Original Investigation

Little Cigar and Cigarillo Graphic Health Warnings and Quitting Behaviors

JAMA Network Open 10.1001/jamanetworkopen.2025.26799

August 15, 2025 at 11:00 AM EDT

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Do graphic health warnings (GHWs) on little cigars and cigarillos (LCCs) improve intention to quit smoking and quitting behaviors?This 3-week randomized clinical trial of 1029 adults showed that those who smoked LCCs and were exposed to LCC GHWs reported significantly higher quitting behaviors compared with those exposed to existing US Food and Drug Administration text-only LCC warnings or a control condition.This study provides the first evidence that LCC GHWs effectively increase quitting behaviors, offering support for policies mandating LCC GHWs to address public health concerns of LCC use in the US and internationally.

Corresponding Author: Adam O. Goldstein, MD, MPH, Department of Family Medicine, University of North Carolina School of Medicine, CB 7595, Manning Drive, Chapel Hill, NC 27599 (aog@med.unc.edu).

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