Cigarette package health warnings can be an important and low-cost means of communicating the health risks of smoking. We examined whether viewing health warnings in an experimental study influenced beliefs about the health effects of smoking, by conducting surveys with ~500 adult male smokers and ~500 male and female youth (age 16–18) in Beijing, China (n = 1070), Mumbai area, India (n = 1012), Dhaka, Bangladesh (n = 1018), and Republic of Korea (n = 1362). Each respondent was randomly assigned to view and rate pictorial health warnings for 2 of 15 different health effects, after which they reported beliefs about whether smoking caused 12 health effects. Respondents who viewed relevant health warnings (vs. other warnings) were significantly more likely to believe that smoking caused that particular health effect, for several health effects in each sample. Approximately three-quarters of respondents in China (Beijing), Bangladesh (Dhaka), and Korea (which had general, text-only warnings) thought that cigarette packages should display more health information, compared to approximately half of respondents in the Mumbai area, India (which had detailed pictorial warnings). Pictorial health warnings that convey the risk of specific health effects from smoking can increase beliefs and knowledge about the health consequences of smoking, particularly for health effects that are lesser-known.

Consistent with research from high-income countries, these findings highlight the importance of selecting imagery that will elicit negative emotional reactions and be perceived as credible. Differential effects among adults and youth highlight the importance of pre-testing images.

BackgroundThere is strong evidence that plain cigarette packaging and health warning labels (HWLs) reduce brand appeal and increase health knowledge. There is limited evidence examining this population-level public health approach for cannabis packaging. This issue is of particular importance in light of the recent legalization of recreational cannabis in Canada. The current study examined perceptions of plain packaging and HWLs for cannabis packages among young adults.MethodsAn online experimental study was conducted with a sample of university students in Alberta, Canada (n = 656). Respondents were randomly assigned to view cannabis packages in one of four conditions: Condition 1: branded pack, Condition 2: plain pack (uniform color, brand imagery removed, standardized font), Condition 3: branded pack with a HWL, and Condition 4: plain pack with a HWL. Respondents in Conditions 3 and 4 viewed five text-based HWLs, each corresponding to a health effect associated with cannabis use: (1) brain development, (2) mental health issues, (3) impaired driving, (4) nonlethal overdose, and (5) addiction. After viewing packs, respondents rated packs and health warnings on various measures.ResultsBranded packages without HWLs were rated as most appealing compared to all other packs (p < 0.001 for all contrasts). No differences were found in ratings of appeal when comparing branded and plain packs with HWLs. Warning messages for cognitive development and impaired driving were rated highest on levels of perceived effectiveness, believability, and fear, whereas the addiction warning was rated among the lowest. In general, there were gaps in health knowledge related to cannabis use, however after viewing packs with warnings (compared to viewing packs without warnings) levels of health knowledge increased across all health effects (p < 0.01 for all). Lastly, a significant majority of young adults reported they would purchase the branded pack without a HWL (39.5%), compared to all other pack types (p < 0.05 for all contrasts). The lowest proportion of young adults reported they would purchase a plain pack with a HWL (1.1%).ConclusionsPlain packaging and health warnings may reduce brand appeal and increase health knowledge among young adults.

BackgroundLittle research has examined the potential protective influence of religiosity against problem gambling; a common addictive behavior, and one with a host of associated negative health and social outcomes. The aims of this study were to examine (1) the potential longitudinal association between religiosity and problem gambling among adults and (2) the potential moderating role of gender on this association.MethodsData were from five waves of the Quinte Longitudinal Study (QLS), between 2006 and 2010. Participants were Canadian adults from Belleville, Ontario, Canada (n = 4121). A multiple group (based on gender) latent growth curve analysis was conducted to examine the overall trajectory of problem gambling severity. Two models were tested; the first examined the influence of past-year religious service attendance, and the second examined an overall measure of personal religiosity on the trajectory of problem gambling. The Problem and Pathological Gambling Measure (PPGM) was used as a continuous measure. The Rohrbaugh-Jessor Religiosity Scale (RJRS) was used to assess past-year frequency of religious service attendance and personal religiosity. Religious affiliation (Protestant, Catholic, Atheist/Agnostic, Other, Prefer not to say) was also included in the models.ResultsAt baseline, higher frequency of past-year religious service attendance (males: β= −0.54, females: β= −0.68, p < 0.001 for both) and greater overall personal religiosity (males: β= −0.17, females: β= −0.13, p < 0.001 for both) were associated with lower PPGM scores. The moderating effect of gender indicated that the influence of past-year religious service attendance was greater among females (χ2diff(44) = 336.8, p < 0.001); however, the effect of overall religiosity was greater among males (χ2diff(36) = 213.4, p < 0.001). Findings were mixed with respect to religious affiliation. No measures of religiosity or religious affiliation were associated with the overall decline in problem gambling severity.ConclusionsThese findings suggest that religiosity may act as a static protective factor against problem gambling severity but may play a less significant role in predicting change in problem gambling severity over time.Electronic supplementary materialThe online version of this article (10.1186/s12888-017-1518-5) contains supplementary material, which is available to authorized users.