Pictorial Health Warnings on Cigarette Packs in the United States: An Experimental Evaluation of the Proposed FDA Warnings

Hammond, David; Reid, Jessica L.; Driezen, Pete; Boudreau, Christian

doi:10.1093/ntr/nts094

Cited by 114 publications

(120 citation statements)

References 14 publications

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“…Literature examining GHWs on tobacco packages were reviewed [31][32][33][34][35][36] , from which relevant survey questions were adjusted to develop an instrument to address this study's goals. The survey's content validity was determined through multiple separate reviews and discussions among the study's authors.…”

Section: Study Toolsmentioning

confidence: 99%

Graphic health warnings and their best position on waterpipes: A cross-sectional survey of expert and public opinion

Mostafa¹,

Mohammed²

2017

Tob. Prev. Cessation

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INTRODUCTION Our aim was to assess the visibility and efficiency of graphic health warnings (GHWs) on waterpipe tobacco packs (WTPs) and to explore other more effective places to display them for better impact. We also evaluated the visibility of GHWs when placed on the waterpipe device. METHODS We conducted 3 cross-sectional study phases using face-to-face survey questionnaires in 2014-2015. Phase I surveyed 31 tobacco control experts, while Phase II surveyed 700 participants and Phase III surveyed 348 from the public in Cairo, Egypt. RESULTS Approximately half of the experts and participants in Phases II and III thought that GHWs on WTPs are not adequately visible, and 68.9% and 79.6% in Phases II and III, respectively, suggested posting warnings also in other places. About one-third of experts and 69.1% of Phase II participants suggested posting GHWs inside cafés or in public places, while 46.9% of Phase III participants favored placing them on waterpipes. After viewing our suggested positions on a waterpipe, all experts, 80.6% of participants in Phase II, and 81.6% in Phase III acknowledged that GHWs would be more visible there. The mouthpiece was the location selected most often across all phases (31.1% in Phase I, 35.6% in Phase II and 36.3% in Phase III). Lung and throat cancers were similarly effective in raising participants' concern about waterpipe smoking health risks (24.7%). CONCLUSIONS This is the first population-based study to explore the best location to place GHWs on waterpipes. Policymakers should consider enacting a regulatory framework for placing GHWs on waterpipe devices.

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Section: Study Toolsmentioning

confidence: 99%

Graphic health warnings and their best position on waterpipes: A cross-sectional survey of expert and public opinion

Mostafa¹,

Mohammed²

2017

Tob. Prev. Cessation

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“…5,6 In general population samples, GWLs have been found to be more effective than TWLs. [6][7][8][9][10] GWLs in Canada significantly decreased smoking rates by 3-4 percentage points over 9 years relative to the United States. 8 GWLs have also increased knowledge about tobacco harms, discouraged nonsmokers from experimenting, prevented former smokers from relapsing, and increased smokers' intentions and attempts to quit, even discouraging them from having a cigarette when they were about to.…”

Section: Assessing the Consequences Of Implementing Graphic Warning Lmentioning

confidence: 99%

Assessing the Consequences of Implementing Graphic Warning Labels on Cigarette Packs for Tobacco-Related Health Disparities

Gibson

Brennan

Momjian

et al. 2015

NICTOB

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Introduction: Population-level communication interventions, such as graphic warning labels (GWLs) on cigarette packs, have the potential to reduce or exacerbate tobacco-related health disparities depending on their effectiveness among disadvantaged sub-populations. This study evaluated the likely impact of nine GWLs proposed by the US Food and Drug Administration on (1) African American and (2) Hispanic smokers, who disproportionately bear the burden of tobaccorelated illness, and (3) low education smokers, who have higher smoking rates. Methods: Data were collected online from current smokers randomly assigned to see GWLs (treatment) or the current text-only warning labels (control). Participants were stratified by age (18-25; 26+) in each of four groups: general population (n = 1246), African Americans (n = 1200), Hispanics (n = 1200), and low education (n = 1790). We tested the effectiveness of GWLs compared to textonly warning labels using eight outcomes that are predictive of quitting intentions or behaviors including negative emotion, intentions to hold back from smoking, intentions to engage in avoidance behaviors, and intentions to quit. Results: Across all outcomes, GWLs were significantly more effective than text-only warning labels more often than expected by chance. Results suggested that African Americans, Hispanics and smokers with low education did not differ from the general population of smokers in their reactions to any of the nine individual GWLs. Conclusions: The nine GWLs were similarly effective for disadvantaged sub-populations and the general population of smokers. Implementation of GWLs is therefore unlikely to reduce or exacerbate existing tobacco-related health disparities, but will most likely uniformly increase intentions and behaviors predictive of smoking cessation.

