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Tobacco UseNCT05849051

Little Cigar and Cigarillo Warnings Among US Adults Who Use LCCs

A study testing Newly developed warnings with images at 30% size and FDA proposed text-only warnings at 30% size in people with Tobacco Use, run by UNC Lineberger Comprehensive Cancer Center at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The goal of this research is to assess whether little Cigars and cigarillos (LCC) warnings developed by the study team are more effective than the current warnings proposed by FDA for LCC products. A 3-week web-based randomized controlled trial will be conducted in the United States. Read more about this study

Who is it for?
Ages 21 years and older
Conditions the study is for
Tobacco Use
What is being tested?
Newly developed warnings with images at 30% size and FDA proposed text-only warnings at 30% size
Could I receive a placebo?
No, everyone receives an active treatment
How many people
1,029 participants
Where
1 siteUnited States
Study dates
22 May 2023to 27 Aug 2023
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 21 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Members of the recruitment panel (the investigators are partnering with a panel provider for recruitment of all participants)
  • Agree to provide their honest answers
  • Current little cigar and/or cigarillo every day or some day users
  • Over 21 years old
  • Currently living in US
  • Feel comfortable taking a survey in English without help
Show all 14Show fewer
  • Feel comfortable taking an online survey without help
  • Have an email address that they check regularly
  • Have access to the internet at work or home
  • Able to read and respond to surveys delivered to their email
  • Able to complete 2 surveys that take approximately 20 minutes
  • Able to complete a 5 minute survey each day for 20 days
  • Able to verify they are not a bot using CAPTCHA
  • Able to answer a simple, random math question

Who cannot join

  • None

Trial locations and contacts

1 site in 1 country.

United States1 site
  • University of North Carolina at Chapel Hill

    Chapel Hill, North Carolina, 27599

Other trials in United States

About this study

Official title: Little Cigar and Cigarillo Warnings to Reduce Tobacco-Related Cancers and Disease: Randomized Controlled Trial Among US Adults Who Use LCCs

The goal of this research is to assess whether little Cigars and cigarillos (LCC) warnings developed by the study team are more effective than the current warnings proposed by FDA for LCC products. A 3-week web-based randomized controlled trial will be conducted in the United States. Participants are adult persons who currently use LCCs.

Read the detailed description

In this study, LCC warnings on packs will be electronically presented to participants over time to determine if newly developed LCC warnings increase quit intentions compared to FDA-proposed text-only warnings and a control condition (in which participants do not see LCC packs or warnings.) A daily diary methodology will be employed to present LCC warnings on packs to participants over time. Qualtrics will contact, screen, consent, and administer the survey. To enroll participants, Qualtrics will screen participants using the inclusion criteria and measures and invite eligible participants to enroll in the study.

At the beginning of the baseline survey (day 0), participants will first consent to participate in the study and then complete a questionnaire about their tobacco use and behaviors (e.g., intentions and quit attempts) and other measures of interest. At the end of the baseline questionnaire, survey software will randomly assign participants to one of the 3 study conditions. The three study conditions are 1) Newly developed warnings with images (the six most effective warnings developed by the study team), 2) FDA-proposed text-only warnings, or 3) control condition in which participants will not receive an intervention (no warnings). Participants will be contacted via email each day (at approximately 6 am) to invite them to complete the survey for that day of the study protocol.

For subsequent days (days 1-6, 8-13, 15-20) participants will be contacted and asked to complete a daily survey which will assess their previous day use of LCCs, as well as cigarettes and e-cigarettes. During these daily surveys, participants assigned to condition 1 or 2 (i.e., the warning conditions) will view an image of a little cigar and cigarillo package with a warning according to the participant's condition. Participants within each warning condition will view a total of 6 different warnings over the course of 6 days each week, this will be repeated 3 times during the study, resulting in a total of 18 exposures. Participants will be required to view the warning for at least 5 seconds before answering questions.

