco use, particularly among youth.

North Carolina Medical Journal, 2013

BACKGROUND: The middle school and high school years are a time when adolescents are at high risk ... more BACKGROUND: The middle school and high school years are a time when adolescents are at high risk for initiation of smoking and progression to nicotine addiction. This research examines the prevalence with which North Carolina students receive smoking-related communication from health professionals and how such communication relates to smoking behaviors.

OBJECTIVES The RTI International-University of North Carolina at Chapel Hill Evidence-based Pract... more OBJECTIVES The RTI International-University of North Carolina at Chapel Hill Evidence-based Practice Center (RTI-UNC EPC) systematically reviewed the evidence on (a) the effectiveness of community- and population-based interventions to prevent tobacco use and to increase consumer demand for and implementation of effective cessation interventions; (b) the impacts of smokeless tobacco marketing on smoking, use of those products, and population harm; and (c) the directions for future research. DATA SOURCES We searched MEDLINE, Cumulative Index to Nursing and Applied Health (CINAHL), Cochrane libraries, Cochrane Clinical Trials Register, Psychological Abstracts, and Sociological Abstracts from January 1980 through June 10, 2005. We included English-language randomized controlled trials, other trials, and observational studies, with sample size and follow-up restrictions. We used 13 Cochrane Collaboration systematic reviews, 5 prior systematic reviews, and 2 meta-analyses as the foundati...

Preventive Medicine Reports, 2019

As rates of traditional cigarette smoking have decreased among youth over the past several years,... more As rates of traditional cigarette smoking have decreased among youth over the past several years, rates of ecigarette use have increased. Little evidence exists on how youth obtain e-cigarettes. We used data from middle and high school students under the age of 18 who reported using an e-cigarette in the past 30 days from the 2017 North Carolina Youth Tobacco Survey (n = 640). We used chi-square tests and multivariable logistic regressions to examine correlates of access and place of acquisition. Over half (51.5%) of youth report acquiring e-cigarettes from a friend. Youth in 12th grade had higher odds of acquiring e-cigarettes from a vape shop (aOR: 2.54, 95% CI: 1.25, 5.15) or retail outlet (aOR: 2.40, 95% CI: 1.18, 4.90) than youth in middle school. Compared to non-Hispanic white youth, Hispanic youth had lower odds of acquiring e-cigarettes from a vape shop (aOR: 0.42, 95% CI: 0.20, 0.87). Youth living with someone who uses e-cigarettes, compared to those who did not, had higher odds of acquiring e-cigarettes from a family member (aOR: 3.95, 95% CI: 1.94, 8.05). Finally, current smokers had higher odds of acquiring e-cigarettes from a retail outlet (aOR: 3.28, 95% CI: 1.88, 5.70) and lower odds of acquiring e-cigarettes from a friend (aOR: 0.53, 95% CI: 0.36, 0.77). Youth primarily reported obtaining e-cigarettes from a friend. Living with someone who uses e-cigarettes may be a risk factor for acquiring ecigarettes from family members. Identifying sources of e-cigarette acquisition will help inform interventions preventing youth e-cigarette access.

Nicotine & Tobacco Research, 2019

Introduction We examined the effect of visual optimizations on warning text recall. Methods We us... more Introduction We examined the effect of visual optimizations on warning text recall. Methods We used Amazon’s Mechanical Turk to recruit 1854 young adult (18–34 years) electronic cigarette (e-cigarette) users or susceptible nonusers. We conducted a between-subjects 3 × 2 × 2 experiment to examine the influence of color (black text on white background [BW] vs. black on yellow [BY] vs. yellow on black [YB]), shape (rectangle vs. novel), and signal word (presence vs. absence of the word “warning”). We randomized participants to view one of 12 warnings on a fictional e-cigarette advertisement. We coded open-ended recall responses into three categories: (1) recalled nothing, (2) recalled something, (3) recalled the concept. We examined main effects on warning text recall using multinomial regression. We examined differences in attention, perceived message effectiveness, and appeal. Results Those exposed to BW or BY warnings were more likely than those exposed to YB to recall something (AO...

International journal of environmental research and public health, Jan 14, 2018

While the Food and Drug Administration (FDA) has had regulatory authority over tobacco products s... more While the Food and Drug Administration (FDA) has had regulatory authority over tobacco products since 2009, public awareness of this authority remains limited. This research examines several broad types of information about FDA tobacco regulatory mission that may improve the perceptions of FDA as a tobacco regulator. Using Amazon Mechanical Turk, 1766 adults, smokers and non-smokers, were randomly assigned to view a statement about FDA regulatory authority that varied three information types in a 2 × 2 × 2 between subjects experimental design: (1) FDA's roles in regulating tobacco (yes/no); (2) The scientific basis of regulations (yes/no); and (3) A potential protective function of regulations (yes/no). Using factorial ANOVA, we estimated the main and interactive effects of all three types of information and of smoking status on the perceptions of FDA. Participants that were exposed to information on FDA roles reported higher FDA credibility and a greater perceived knowledge of ...

