NCT03723616 is a NA clinical trial of Ads Only in Reactions to Warnings, sponsored by Duke University.

Who is sponsoring NCT03723616?

NCT03723616 is sponsored by Duke University.

What drugs are being tested in NCT03723616?

Interventions in NCT03723616: Ads Only, Ads with text-only health warning labels (HWLs), Ads with text + graphic health warning labels (HWLs).

What condition does NCT03723616 study?

NCT03723616 studies Reactions to Warnings, Hookah Smoking.

Is NCT03723616 still recruiting?

NCT03723616 is currently completed. Last updated 18 December 2025.

Are results published for NCT03723616?

Yes — primary outcome results have been posted to ClinicalTrials.gov. See the outcomes section above for details.

Last reviewed 2025-12-18 · How we verify

NCT03723616

Name: Drug Landscape Pharmaceutical Database
Creator: Drug Landscape
Published: 2026-01-01
License: https://creativecommons.org/licenses/by/4.0/

Reactions to Warnings on Hookah Ads

Completed NA Results posted Last updated 18 December 2025

What this trial tests

NA trial testing Ads Only in Reactions to Warnings in 2,588 participants. Completed in 26 March 2021.

Timeline

5 October 2018

Primary endpoint
26 March 2021

26 March 2021

Quick facts

Lead sponsor	Duke University
Phase	NA
Status	Completed
Study type	INTERVENTIONAL
Allocation	randomized
Design	parallel
Masking	single
Primary purpose	other
Enrollment	2,588
Start date	5 October 2018
Primary completion	26 March 2021
Estimated completion	26 March 2021
Sites	1 location across United States

Drugs / interventions tested

Ads Only
Ads with text-only health warning labels (HWLs)
Ads with text + graphic health warning labels (HWLs)

Conditions studied

Reactions to Warnings — all drugs for Reactions to Warnings →
Hookah Smoking — all drugs for Hookah Smoking →

Sponsor

Duke University

Who can join

Adults 18 to 34, any sex, with Reactions to Warnings or Hookah Smoking. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Emotional Reactions to Ads Primary · up to 45 minutes

Participants rated on 7-point bipolar scales the extent each ad made them feel not at all anxious/very anxious, not at all worried/very worried, not at all fearful/very fearful and good /bad. Reported as a composite score created by averaging the items. Mean scores range from 1 to 7 where higher mean values represent more negative emotional reactions to viewing the ad.

Group	Value	95% CI
Social Allure Ads Only	2.81	± 0.08
Social Allure Ads With Text-only Health Warning Labels (HWLs)	3.46	± 0.06
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	3.74	± 0.06
Product Ads Only	2.83	± 0.10
Product Ads With Text-only Health Warning Labels (HWLs)	3.60	± 0.07
Product Ads With Text + Graphic Health Warning Labels (HWLs)	4.03	± 0.07

Attitudes Toward Waterpipe Tobacco Smoking (WTS) as Measured by Questionnaire Primary · up to 45 minutes

Participant rated on 9-point bipolar scale an ad's portrayal of WTS. The five attributes that tapped cognitions were: safe/unsafe, healthy/unhealthy, useful/useless, harmful/beneficial, and wise/foolish. The five attributes that captured affect were: pleasant/unpleasant, nice/nasty, enjoyable/not enjoyable, satisfying/unsatisfying, gratifying/revolting. Reported as a composite score created by averaging the items. The mean scores could range from 1 to 7 where a higher mean score reflects a more negative attitude towards WTS.

Group	Value	95% CI
Social Allure Ads Only	3.79	± 0.08
Social Allure Ads With Text-only Health Warning Labels (HWLs)	4.59	± 0.06
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	4.84	± 0.06
Product Ads Only	3.87	± 0.10
Product Ads With Text-only Health Warning Labels (HWLs)	4.88	± 0.07
Product Ads With Text + Graphic Health Warning Labels (HWLs)	5.31	± 0.07

Reactance to Ads Primary · up to 45 minutes

Two items from the University of North Carolina (UNC) short reactance scale were asked from 1=strongly disagree to 7=strongly agree: "This ad is trying to manipulate me", and "This ad annoys me." Reported as a composite score created by averaging the items. Mean scores can range from 1 to 7. A higher mean score reflect higher reactance, meaning that participants felt more reactance (e.g., felt their freedoms were being taken away).

Group	Value	95% CI
Social Allure Ads Only	3.87	± 0.08
Social Allure Ads With Text-only Health Warning Labels (HWLs)	3.99	± 0.06
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	3.91	± 0.06
Product Ads Only	3.47	± 0.10
Product Ads With Text-only Health Warning Labels (HWLs)	3.79	± 0.07
Product Ads With Text + Graphic Health Warning Labels (HWLs)	3.82	± 0.07

Perceived Effectiveness of Health Warnings Primary · up to 45 minutes

Participants used a three-item measure as a gestalt assessment of how well an ad dissuaded WTS. The three items, rated from 1=strongly disagree to 7=strongly agree were: "This ad discourages me from wanting to smoke waterpipe tobacco", "This ad makes me concerned about the health effects of smoking waterpipe tobacco", and "This ad makes smoking waterpipe tobacco seem unpleasant to me". Reported as a composite score created by averaging the items. The mean score could ranged from 1 to 7. A higher mean score reflects that the ad was more effective at dissuading WTS.

Group	Value	95% CI
Social Allure Ads Only	2.89	± 0.09
Social Allure Ads With Text-only Health Warning Labels (HWLs)	3.88	± 0.06
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	4.13	± 0.06
Product Ads Only	3.09	± 0.11
Product Ads With Text-only Health Warning Labels (HWLs)	4.15	± 0.07
Product Ads With Text + Graphic Health Warning Labels (HWLs)	4.46	± 0.07

Ad Effect on Desire to Smoke Primary · up to 45 minutes

Participants were asked, "To what extent did this ad affect your desire to smoke waterpipe tobacco?" from 1=Reduced my desire a lot to 7=Increased my desire a lot. Mean scores could range from 1 to 7. A higher mean score reflects that the ad increased a participant's desire to smoke waterpipe tobacco.