On days 7 and 14 participants will be asked to complete a slightly longer survey with questions about their LCC behaviors including the number of LCCs used in the past week, the number of LCCs butted out because they wanted to smoke less, the number of LCCs forgone, other tobacco use, blunt use, and quit intentions and attempts.

For the post-test on day 21, participants will be asked to complete a longer questionnaire about their current tobacco use and behaviors including current LCC smoking behavior, LCC nicotine dependence, other tobacco product (OTP) use, LCC and OTP quit intentions, and LCC and O

Conditions
Tobacco Use
Being tested
Newly developed warnings with images at 30% size, FDA proposed text-only warnings at 30% size
Keywords
Cigar Warnings, Little Cigar Use, Cigar Use, Cigarillo Use
Medical subject headings
Tobacco Use

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Newly developed warnings with images at 30% sizeBehavioural

    On study days 1-6, 8-13 and 15-20, participants in this condition will view an image of a little cigar and cigarillo package with a warning developed by the study team that includes an image. The warnings will take up 30% of the package. Participants will view a total of 6 different warnings over the course of 6 days each week, this will be repeated 3 times during the study, resulting in a total of 18 exposures. Participants will be required to view the warning for at least 5 seconds.

  • FDA proposed text-only warnings at 30% sizeBehavioural

    On study days 1-6, 8-13 and 15-20, participants in this condition will view an image of a little cigar and cigarillo package with a warning proposed by the FDA which is text only. The warnings will take up 30% of the package. Participants will view a total of 6 different warnings over the course of 6 days each week, this will be repeated 3 times during the study, resulting in a total of 18 exposures. Participants will be required to view the warning for at least 5 seconds.

Study groups in NCT05849051
Study groupRoleWhat they receive
Newly developed warnings with imagesExperimentalParticipants receive newly developed warnings intervention
Receives: Behavioral: Newly developed warnings with images at 30% size
FDA proposed text-only warningsExperimentalParticipants receive FDA proposed text only warning intervention
Receives: Behavioral: FDA proposed text-only warnings at 30% size
Control group, no interventionNo interventionParticipants do not receive an intervention

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. LCC Quit Intentions

    Average quit intention score measured by survey. Quit intention measured with 3 questions, the final quit intention score is a mean of the response to the 3 questions, on a scale of 1 to 4, where 1 indicates low intention to quit, and 4 indicates a high intention to quit.

    Measured: day 21 (post test)

Secondary outcomes (39)
  1. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant.

    Measured: day 1

  2. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 2

  3. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day was reported by participants.

    Measured: day 3

  4. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant.

    Measured: day 4

  5. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 5

  6. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 6

  7. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 7

  8. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 8

  9. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 9

  10. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 10

  11. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 11

  12. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 12

  13. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 13

  14. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 14

  15. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 15

  16. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 16

  17. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 17

  18. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 18

  19. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 19

  20. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 20

  21. Number of LCCs Smoked in Past Day

    The mean number of little cigars and cigarillos (LCCs) smoked in the past day reported by participant

    Measured: day 21 (post test)

  22. Number of Days Smoked LCCs in Past Week

    The mean number days that a participant reported smoking little cigars and cigarillos (LCCs) smoked in the past week

    Measured: day 7

  23. Number of Days Smoked LCCs in Past Week

    The mean number days that a participant reported smoking little cigars and cigarillos (LCCs) smoked in the past week

    Measured: day 14

  24. Number of Days Smoked LCCs in Past Week

    The mean number days that a participant reported smoking little cigars and cigarillos (LCCs) smoked in the past week

    Measured: day 21 (post test)

  25. Number of LCCs Smoked in the Past Week

    The mean number of little cigars and cigarillos (LCCs) smoked in the past week reported by participant

    Measured: day 7

  26. Number of LCCs Smoked in the Past Week

    The mean number of little cigars and cigarillos (LCCs) smoked in the past week reported by participant

    Measured: day 14

  27. Number of LCCs Smoked in the Past Week

    The mean number of little cigars and cigarillos (LCCs) smoked in the past week reported by participant

