Although e-cigarettes in the United States are required to carry one nicotine addiction warning, little is known about the impact of other potential e-cigarette warning themes, nor about pairing warnings with messages that communicate e-cigarettes’ reduced-harm potential relative to cigarettes. We randomly assigned 876 young adults (ages 18–29) to view e-cigarette ads in a 3 × 2 plus control online experiment that varied by warning theme (i.e., nicotine addiction; nicotine’s impact on adolescent brain development; presence of harmful chemicals) and warning type—i.e., the presence (“relative harm warning”) or absence (“standard warning”) of a relative harm (RH) statement in the warning label (“e-cigarettes may cause harm to health but are less harmful than cigarettes”). Warning believability, informativeness, understandability and support were high across conditions and there were no significant differences by warning theme on e-cigarette harm perceptions or use intentions nor on nicotine (mis)perceptions. Perceived warning effectiveness for discouraging youth initiation was higher for the “brain” and “chemicals” warnings compared to the addiction warning. Warnings with the included RH statement were perceived as less believable and credible and were less frequently correctly recalled. Research should continue to investigate the impact of different e-cigarette warning themes and formats with priority audiences.

Background: Framing used in health communication makes certain perspectives salient in order to persuade viewers of healthy behavior to improve mental health. Visuals used in these messages, however, do not always appropriately reflect the purpose of the written message and may interfere with message adherence. Because visuals communicate and elicit emotion more powerfully than text, it is important to investigate how visuals themselves are framed (i.e. what they make salient to viewers) and what effect they have on message effectiveness. Depression among college students provides context for this study, as college students suffer from depression more than other populations, and most do not seek help. Method: An online experiment assessed participants’ (N = 488) reactions to depression messages that incorporated visuals that were framed to reflect three stages of depression: suffering, treatment, recovery. Participants were randomly assigned to one of three message conditions in which they viewed three messages and responded to questions pertaining to affective reactions, perceived behavioral attainment, and aspiration. Results: Participants who viewed messages using recovery-related visual frames reported greater positive emotion and increased aspiration to be like the models in the visuals, while those who viewed suffering-related visual frames reported greater negative emotion and decreased aspiration to be like the models. Positive emotion mediated the relationship between recovery-related visual frames and aspiration. Conclusions: Depression messages that use recovery-related visual frames may be more effective than suffering visual frames in motivating help-seeking behaviors among college students with depressive symptoms.