A comparison of on-pack Quitline information formats

Hoek, Janet; Gendall, Philip; Eckert, Christine; Rolls, Kirsty; Louviere, Jordan J.

doi:10.1136/tobaccocontrol-2014-051820

Cited by 20 publications

(14 citation statements)

References 32 publications

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“…gain-frame) messages about how and why to quit smoking, a recommendation supported by the Extended Parallel Process Model (41) of message communication. It remains to be investigated whether adding a smoking cessation resource and call-to-action (such as a Quitline or stop-smoking web address) alongside the health warning, as is now common practice for many countries, is also effective (54).…”

Section: Discussionmentioning

confidence: 99%

Avoidance of tobacco health warnings? An eye-tracking approach

Sillero‐Rejon¹,

Leonards²,

Munafò³

et al. 2019

Preprint

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Aims: Across three eye-tracking studies, we examined how the location, framing, immediacy, and severity of health warnings on branded cigarette packs affected visual attention and self-reported avoidance of and reactance to warnings. Design: Study 1: smoking status × warning immediacy (short-term vs. long-term) × warning location (top of back vs. bottom of pack). Study 2: smoking status × warning framing (gain-framed vs. loss-framed) × warning format (text-only vs. pictorial). Study 3: smoking status × warning severity (highly-severe vs. moderately-severe). Setting: University of Bristol, UK, eye-tracking laboratory. Participants Study 1: non-smokers (n=25), weekly smokers (n=25), and daily smokers (n=25). Study 2: non-smokers (n=37), smokers contemplating quitting (n=37) and smokers not contemplating quitting (n=43). Study 3: non-smokers (n=27), weekly smokers (n=26) and daily smokers (n=26). Measurements: For all studies: relative number of fixations to the warning vs. the brand, self-reported avoidance of and reactance to warnings and for Study 3: effect of warning on quitting motivation. Findings: Study 1: Greater self-reported avoidance (p<0.001) and greater visual attention (p=0.03) to long-term warnings, but no difference for reactance (p=0.12). Increased visual attention to warnings on the upper- versus lower-half of the pack (p=0.02). Study 2: Higher self-reported avoidance of (p<0.001) and reactance to (p<0.001) loss-framed warnings but little evidence of a difference for visual attention (p=0.30). Greater visual attention, avoidance and reactance to pictorial versus text-only warnings (all ps>0.001). Study 3: Greater self-reported avoidance of (p<0.001) and reactance (p=0.003) to highly-severe warnings but no clear difference in visual attention (p=0.24). Conclusions: Subjective (self-report) and objective (eye-tracking) measures of warning avoidance produced different outcomes, suggesting these capture different constructs. Visual avoidance of warnings indicates low-level disengagement with warnings, while self-reported avoidance reflects higher-level cognitive awareness and engagement with warnings. We suggest that loss-framed, long-term, highly-severe images are likely to be most effective in communicating harm.

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Section: Discussionmentioning

confidence: 99%

Avoidance of tobacco health warnings? An eye-tracking approach

Sillero‐Rejon¹,

Leonards²,

Munafò³

et al. 2019

Preprint

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“…According to theoretical models of the persuasive impact of threatening messages [ 58 ], it is advisable to juxtapose them with reassuring ones (e.g., the positive effects of giving up smoking, encouragement to quit, information on quitting, etc.) to increase their impact on behaviors [ 59 , 60 ]. Recent research has underlined that the combination of TVWs with positive and salient information on/in packs (inserts, quit-line telephone numbers, etc.)…”

Section: Discussionmentioning

confidence: 99%

The influence of threatening visual warnings on tobacco packaging: Measuring the impact of threat level, image size, and type of pack through psychophysiological and self-report methods