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“…Las imágenes de advertencia muestran el impacto negativo del consumo de tabaco mediante imágenes impactantes, y pretenden promover conductas de rechazo hacia el consumo (Farrelly et al, 2008). Esta estrategia ha demostrado ser efectiva para un amplio grupo de personas (Borland et al, 2009;Hammond, Reid, Driezen y Boudreau, 2013;Hammond et al, 2012;Thrasher et al, 2012), particularmente aquellas que han iniciado recientemente la conducta de fumar y aquellas que están interesadas en abandonarlo, especialmente cuando las imágenes de advertencia son muy visibles y señalan los efectos negativos del consumo de tabaco (Hammond, Fong, McNeill, Borland y Cummings, 2006). El estudio de la respuesta emocional hacia las imágenes de advertencia se ha limitado, por lo general, al uso de encuestas y grupos focales (Hammond, 2011), los resultados de estas investigaciones muestran que las imágenes son más efectivas para comunicar el mensaje de daño y peligro en comparación a cuando sólo se usa el mensaje en texto (Vardavas, Connolly, Karamanolis y Kafatos, 2009) y que los fumadores reportan algún grado de miedo, asco o ira ante las imágenes de advertencia, y que las emociones de miedo y asco se asocian a la disminución del consumo de tabaco posteriormente (Hammond, Fong, McDonald, Brown y Cameron, 2004).…”

Section: Introductionunclassified

Respuestas faciales ante imágenes de advertencia de tabaco

2016

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ResumenEn 2003, la Comisión Europea propuso una serie de advertencias visuales para ser incluidas en los embalajes de tabaco, con el objetivo de motivar a los fumadores a dejar de fumar y promover actitudes negativas hacia el tabaco. El objetivo de este estudio fue evaluar el impacto de las advertencias sanitarias mediante autoinformes y medidas psicofisiológicas. Cincuenta sujetos sanos (19-23 años) visionaron un conjunto de treinta y seis imágenes de diferente contenido emocional y veinticuatro del banco de imágenes preventivas propuestas por la Comisión Europea. Se registró la actividad eléctrica de los músculos cigomático mayor y corrugador mientras los sujetos visionaban estas imágenes. A continuación, los participantes evaluaban las imágenes en las dimensiones de agradabilidad y activación. Los resultados muestran una mayor actividad eléctrica del musculo corrugador ante la presentación de imágenes desagradables comparadas con advertencias desagradables incluidas en los paquetes de tabaco. Estos resultados sugieren que la campaña preventiva podría beneficiarse de imágenes preventivas más impactantes, promoviendo así la activación del sistema motivacional evitativo/defensivo. Palabrasclave: advertencias sanitarias antitabaco; motivación; emoción. AbstractIn 2003, the European Commission proposed a series of visual warnings to be included on the packaging of tobacco, with the target of motivating smokers to quit and promoting negative attitudes

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Pictorial Health Warnings on Cigarette Packs in the United States: An Experimental Evaluation of the Proposed FDA Warnings

Cited by 114 publications

References 14 publications

Graphic health warnings and their best position on waterpipes: A cross-sectional survey of expert and public opinion

Graphic health warnings and their best position on waterpipes: A cross-sectional survey of expert and public opinion

Assessing the Consequences of Implementing Graphic Warning Labels on Cigarette Packs for Tobacco-Related Health Disparities

Respuestas faciales ante imágenes de advertencia de tabaco

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