Group	Value	95% CI
Social Allure Ads Only	4.37	± 0.08
Social Allure Ads With Text-only Health Warning Labels (HWLs)	4.07	± 0.06
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	3.89	± 0.06
Product Ads Only	4.70	± 0.10
Product Ads With Text-only Health Warning Labels (HWLs)	4.03	± 0.07
Product Ads With Text + Graphic Health Warning Labels (HWLs)	3.79	± 0.07

Ad Effect on Event Participation Primary · up to 45 minutes

Participants who completed the social allure study were asked, "If the activities in the ad were to take place in a location near you, how likely are you to participate in those activities?". Response options were: 1=No chance, 2=Very unlikely, 3=Unlikely, 4=Moderately likely, 5=Likely, 6=Very Likely, and 7=Certain to happen. Mean scores could range from 1 to 7. A higher mean score reflects a higher probability that the participant would participate in the event depicted in the ad.

Group	Value	95% CI
Social Allure Ads Only	3.58	± 0.09
Social Allure Ads With Text-only Health Warning Labels (HWLs)	3.52	± 0.06
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	3.43	± 0.06

Ad Effect on Product Purchase Primary · up to 45 minutes

Participants who completed the social allure study were asked, "How likely are you to buy the product in the ad?". Response options were: 1=No chance, 2=Very unlikely, 3=Unlikely, 4=Moderately likely, 5=Likely, 6=Very Likely, and 7=Certain to happen. Means scores could range from 1 to 7. A higher mean score reflects that the study participant would have a higher probability of purchasing the product depicted in the ad.

Group	Value	95% CI
Product Ads Only	4.04	± 0.13
Product Ads With Text-only Health Warning Labels (HWLs)	3.51	± 0.09
Product Ads With Text + Graphic Health Warning Labels (HWLs)	3.38	± 0.09

Perceived Risk as Measured by Questionnaire Secondary · up to 45 minutes

Participants responded to three questions tapping perceived personal risk, "What do you think is your chance of getting a serious smoking-related disease in your lifetime, such as cancer, lung disease or heart disease, if you do not quit waterpipe tobacco smoking?" (1=No chance to 7=Certain to happen), "How worried are you about getting a serious smoking-related disease in your lifetime, such as cancer, lung disease, or heart disease, if you do not quit waterpipe tobacco smoking?" (1=Not at all worried to 7=Extremely worried, and "Your 'gut feeling' tells you that you are hurting your health w

Group	Value	95% CI
Social Allure Ads Only	4.71	± 0.07
Social Allure Ads With Text-only Health Warning Labels (HWLs)	4.93	± 0.05
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	5.03	± 0.05
Product Ads Only	4.73	± 0.10
Product Ads With Text-only Health Warning Labels (HWLs)	4.98	± 0.07
Product Ads With Text + Graphic Health Warning Labels (HWLs)	4.90	± 0.07

Global Attitude on Waterpipe Tobacco Smoking (WTS) Secondary · up to 45 minutes

Four 7-point bipolar scales tapped views on WTS: negative/positive, dislike/like, bad/good, undesirable/desirable. Reported as a composite score created by averaging the items. The mean scores range from 1 to 7. A higher mean score reflect a more positive overall attitudes towards smoking waterpipe tobacco.

Group	Value	95% CI
Social Allure Ads Only	4.14	± 0.10
Social Allure Ads With Text-only Health Warning Labels (HWLs)	3.83	± 0.07
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	3.61	± 0.07
Product Ads Only	4.39	± 0.12
Product Ads With Text-only Health Warning Labels (HWLs)	3.85	± 0.08
Product Ads With Text + Graphic Health Warning Labels (HWLs)	3.79	± 0.09

Urge to Smoke Secondary · up to 45 minutes

Assessed from 1=Not at all strong to 7=Extremely strong by, "How strong is your urge to smoke waterpipe tobacco right now?" Mean scores range from 1 to 7. A higher mean score reflects the participant had a stronger urge to smoke waterpipe tobacco.

Group	Value	95% CI
Social Allure Ads Only	3.34	± 0.12
Social Allure Ads With Text-only Health Warning Labels (HWLs)	3.28	± 0.08
Social Allure Ads With Text + Graphic Health Warning Labels (HWLs)	3.06	± 0.08
Product Ads Only	3.82	± 0.14
Product Ads With Text-only Health Warning Labels (HWLs)	3.29	± 0.10
Product Ads With Text + Graphic Health Warning Labels (HWLs)	3.27	± 0.10

Sponsor's own description

The purpose of this study is to help us better understand what kinds of waterpipe tobacco advertisements appeal to young adults as well as to help evaluate and create health warnings that can be placed on waterpipe tobacco advertisements to inform young adults of the risks associated with smoking hookah tobacco.

Publications & conference data

No peer-reviewed publications indexed yet for this trial. Completed trials usually publish results within 12-18 months.

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Verify against primary sources

ClinicalTrials.gov — authoritative US registry record
WHO ICTRP — international registry index
EU Clinical Trials Register
Sponsor press releases (Google)

Data sources for this page

Trial protocol + status: ClinicalTrials.gov NCT03723616 (US National Library of Medicine, public domain)
Drug + disease cross-links: matched in real time against Drug Landscape's normalised drug + company + condition tables
Sponsor: as reported to ClinicalTrials.gov by Duke University
Last refreshed: 18 December 2025

Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT03723616.

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