Evidence mapPaperPMID 41124756Full record

Trial reportAddictive behaviors2026

Effect of graphic warning label on acute changes in waterpipe tobacco smoking behavior, biomarkers of exposure and harm, and subjective effects in a randomized trial.

Marielle C Brinkman, Toral Mehta, Michael L Pennell, David Angeles, Soliana Kahassai, Chieh-Ming Wu, Hayley Curran, Brittney Keller-Hamilton, Elizabeth G Klein, Megan E Roberts and 8 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Addictive behaviors, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Marielle C BrinkmanDivision of Epidemiology, College of Public Health, The Ohio State University, College of Public Health, United States; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States. Electronic address: brinkman.224@osu.edu.
Toral MehtaCenter for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States. Electronic address: Toral.Mehta@osumc.edu.
Michael L PennellDivision of Biostatistics, College of Public Health, The Ohio State University, United States. Electronic address: Pennell.28@osu.edu.
David AngelesDivision of Biostatistics, College of Public Health, The Ohio State University, United States. Electronic address: Angeles.6@buckeyemail.osu.edu.
Soliana KahassaiDivision of Epidemiology, College of Public Health, The Ohio State University, College of Public Health, United States. Electronic address: Kahassai.1@osu.edu.
Chieh-Ming WuCenter for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States; Division of Environmental Health Sciences, College of Public Health, The Ohio State University, United States. Electronic address: Wu.1615@osu.edu.
Hayley CurranCenter for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States. Electronic address: Hayley.Curran@osumc.edu.
Brittney Keller-HamiltonCenter for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States; Divison of Medical Oncology, College of Medicine, The Ohio State University, United States. Electronic address: Brittney.Keller-Hamilton@osumc.edu.
Elizabeth G KleinDivision of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, United States. Electronic address: Klein.232@osu.edu.
Megan E RobertsCenter for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States; Division of Health Behavior and Health Promotion, College of Public Health, The Ohio State University, United States. Electronic address: Roberts.1558@osu.edu.
Paul NiniDepartment of Design, College of Arts and Sciences, The Ohio State University, United States. Electronic address: Nini.1@osu.edu.
Olorunfemi AdetonaDivision of Environmental Health Sciences, College of Public Health, The Ohio State University, United States. Electronic address: Adetona.1@osu.edu.
Joanne G PattersonCenter for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States. Electronic address: Patterson.1191@osu.edu.
Darren MaysCenter for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States; Divison of Medical Oncology, College of Medicine, The Ohio State University, United States. Electronic address: Darren.Mays@osumc.edu.
Lucia MandaranoDivision of Epidemiology, College of Public Health, The Ohio State University, College of Public Health, United States. Electronic address: Mandarano.2@buckeyemail.osu.edu.
Emma JankowskiDivision of Epidemiology, College of Public Health, The Ohio State University, College of Public Health, United States. Electronic address: Jankowski.58@osu.edu.
Annabelle ThomasDivision of Epidemiology, College of Public Health, The Ohio State University, College of Public Health, United States. Electronic address: Thomas.3983@buckeyemail.osu.edu.
Amy K FerketichDivision of Epidemiology, College of Public Health, The Ohio State University, College of Public Health, United States; Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, United States. Electronic address: Ferketich.1@osu.edu.

Funding

NCI NIH HHS R01 CA229306
6 · The paper itself

Abstract

introductionWaterpipe (WP) smoking is commonly misperceived as less harmful than cigarette smoking. Graphic warning labels (GWLs) may correct misperceptions and reduce WP smoking. We determined the impact of a GWL placed on a WP on short-term smoking behaviors and other outcomes among young adults who smoke WP.

methodsYoung adults, ages 21-35 years, who smoke WP were randomized to a control (Visit1 = Blank, Visit2 = Blank label) or experimental (Visit1 = Blank, Visit2 = GWL, Visit3 = GWL) group. Participants smoked a research-grade WP in the lab ad lib to satiation, for a maximum of 60 min, for up to 3 visits, each separated by a week. Puffing topography was measured continuously throughout the session. Exhaled CO, harm perceptions, and subjective effects were measured before and after each smoking session. Outcome data were analyzed using linear mixed models to account for incomplete, repeated measurements.

resultsThere were no significant differences in study outcomes within and between assigned groups, except for the following from Visit1 and Visit3 in the GWL group: 1) a reduction in puff volume (p = 0.048); 2) a reduction in good taste and calmness (p = 0.027 and 0.007, respectively); and 3) a reduction in being confused after smoking (p = 0.042).

conclusionsGWLs on WPs may not be the sole effective tool for reducing the harm from WP smoking. More research is needed to determine if WP interventions aimed at improving population health should include a wider variety of tools, such as education, cessation services, and product standards that limit the appealing aspects of WP tobacco.

Indexed as

Product LabelingWater Pipe SmokingAdultBiomarkersCarbon MonoxideFemaleHumansMaleYoung AdultBiomarkersCarbon Monoxide

Identifiers

PMID41124756
PMCPMC13266813

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.