    Measured: day 21 (post test)

  28. Number of LCCs Butted Out in the Past Week

    The mean number of little cigars and cigarillos (LCCs) that participants reported butting out in the past week

    Measured: day 7

  29. Number of LCCs Butted Out in the Past Week

    The mean number of little cigars and cigarillos (LCCs) that participants reported butting out in the past week

    Measured: day 14

  30. Number of LCCs Butted Out in the Past Week

    The mean number of little cigars and cigarillos (LCCs) that participants reported butting out in the past week

    Measured: day 21 (post test)

  31. Number of LCCs Forgone in the Past Week

    The mean number of little cigars and cigarillos (LCCs) that participants reported forgoing in the past week

    Measured: day 7

  32. Number of LCCs Forgone in the Past Week

    The mean number of little cigars and cigarillos (LCCs) that participants reported forgoing in the past week

    Measured: day 14

  33. Number of LCCs Forgone in the Past Week

    The mean number of little cigars and cigarillos (LCCs) that participants reported forgoing in the past week

    Measured: day 21 (post test)

  34. LCC Quit Attempts in Past Week

    The number and percent of participants who reported trying to quit smoking little cigars and cigarillos (LCCs) in the past week

    Measured: day 7

  35. LCC Quit Attempts in Past Week

    The number and percent of participants who reported trying to quit smoking little cigars and cigarillos (LCCs) in the past week

    Measured: day 14

  36. LCC Quit Attempts in Past Week

    The number and percent of participants who reported trying to quit smoking little cigars and cigarillos (LCCs) in the past week

    Measured: day 21 (post test)

  37. LCC Quit Intentions

    Average quit intention score measured by survey. Quit intention measured with 3 questions, the final quit intention score is a mean of the response to the 3 questions, on a scale of 1 to 4, where 1 indicates low intention to quit, and 4 indicates a high intention to quit.

    Measured: day 7

  38. LCC Quit Intentions

    Average quit intention score measured by survey. Quit intention measured with 3 questions, the final quit intention score is a mean of the response to the 3 questions, on a scale of 1 to 4, where 1 indicates low intention to quit, and 4 indicates a high intention to quit.

    Measured: day 14

  39. Self Reported Learning

    Mean self-reported learning reported by participants. Self-reported learning measured with one item on a 1 to 5 scale, where 1 indicates no learning, and 5 indicates a great deal of learning from the warnings in the study. Self reported learning is only measured in conditions 1 and 2, the conditions that receive warnings.

    Measured: day 21 (post test)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 May 2023
  2. Study start22 May 2023
  3. Primary completion27 Aug 2023
  4. Study completion27 Aug 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
1,029 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05849051
Sponsor's protocol ID
22-2531
Other IDs
R01CA240732
Status last verified
Jan 2025
First submitted
26 Apr 2023
Last updated
8 Jan 2025
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: The investigators will make data collection instruments available for public use after data collection and analyses are complete. On request, the investigators will also make data sets available, stripped of individual identifiers, following publication of the study's main findings.

Publications

  • Goldstein AO, Jarman KL, Ranney LM, Cornacchione Ross J, Kowitt SD, Enyioha C, Clark SA, Sheeran P, Thrasher JF, Jenson D, Vielot NA. Little Cigar and Cigarillo Graphic Health Warnings and Quitting Behaviors: A Randomized Clinical Trial. JAMA Netw Open. 2025 Aug 1;8(8):e2526799. doi: 10.1001/jamanetworkopen.2025.26799.

    PubMed 40815515

Questions about this trial

What is this clinical trial studying?

A study testing Newly developed warnings with images at 30% size and FDA proposed text-only warnings at 30% size in people with Tobacco Use, run by UNC Lineberger Comprehensive Cancer Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 8 Jan 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 8 Jan 2025). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

LCC Quit Intentions (time frame: day 21 (post test)). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT05849051, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 Jan 2025.

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