Longitudinal effects of cigarette pictorial warning labels among young adults

Johnson, Andrea C; Simmens, Samuel J.; Turner, Monique Mitchell; Evans, W. Douglas; Strasser, Andrew A.; Mays, Darren

doi:10.1007/s10865-021-00258-2

Cited by 4 publications

(5 citation statements)

References 38 publications

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“…We suspect that the reasons for the modest impact of partial and complete smoke-free policies on smoking cessation are related to warnings on cigarette packaging, 25 tobacco prices 26 and policy implementation, 10 such as the impact of the 2015 tobacco tax increase on cigarette prices, which increased retail cigarette prices by an average of 11% and the cheapest cigarette brands by 20%. However, the cheapest cigarettes are still cheaper than in other countries and the persistence of such cigarettes remains a major public health challenge and will become more widespread over time as people's incomes continue to rise.…”

Section: Discussionmentioning

confidence: 99%

“…First, managers of smoky workplaces, restaurants and bars should strictly enforce smoke-free policies 16 to protect customers’ rights; second, this can be achieved by changing the textual warnings on cigarette packages to graphic warnings. 25 Some studies have shown that the use of graphic warnings can reduce the intention to smoke among young people. 29 Policymakers, practitioners and researchers should design more appropriate warnings to reduce smoking rates.…”

Section: Discussionmentioning

confidence: 99%

“…This result is consistent with the findings from studies of provinces with comprehensive smoke-free policies -Beijing, 21,22 Guangzhou 23 and Shanghai 24 where comprehensive smoke-free policies have better tobacco control effects, reducing exposure to second-hand smoke in public places and helping smokers to quit. We suspect that the reasons for the modest impact of partial and complete smoke-free policies on smoking cessation are related to warnings on cigarette packaging, 25 tobacco prices 26 and policy implementation, 10 such as the impact of the 2015 tobacco tax increase on cigarette prices, which increased retail cigarette prices by an average of 11% and the cheapest cigarette brands by 20%. However, the cheapest cigarettes are still cheaper than in other countries and the persistence of such cigarettes remains a major public health challenge and will become more widespread over time as people's incomes continue to rise.…”

Section: Discussionmentioning

confidence: 99%

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China’s Smoke-free Policies in Public Place and the Smoking Cessation Status of Smokers

et al. 2023

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INTRODUCTION Smoking remains a major health risk factor and China is the world’s largest consumer of tobacco. Smoke-free policies in public places are a powerful weapon in tobacco control. Therefore, the aim of this study was to assess the association between smoke-free policies in public places and smoking cessation among smokers in China from 2012 to 2020. METHODS In this study, we assessed the impact of smoke-free public places policies on smoking cessation situation among smokers aged 16 years and older. We do this by conducting a difference-in-differences analysis using data from the China Family Panel Study (CFPS) 2012-2020. FINDINGS By 2020, about 60.2% of the cities were covered by partial smoke-free policies and about 38.5% by comprehensive smoke-free policies. Based on the results of the study, we found that the medium-term effect model (Model 2, 2012:2016; Model 3, 2012:2018) of the impact of partial smoke-free policies on smoking cessation was not statistically significant using 2012 as the study baseline; the short-term effect model (Model 1; 2012:2014; P< .01) and the long-term effect model (Model 4; 2012:2020; P< .05) were statistically significant; the effect of a comprehensive smoke-free policy on smoking cessation (Model 5; 2012:2020; P<.05) was statistically significant. CONCLUSION China’s existing comprehensive smoke-free policies have had a modest impact on smoking cessation among the smoking population, and a strong, comprehensive national smoke-free law is urgently needed to achieve greater public health outcomes. IMPLICATIONS Smoke-free policies are an important intervention to influence smoking behavior. This study demonstrates that comprehensive smoke-free policies in public places in China can effectively influence smoking behavior and show long-term trends in smoke-free behavior, while also reflecting the need to promote comprehensive smoke-free policies. This study provides a basis for the implementation of comprehensive smokefree policies into law and also provides a basis for policy makers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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China’s Smoke-free Policies in Public Place and the Smoking Cessation Status of Smokers

et al. 2023

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“…Second, we used the appraisal approach to emotions (e.g., Lazarus, 1991) to explain how the three negative emotions can mediate the effects of warning labels. Although these emotions have been examined in research on health warning labels (e.g., Hammond et al, 2004; Johnson et al, 2022), more theoretical rationale is needed as to why various warning types differ in emotions, and what effects these emotions have. The appraisal perspective offers a clear explanation: Emotions arise from people’s perception of the warning labels, and the action tendencies of emotions are reflected in the intentions to reduce alcohol use.…”

