The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies

Noar, Seth M.; Francis, Diane B.; Bridges, Christy C.; Sontag, Jennah M.; Ribisl, Kurt M.; Brewer, Noel T.

doi:10.1016/j.socscimed.2016.06.011

Cited by 270 publications

(254 citation statements)

References 36 publications

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“…In Australia, 57% of smokers and 72% of recent quitters in 2008 reported that PWLs made them think about quitting and had helped them try to quit 58. A recent experimental study59 obtained an 18% ((40–34)/34) relative increase in quit attempts, and a meta-analysis obtained a 9% relative increase in quit attempts associated with PWLs 39…”

Section: Resultsmentioning

confidence: 98%

“…We reviewed evidence from diverse sources, including population-level and individual-level studies, data on trends in nations that have implemented PWLs and recent meta-analyses 39 40. Our best estimate of a 10% relative reduction in long-term smoking prevalence is lower than the 13% relative reduction obtained in a recent meta-analysis 39…”

Section: Discussionmentioning

confidence: 99%

“…While estimation of the effects of PWLs on cessation is based on studies that specifically examine cessation behaviours, studies also indicate that PWLs increase calls to quitlines,39 which have been found to improve quit success 71. In addition, studies5 39 72 find that PWLs have reduced the quantity smoked per smoker, which may contribute to quit success.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, studies5 39 72 find that PWLs have reduced the quantity smoked per smoker, which may contribute to quit success. Nevertheless, the evidence on initiation effects is more limited, since no previous studies have specifically examined initiation following the implementation of PWLs.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the results for cessation and prevalence effects depend on the ability to isolate the effects of PWLs from other policies that may have been implemented around the same period of time. However, some of the better studies included controls for other policies,20 and there were limited policy changes around the time that PWLs were implemented in the UK53 and Australia 39…”

Section: Discussionmentioning

confidence: 99%

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Public health benefits from pictorial health warnings on US cigarette packs: a SimSmoke simulation

et al. 2016

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Introduction While many countries have adopted prominent pictorial warning labels (PWLs) for cigarette packs, the USA still requires only small, text-only labels located on one side of the cigarette pack that have little effect on smoking-related outcomes. Tobacco industry litigation blocked implementation of a 2011 Food and Drug Administration’s (FDA) rule requiring large PWLs. To inform FDA action on PWLs, this study provides research-based estimates of their public health impacts. Methods Literature was reviewed to identify the impact of cigarette PWLs on smoking prevalence, cessation and initiation. Based on this analysis, the SimSmoke model was used to estimate the effect of requiring PWLs in the USA on smoking prevalence and, using standard attribution methods, on smoking-attributable deaths (SADs) and key maternal and child health outcomes. Results Available research consistently shows a direct association between PWLs and increased cessation and reduced smoking initiation and prevalence. The SimSmoke model projects that PWLs would reduce smoking prevalence by 5% (2.5%–9%) relative to the status quo over the short term and by 10% (4%–19%) over the long term. Over the next 50 years, PWLs are projected to avert 652 800 (327 000–1 190 500) SADs, 46 600 (17 500–92 300) low-birth-weight cases, 73 600 (27 800–145 100) preterm births and 1000 (400–2000) cases of sudden infant death syndrome. Conclusions Requiring PWLs on all US cigarette packs would be appropriate for the protection of the public health, because it would substantially reduce smoking prevalence and thereby reduce SADs and the morbidity and medical costs associated with adverse smoking-attributable birth outcomes.

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Section: Resultsmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Public health benefits from pictorial health warnings on US cigarette packs: a SimSmoke simulation

et al. 2016

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Estimated Prevalence of Smoking and Smoking-Attributable Mortality Associated With Graphic Health Warnings on Cigarette Packages in the US From 2022 to 2100

