Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey

Abstract

Background:Health warnings on cigarette packages are among the most common means of communicating the health risks of smoking. However, few studies have evaluated the impact of package warnings on consumer knowledge about tobacco risks.Objective:The aim of the current study was to use nationally representative samples of adult smokers from the United States (USA), the United Kingdom (UK), Canada (CAN), and Australia (AUS) from the International Tobacco Control Four Country Survey (ITC-4) to examine variations in smokers’ knowledge about tobacco risks and the impact of package warnings.Methods:A telephone survey was conducted with 9058 adult smokers from the following countries: USA (n = 2138), UK (n = 2401), CAN (n = 2214) and AUS (n = 2305). Respondents were asked to state whether they believed smoking caused heart disease, stroke, impotence, lung cancer in smokers, and lung cancer in non-smokers. Respondents were also asked whether the following chemicals are found in cigarette smoke: cyanide, arsenic and carbon monoxide.Findings:Smokers in the four countries exhibited significant gaps in their knowledge of the risks of smoking. Smokers who noticed the warnings were significantly more likely to endorse health risks, including lung cancer and heart disease. In each instance where labelling policies differed between countries, smokers living in countries with government mandated warnings reported greater health knowledge. For example, in Canada, where package warnings include information about the risks of impotence, smokers were 2.68 (2.41–2.97) times more likely to agree that smoking causes impotence compared to smokers from the other three countries.Conclusion:Smokers are not fully informed about the risks of smoking. Warnings that are graphic, larger, and more comprehensive in content are more effective in communicating the health risks of smoking.

Role of Tobacco Warning Labels in Informing Smokers about Risks of Smoking among Bus Drivers in Mangalore, India

“…However, Hammond et al, (2006) reported a higher knowledge about lung cancer in smokers (94.3%), heart disease (88.7%), stroke and lung cancer in non-smokers (73% and 70% respectively). However, knowledge regarding impotence associated with smoking was low, similar to findings of the present study.…”

“…The instrument was a self-administered, close ended, pre-validated questionnaire adapted from the International Tobacco Control-4 country survey (Hammond et al, 2006). Demographic details such as age, gender, education level, work experience and tobacco history was obtained from the respondents.…”

An image is worth a thousand words: the effects of visual health warnings in the decrease of tobacco consumption: a research from the perspective of social marketing

“…Debido a los pobres resultados obtenidos, resumidos anteriormente, un gran número de investigadores, entre los que citamos a Myers et al (1981), Daube (1982), Purdy y Luepnitz (1982), Riley et al (1982), Bhalla y Lastovicka (1984), Linthwaite (1985), Wogalter et al (1987), Magat et al (1988), Popper y Murray (1989), Wogalter et al (1989), Cragg (1990), Jaynes y Boles (1990), Young y Wogalter (1990), Beede, Lawson y Shepherd (1991), Young (1991), Laughery et al (1993), Barlow y Wogalter (1993), Fischer et al (1993), Naett y Howie (1993), Borland (1997), Liefeld (1999), Mahood (1999), Nilsson (1999), Duffy y Burton (2000), Hammond et al (2003), Hammond (2004), Hoeck et al (2005) y Hammond et al (2006), han cuestionado los esfuerzos necesarios para conseguir que las advertencias sanitarias sean más eficaces. Para ello, han experimentado con distintos elementos, como el tamaño (incremento de las palabras y formato de los anuncios), la forma (formas originales y presencia de iconos), el contraste de colores, la longitud del texto (más corto, más directo y simple), el contenido y el tono (uso de visuales chocantes).…”

An Assessment of the Relationship between Condom Labels and HIV-Related Beliefs and Intentions

“…Both alcohol and tobacco warning labels were found to be ineffective in preventing alcohol (MacKinnon, et al, 2000) and tobacco use (Robinson & Killen, 1997) among adolescents in the United States. However, tobacco warning labels with graphic imagery and more salient, specific messages like those in Canada and the United Kingdom were successful at increasing smokers' perceived health risks (Hammond et al, 2006) and increasing intentions to quit among smokers (Hammond et al, 2007).…”