Community Mental Health Journal, 2017

International Journal of Environmental Research and Public Health, 2017

To inform potential governmental regulations, we aimed to develop a list of electronic nicotine d... more To inform potential governmental regulations, we aimed to develop a list of electronic nicotine delivery system (ENDS) product features important to U.S. consumers by age and gender. We employed qualitative data methods. Participants were eligible if they had used an ENDS at least once. Groups were selected by age and gender (young adult group aged 18-25, n = 11; middle-age group aged 26-64, n = 9; and women's group aged 26-64, n = 9). We conducted five individual older adult interviews (aged 68-80). Participants discussed important ENDS features. We conducted a structured content analysis of the group and interview responses. Of 34 participants, 68% were white and 56% were female. Participants mentioned 12 important ENDS features, including: (1) user experience; (2) social acceptability; (3) cost; (4) health risks/benefits; (5) ease of use; (6) flavors; (7) smoking cessation aid; (8) nicotine content; (9) modifiability; (10) ENDS regulation; (11) bridge between tobacco cigarettes; (12) collectability. The most frequently mentioned ENDS feature was modifiability for young adults, user experience for middle-age and older adults, and flavor for the women's group. This study identified multiple features important to ENDS consumers. Groups differed in how they viewed various features by age and gender. These results can inform ongoing regulatory efforts.

North Carolina Medical Journal, 2017

H ookah, also known as water pipe, nargileh, and shisha, smoking has become a global epidemic, sp... more H ookah, also known as water pipe, nargileh, and shisha, smoking has become a global epidemic, spreading from its origin in the Middle East to most parts of the world. Hookah smoking has gained popularity in Western countries, including the United States, United Kingdom, and Canada [1-3]. According to the most recent Global Youth Tobacco Survey, hookah use has already replaced cigarettes as the most common form of tobacco product used by adolescents aged 13-15 years in 17 eastern Mediterranean countries, with a prevalence of hookah smoking ranging from 9% to 15% [3]. Hookah use is widespread and rising among United States adolescents and young adults, despite declines in youth cigarette use over time [4, 5]. The Centers for Disease Control and Prevention (CDC) suggests that this decline in cigarette smoking may be offset by the rapidly increasing use of other forms of smoked tobacco [6], including hookah. The prevalence of past 30-day hookah use among United States high school students significantly increased from 4.1% in 2011 to 7.2% in 2015 [7-9]. Evidence suggests that health risks associated with hookah use are similar to those with cigarette smoking, including nicotine addiction, lung cancer, respiratory illness, low birthweight, and periodontal disease [10]. Hookah users may smoke over a longer period of time compared to cigarette users, and absorb higher concentrations of the same toxins found in cigarette smoke due to the method of smoking [11]. Representative data from many countries indicate that hookah use is more prevalent among those who are younger, male, have a high socioeconomic status, live in an urban area, and occasionally and socially use tobacco [3]. Factors that drive this hookah phenomenon include introduction of flavored hookah tobacco (ie, Maassel), reduced risk misperceptions, popular lounge or café culture, growing social appeal, rise of Internet and social media, and lack of regulation [2, 3, 12-14]. The epicenter of the hookah use epidemic includes young adults, with peak use among 19-21 year olds [3, 7, 15]. The majority of hookah research has been conducted on college populations and shows hookah use is associated with being younger [15, 16], being male [15-17], being White [15], using cigarettes [16-19], using other drugs [16, 19], and having a belief that hookah smoking is less harmful than cigarette smoking [17, 19, 20]. Research on adolescent hookah use indicates that factors associated with use include being male, current cigarette use, reduced perception of harm, and higher perceived social acceptability [21-28]. The Internet has been widely exploited to sell tobacco products. Tobacco sale websites serve as a direct form of tobacco promotion and advertising where users or potential buyers can post comments on tobacco products [29, 30].

Tobacco Regulatory Science, 2016

• Inclusion criteria: 1) eye tracking outcomes reported and 2) tobacco control focus • CM and KJ ... more • Inclusion criteria: 1) eye tracking outcomes reported and 2) tobacco control focus • CM and KJ independently reviewed each title and abstract, then each article considered for full text review

International Journal of Environmental Research and Public Health, 2015

Although cigarette use by adolescents is declining, emerging tobacco products are becoming increa... more Although cigarette use by adolescents is declining, emerging tobacco products are becoming increasingly popular and youth may use more than one type of tobacco product. The purposes of this study were: (1) to assess patterns of poly-tobacco use among a representative sample of high school students and (2) to determine how beliefs correlate with poly-tobacco use. Data came from the 2013 North Carolina Youth Tobacco Survey (n = 4092). SAS logistic regression survey procedures were used to account for the complex survey design and sampling weights. Among all high school students in NC in 2013, 29.7% reported current any tobacco use, with 19.1% reporting current poly-tobacco use, and 10.6% reporting current use of only one product. Among poly-tobacco users, 59.3% reported that one of the products they currently used was cigarettes. Positive tobacco product beliefs were found to be significantly associated with poly-tobacco use. Communication campaigns, policy efforts, and future research are needed for prevention, OPEN ACCESS regulation, and control of poly-tobacco use among adolescents, which represents a significant public health problem.

Preventing chronic disease, Jan 8, 2015

Retailer noncompliance with limited US tobacco regulations on advertising and labeling was histor... more Retailer noncompliance with limited US tobacco regulations on advertising and labeling was historically patterned by neighborhood in ways that promote health disparities. In 2010, the US Food and Drug Administration (FDA) began enforcing stronger tobacco retailer regulations under the Family Smoking Prevention and Tobacco Control Act of 2009. However, recent research has found no differences in compliance by neighborhood characteristics for FDA advertising and labeling inspections. We sought to investigate the neighborhood characteristics associated with retailer noncompliance with specific FDA advertising and labeling inspections (ie, violations of bans on self-service displays, selling single cigarettes, false or mislabeled products, vending machines, flavored cigarettes, and free samples). We coded FDA advertising and labeling warning letters (n = 718) for type of violations and geocoded advertising and labeling inspections from January 1 through July 31, 2014 (N = 33,543). Using...