Section: Discussionmentioning

confidence: 99%

Designing Cancer Warning Labels for Alcoholic Beverages: Examining the Impact of Visual Elements

2023

Health Educ Behav

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Alcohol is a known carcinogen. However, public awareness of cancer risk associated with alcohol use is low. A promising approach to raising awareness is to include cancer warning labels on alcohol-containing products, but there is limited knowledge of the design and effect of such warnings. The present study investigated the impact of visual elements on the effectiveness of cancer warning labels. In a randomized online experiment, alcohol consumers ( N = 1,190) were randomly assigned to one of three conditions: exposure to (a) text-only warning labels, (b) pictorial warning labels showing graphic health effects (e.g., diseased organs), and (c) pictorial warning labels showing lived experience (e.g., cancer patients in a medical setting). The results showed that whereas the three warning types did not differ significantly in behavioral intentions, pictorial warnings featuring health effects led to greater disgust and anger than text-only warnings and pictorial warnings featuring lived experience. Moreover, anger predicted lower intentions to reduce alcohol use and was a significant mediator of the effects of warning type on behavioral intentions. The findings highlight the role of emotions in responses to health warning labels with different visual elements and suggest that text-only warnings and pictorial warnings with lived experience may be useful in preventing boomerang effects.

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“…Noar and other researchers (2015) reviewed 48 quantitative studies with independent samples and concluded that pictorial warnings were more effective than text-only warnings across eight outcomes, including intention to quit smoking as well as attitudes, beliefs, warning reactions, attention and recall [ 27 ]. Johnson and colleagues (2021) utilized randomized controlled trials of 229 adult smokers and suggested that pictorial warning labels produced stronger motivations to quit smoking and trigger emotional response [ 28 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Reactions to Pictorial and Text Cigarette Pack Warning Labels among Chinese Smokers

Wang

Yao

Wang

et al. 2022

IJERPH

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Objectives. This study aims at examining the impact of graphic pictorial warning labels on inten-tion to quit smoking and perceived harms among Chinese working-age adults (n = 661). Methods. A randomized controlled trial is utilized as the research design by comparing three scenarios: Group 1 as baseline (n = 193) and presented with real market tobacco products with text-only la-bels, Group 2 as price group and with hypothetical scenarios of manipulated prices, and Group 3 as the imaging group and with hypothetical scenarios of graphic pictorial cigarette warning la-bels. Both bivariate and multivariate analyses are utilized to determine the effectiveness of warn-ing labels. Results. Graphic pictorial cigarette warning labels are associated with stronger inten-tion to quit smoking and greater perceived harms. Smokers have a greater number of attempts if they are less nicotine dependent and express greater smoking risk perceptions. Conclusions. This study adds to the evidence that graphic pictorial warning labels are more effective than text-only labels in increasing intention to quit smoking. As China strives to achieve a reduction in smoking to meet the goal of the Healthy China 2030 initiative, this work strengthens the evidence base for policy makers, practitioners, and researchers to design low-cost warning labels on cigarette packs to promote tobacco control.

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Longitudinal effects of cigarette pictorial warning labels among young adults

Cited by 4 publications

References 38 publications

China’s Smoke-free Policies in Public Place and the Smoking Cessation Status of Smokers

China’s Smoke-free Policies in Public Place and the Smoking Cessation Status of Smokers

Designing Cancer Warning Labels for Alcoholic Beverages: Examining the Impact of Visual Elements

Reactions to Pictorial and Text Cigarette Pack Warning Labels among Chinese Smokers

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