et al. 2017

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The first aim of this research was to assess the effectiveness, in terms of emotional and behavioral reactions, of moderately vs. highly TVWs (Threatening Visual Warnings) displayed on tobacco packs. Given the key role that emotional reactions play in explaining the effect of TVWs on behaviors, psychophysiological and self-report methods were used–for the first time in this context–to measure the emotions provoked by TVWs. The second aim of this research was to determine whether increasing the size of warnings, and their display on plain packaging (compared with branded packaging) would improve their effectiveness.A within-subjects experiment was conducted. Three variables were manipulated: health warning threat level (high vs. moderate), image size (40% vs. 75%) and pack type (plain vs. branded). A convenience sample of 48 French daily smokers participated. They were exposed to eight different packs of cigarettes in a research lab at the University of Rennes. Smokers’ emotions and behavioral intentions were recorded through self-reports. Emotions were also evaluated using psychophysiological measurements: electrodermal activity and facial electromyography. The results revealed that TVWs with a high threat level are the most effective in increasing negative emotions (fear, disgust, valence, arousal) and behavioral intentions conducive to public health (desire to quit, etc.). They also highlight the appeal of increasing the size of the warnings and displaying them on plain packs, because this influences emotions, which is the first step toward behavioral change.Increasing the threat level of TVWs from moderate to high seems beneficial for public health. Our results also confirm the relevance of recent governmental decisions to adopt plain packaging and larger TVWs (in the UK, France, Ireland, Canada, New Zealand, Hungary, etc.).

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“…Participants viewed the e-cigarette ad stimuli for as long as they wished, and then completed e-cigarette outcome measures. While viewing the ads, participants in the Ad Only and Ad with Warning conditions also completed a heat map task where they were asked to identify up to 5 areas in the e-cigarette ads that attracted their attention by pointing their cursor and clicking on the areas of the e-cigarette ad image [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

An experimental study of the effects of electronic cigarette warnings on young adult nonsmokers’ perceptions and behavioral intentions

Mays¹,

Smith²,

Johnson³

et al. 2016

Tob. Induced Dis.

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BackgroundElectronic cigarette (“e-cigarette”) manufacturers use warning labels on their advertising that vary widely in content and the U.S. Food and Drug Administration has issued a warning label requirement for e-cigarettes. There is limited data on the effects of these warnings on e-cigarette perceptions and other potential predictors of future tobacco use behavior in populations of interest to inform future regulatory requirements. This study examined the effects of e-cigarette warnings on perceptions of e-cigarettes and cigarettes and other cognitive precursors to tobacco use among young adult non-smokers.MethodsNon-smoking young adults ages 18 to 30 years (n = 436) were recruited through an internet-based crowdsourcing platform for an online experiment. Participants completed pre-exposure measures of demographics, tobacco use, and other relevant constructs and were randomized to view 1 of 9 e-cigarette stimuli in a 3 (Ad/Warning condition: Ad Only, Ad with Warning, Warning Only) x 3 (E-cigarette brand: Blu, MarkTen, Vuse) design. After viewing e-cigarette stimuli, participants reported perceptions of e-cigarettes and behavioral intentions to use e-cigarettes. Participants in the Ad Only and Ad with Warning conditions also completed a heat-mapping task assessing aspects of the ads that captured their attention. Then, participants were randomized to view cigarette ads from 1 of 3 major cigarette brands and reported perceptions of cigarettes and intentions to smoke cigarettes.ResultsParticipants in the Warning Only condition reported significantly greater perceived harm and addictiveness of e-cigarettes and thoughts about not using e-cigarettes than the Ad Only and Ad with Warning conditions (p’s < .05). The Ad Only and Ad with Warning conditions did not differ on these outcomes. Participants in the Warning Only condition also reported the harms of e-cigarettes were closer to those of cigarettes than the Ad Only condition (p < .05), but neither differed from the Ad with Warning condition. Visual inspection of heat-mapping task data indicate warnings drew few participants’ attention. There were no significant differences across study conditions on perceptions of cigarettes or intentions to smoke.ConclusionsText-based warning messages influenced young non-smokers’ perceptions in a way that may dissuade e-cigarette use, but warnings appearing on advertisements had little impact.Electronic supplementary materialThe online version of this article (doi:10.1186/s12971-016-0083-x) contains supplementary material, which is available to authorized users.

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A comparison of on-pack Quitline information formats

Cited by 20 publications

References 32 publications

Avoidance of tobacco health warnings? An eye-tracking approach

Avoidance of tobacco health warnings? An eye-tracking approach

The influence of threatening visual warnings on tobacco packaging: Measuring the impact of threat level, image size, and type of pack through psychophysiological and self-report methods

An experimental study of the effects of electronic cigarette warnings on young adult nonsmokers’ perceptions and behavioral intentions

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