Graphic Health Warnings on Cigarette Packs: How Long Before the Effects on Adolescents Wear Out?

White, Victoria; Bariola, Emily; Faulkner, Agatha; Coomber, Kerri; Wakefield, Melanie

doi:10.1093/ntr/ntu184

Cited by 41 publications

(39 citation statements)

References 23 publications

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“…On the other hand, the lack of effect associated with graphic health warnings is consistent with the results of Wakefield et al 19 . This does not mean that the measure is ineffective as graphic health warnings were introduced in the middle of the implementation of strict smoking bans and the dichotomous ghw indicator may be ill-suited to represent their characteristic wear-in/wear-out effect 29 .…”

Section: Tobacco Prevention and Cessationmentioning

confidence: 99%

Refuting tobacco-industry funded research: empirical data shows decline in smoking prevalence following introduction of plain packaging in Australia

Diethelm¹,

Farley²

2015

Tob. Prev. Cessation

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IntroductIon Legislation to introduce plain packaging of tobacco products, advocated as an important tobacco control policy in the Framework Convention on Tobacco Control, has been vigorously attacked by the tobacco industry on the grounds that it results in no measurable impact on smoking rates. This claim is based on two industry-funded working papers that examined trends in smoking prevalence in Australia.objectIve To assess the effect of plain packaging on smoking prevalence in Australia, taking into account key tobacco control measures introduced over the period [2001][2002][2003][2004][2005][2006][2007][2008][2009][2010][2011][2012][2013], which could potentially act as confounders, with the aim of investigating the findings of the industry-funded papers. MethodsMonthly smoking prevalence and sample sizes from repeat cross-sectional surveys were reconstructed from the working paper by reverse engineering of the industry presented data and analysed as a time series using logistic regression. Indicator variables reflecting comprehensive smokefree policy, graphic health warnings, 25% taxation increase, and introduction of plain packaging were constructed from official information.results Smoking prevalence in Australia declined from 25% to 18% over the 13 year period examined -an overall 28% relative reduction or an average annual reduction of 2.8% (95% confidence interval 2.6% -2.9%). A significantly improved fit was obtained by the full model which included terms for tax increase (4.8%, 2.7% -6.8% reduction), comprehensive smoke-free policy (4.5%, 1.7% -7.2% reduction) and plain packaging (3.7%, 1.1% -6.2% reduction) in addition to an adjusted average annual reduction of 1.7% (1.3% -2.2%).conclusIons A significant decline in smoking prevalence in Australia followed the introduction of plain packaging, after adjusting for the impact of other tobacco control measures. This conclusion is in marked contrast to that of the industry-funded analysis. IntroductIonGuidelines on Article 13 of the WHO Framework-convention for Tobacco Control explain how Parties can fulfil their treaty obligations with respect to enacting and enforcing a comprehensive ban on tobacco advertising, promotion and sponsorship. Among the proposed measures, Parties are invited "to restrict or prohibit the use of logos, colours, brand images or promotional information on packaging other than brand names and product names displayed in a standard colour and font style."1 Australia was the first country to introduce this proposal by adopting the Tobacco Plain Packaging Act in November 2011 with progressive implementation between 1st October and 1st December 2012 2,3 . The objectives of the plain (or standardized) packaging measure are to: "(a) reduce the appeal of tobacco products to consumers; and (b) increase the effectiveness of health warnings on the retail packaging of tobacco products; and (c) reduce the ability of the retail packaging of tobacco products to mislead consumers about the harmful effects of smoking or using tobacco pro...

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Section: Tobacco Prevention and Cessationmentioning

confidence: 99%

Refuting tobacco-industry funded research: empirical data shows decline in smoking prevalence following introduction of plain packaging in Australia

Diethelm¹,

Farley²

2015

Tob. Prev. Cessation

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“…Because the extent of PHWs' wear-out is differ from country to country and depends on the specific PHWs implemented (Moodie et al, 2013;White et al, 2014;Auemaneekul et al, 2015;Li et al, 2015), it is important to find out how long the salience may reach its peak in Vietnam to determine the appropriate time for rotation cycle and routinely refreshing the PHWs. For instance, the set of PHWs is changed every 12 months in Belgium, Australia, New Zealand and every 24 months in Switzerland (Canadian Cancer Society, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…After that peak, the warnings are supposed to lose some of their impact with time (Hammond et al, 2006;Borland et al, 2009b;Miller et al, 2009 , 2010). The extent of PHW wear-out is differ from country to country and depends on the specific PHWs implemented (Moodie et al, 2013;White et al, 2014;Auemaneekul et al, 2015;Li et al, 2015). Hence, it is important to understand the trend of change in 1) PHWs' salience and 2) reaction of smokers towards the PHWs as well as influence of that trend on smokers' intention to quit.…”

