{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:01:15Z","timestamp":1790870475552,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Modified risk statements (MRS), claiming e-cigarettes are less harmful than cigarettes, attempt to alter tobacco risk beliefs but may conflict with warning messages. Absolute risk beliefs reflect the perceived likelihood of harm from e-cigarettes, while relative risk beliefs reflect the likelihood of harm from e-cigarettes versus cigarettes. This systematic review and meta-analysis examined whether adding MRS to e-cigarette advertisements and packages containing warnings affects risk beliefs and intentions to vape.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched PubMed, Embase, Scopus, PsycInfo, and Business Source Premier, and supplemental sources, identifying 10 eligible experimental studies (N = 11,025). Studies compared e-cigarette advertisement or packages containing warnings with versus without MRS. Random-effects meta-analyses estimated effect sizes (d), heterogeneity, and three moderators. Databases were last searched in May 2025. Risk of bias was assessed using a modified JBI tool for randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with no MRS, advertisements and packages containing MRS reduced absolute risk beliefs of e-cigarettes (d = - 0.08, p = .003). No significant effects emerged for relative risk beliefs (d = - 0.05, p = .108) or intentions to vape (d = 0.03, p = .173). Smoking status moderated effects on relative risk beliefs (p = .03); MRS reduced relative risk beliefs that e-cigarettes are more harmful than cigarettes among non-smokers only (d = -0.12).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MRS lowered absolute risk beliefs, but the effect was very small and MRS did not affect overall relative risk beliefs or intentions to vape. Given the modest number of studies available for this review, additional work is needed on communicating about the continuum of tobacco product risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Funding<\/jats:title>\n                    <jats:p>NIH\/NIDA (R01DA049155) and NCI (R37CA222002).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p>OSF(https:\/\/osf.io\/8t9hz)<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ntr\/ntag216","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T11:50:24Z","timestamp":1790855424000},"source":"Crossref","is-referenced-by-count":0,"title":["Does Adding Modified Risk Statements to E-Cigarette Advertisements and Packages Change Risk Beliefs? A Systematic Review and Meta-Analysis"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6106-2908","authenticated-orcid":false,"given":"Youjin","family":"Jang","sequence":"first","affiliation":[{"name":"Department of Communication, Journalism, and Film, The College of New Jersey , Ewing, NJ"},{"name":"Department of Public Health, The College of New \u00a0 , Ewing, NJ","place":["Jersey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Shaw","sequence":"additional","affiliation":[{"name":"Klein College of Media and Communication, Temple University , Philadelphia, PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivia A","family":"Wackowski","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Society and Policy, Rutgers School of Public Health , New Brunswick, NJ"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seth M","family":"Noar","sequence":"additional","affiliation":[{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina , Chapel Hill, NC"},{"name":"Hussman School of Journalism and Media, University of North Carolina , Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,10,1]]},"container-title":["Nicotine &amp; Tobacco Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntag216\/71560950\/ntag216.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article-pdf\/doi\/10.1093\/ntr\/ntag216\/71560950\/ntag216.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T15:35:21Z","timestamp":1790868921000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ntr\/advance-article\/doi\/10.1093\/ntr\/ntag216\/8859221"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/ntr\/ntag216","relation":{},"ISSN":["1469-994X"],"issn-type":[{"value":"1469-994X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,1]]},"article-number":"ntag216"}}