Section: Introductionmentioning

confidence: 99%

Changes in Vietnamese Male Smokers' Reactions Towards New Pictorial Cigarette Pack Warnings Over Time

Ngan

Anh²,

et al. 2016

Asian Pacific Journal of Cancer Prevention

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Printing of pictorial health warnings (PHWs) on cigarette packages became obligatory by the Vietnam Law on Prevention and Control of Tobacco Harm in May 2013. Literature from high-income countries suggests that PHWs motivate smokers to quit smoking although their long-term effects have been questioned due to reduction of impact over time. This study aimed to assess the salience of PHWs and smokers' reactions towards PHWs over time. In May 2014 and May 2015, a cross-sectional questionnaire-based household survey was administered to respectively 1,462 and 1,509 Vietnamese male smokers aged 18 to 35. The result showed that salience of the PHWs 2 years after the implementation was higher than at the point of 1 year after the implementation. The proportion of respondents who tried to avoid noting the PHWs was reduced from 35% in wave 1 to 23% in wave 2. However, "Tried to avoid looking/thinking about the PHWs" increased 1.5 times the odds of presenting quit intention compared to those respondents who did not try to avoid looking/thinking about the PHWs (OR=1.5; 95%CI: 1.2-2.0). In conclusion, avoidance regarding PHWs may not work as a barrier when aiming at a higher level of quit intention. Salience of the PHWs may increase in the period shortly after their introduction onto packs but can be expected to decrease with time. In other words, it might be advisable to change or renew PHWs after a period of implementation to maintain their beneficial effects.

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“…The purpose of this is to further increase the number of app users and to counteract the diminishing salience of the original posters to the students over time, a process which has been described in detail with graphic health warnings. 17 However, since no selfie looks the same, we expect that at least the pupils who installed the app do not get used to the effects as fast as this is the case with graphic health warnings.…”

Section: Letters To Students Teachers and Parentsmentioning

confidence: 99%

Photoaging smartphone app promoting poster campaign to reduce smoking prevalence in secondary schools: the Smokerface Randomized Trial: design and baseline characteristics

et al. 2016

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IntroductionSmoking is the largest cause of preventable death globally. Most smokers smoke their first cigarette in early adolescence. We took advantage of the widespread availability of mobile phones and adolescents’ interest in appearance to develop a free photoaging app which is promoted via a poster campaign in secondary schools. This study aims to evaluate its effectiveness regarding smoking prevalence and students’ attitudes towards smoking.Methods and analysisA randomised controlled trial is conducted with 9851 students of both genders with an average age of 12 years in grades 6 and 7 of 126 secondary schools in Germany. At present, cigarette smoking prevalence in our sample is 4.7%, with 4.6% of the students currently using e-cigarettes (1.6% use both). The prospective experimental study design includes measurements at baseline and at 6, 12 and 24 months postintervention via a questionnaire plus a random cotinine saliva sample at 24 months postintervention. The study groups consist of randomised schools receiving the Smokerface poster campaign and control schools with comparable baseline data (no intervention). The primary end point is the difference of change in smoking prevalence in the intervention group versus the difference in the control group at 24 months follow-up. Longitudinal changes in smoking-related attitudes, the number of new smokers and quitters and the change in the number of never-smokers will be compared between the two groups as secondary outcomes.Ethics and disseminationEthical approval was obtained from the ethics committee of the University of Gießen and the ministries of cultural affairs, both in Germany. Results will be disseminated at conferences, in peer-reviewed journals, on our websites and throughout the multinational Education Against Tobacco network.Trial registration numberNCT02544360, Pre-results.

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Graphic Health Warnings on Cigarette Packs: How Long Before the Effects on Adolescents Wear Out?

Cited by 41 publications

References 23 publications

Refuting tobacco-industry funded research: empirical data shows decline in smoking prevalence following introduction of plain packaging in Australia

Refuting tobacco-industry funded research: empirical data shows decline in smoking prevalence following introduction of plain packaging in Australia

Changes in Vietnamese Male Smokers' Reactions Towards New Pictorial Cigarette Pack Warnings Over Time

Photoaging smartphone app promoting poster campaign to reduce smoking prevalence in secondary schools: the Smokerface Randomized Trial: design and baseline characteristics

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