et al. 2021

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IMPORTANCE Starting in 2022, the US Food and Drug Administration (FDA) plans to require all cigarette packages in the US to display graphic health warnings depicting health harms associated with smoking. The FDA originally planned to implement such warnings in 2012, but tobacco industry litigation delayed the effort.OBJECTIVE To assess the estimated population health outcomes associated with a policy requiring graphic health warnings on cigarette packages in the US and with a 10-year delay in implementation. DESIGN, SETTING, AND PARTICIPANTSThis decision analytical model used simulation modeling of smoking prevalence and smoking-attributable mortality in the US from 2012 to 2100, using the Cancer Intervention and Surveillance Modeling Network smoking population model. The study was conducted from October 2020 to July 2021. MAIN OUTCOMES AND MEASURESThe primary outcomes were annual adult smoking prevalence, smoking-attributable deaths averted, and life-years gained vs the baseline scenario. A baseline scenario assuming no graphic health warnings was compared with expected outcomes of implementing graphic health warnings in 2022 vs 2012. Policy effects were considered under varying assumptions of the association of the policy with smoking initiation and cessation, ranging from most conservative to most optimistic. A maximum smoking reduction scenario in which all smoking would stop by the end of 2022 was evaluated. RESULTSIn the baseline scenario, an estimated 13.2 million smoking-attributable deaths would have occurred from 2012 to 2100. Under a maximum smoking-reduction scenario, 5.5 million of these deaths would be averted. Implementation of graphic health warnings from 2022 to 2100 would be associated with 539 000 (range, 275 000-794 000) smoking-attributable deaths averted and 7.9 million (range, 4.0-11.6 million) life-years gained, representing less than 10% of the 5.5 million estimated smoking-attributable deaths averted and 81.8 million life-years gained in the maximum smoking-reduction scenario. Implementation from 2012 to 2100 would be associated with 33.2% (range, 32.9%-33.5%) more deaths averted (718 000; range, 365 000 to 1.1 million) and 42.7% (range, 42.3%-43.1%) more life-years gained (11.2 million; range, 5.7-16.6 million) compared with implementation in 2022. CONCLUSIONS AND RELEVANCEThis decision analytical model estimated that FDA cigarette graphic health warnings, if implemented in 2022, would be associated with public health benefits.The model also estimated that more smoking-attributable deaths would have been averted if the policy had been implemented in 2012. Industry litigation and delays to implementing tobacco regulations may have been harmful for public health.

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Combustible and Electronic Tobacco and Marijuana Products in Hip-Hop Music Videos, 2013-2017

2018

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IMPORTANCE Hip-hop is the leading music genre in the United States and its fan base includes a large proportion of adolescents and young adults of all racial and ethnic groups, particularly minorities. The appearance of combustible and electronic tobacco and marijuana products, especially brand placement and use by popular and influential artists, may increase the risk of tobacco and marijuana use and decrease perceptions of harm. OBJECTIVE To assess the prevalence of the appearance and use of combustible and electronic tobacco and marijuana products, including brand placement, in leading hip-hop songs. DESIGN, SETTING, AND PARTICIPANTS Analysis of top 50 songs from 2013 to 2017 of Billboard magazine's weekly Hot R&B/Hip-Hop Songs with videos that included the appearance or use of combustible tobacco and marijuana products (manufactured cigarettes, cigars, hookah or waterpipe, pipe, hand-rolled tobacco and marijuana products, marijuana buds); appearance of exhaled smoke or vapor without an identifiable source product; appearance or use of electronic tobacco and marijuana products (eg, electronic cigarettes); tobacco or marijuana brand placement; appearance or use of combustible and electronic tobacco and marijuana by main or featured artist. Data were collected from December 6, 2017, to June 4, 2018. MAIN OUTCOMES AND MEASURES Prevalence of (1) appearance or use of combustible tobacco and marijuana products, (2) appearance of smoke or vapor, (3) appearance or use of electronic tobacco and marijuana products, (4) tobacco or marijuana brand placement, and (5) appearance or use of combustible and electronic tobacco and marijuana by main or featured artist. Probability of appearance or use of combustible and electronic tobacco and marijuana products by quartile of viewership of videos. RESULTS The proportion of leading hip-hop videos containing combustible use, electronic use, or smoke or vapor ranged from 40.2% (76 of 189) in 2015, to 50.7% (102 of 201) in 2016. For each year, the leading category of combustible use was hand-rolled products. The appearance of branded products increased from 0% in 2013 (0 of 82) to 9.9% in 2017 (10 of 101) for combustible products, and from 25.0% in 2013 (3 of 12) to 87.5% in 2017 (14 of 16) for electronic products. The prevalence of combustible or electronic product use or exhaled smoke or vapor increased by quartile of total number of views: 41.9% (8700 to 19 million views) among songs in the first quartile of viewership and 49.7% among songs in the fourth quartile of viewership (112 million to 4 billion views). CONCLUSIONS AND RELEVANCE Combustible and electronic tobacco and marijuana use frequently occurred in popular hip-hop music videos. The genre's broad appeal, use of branded products by influential artists, and rise of electronic product and marijuana use may contribute to a growing public health concern of tobacco and marijuana use.

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The impact of strengthening cigarette pack warnings: Systematic review of longitudinal observational studies

Cited by 270 publications

References 36 publications

Public health benefits from pictorial health warnings on US cigarette packs: a SimSmoke simulation

Public health benefits from pictorial health warnings on US cigarette packs: a SimSmoke simulation

Estimated Prevalence of Smoking and Smoking-Attributable Mortality Associated With Graphic Health Warnings on Cigarette Packages in the US From 2022 to 2100

Combustible and Electronic Tobacco and Marijuana Products in Hip-Hop Music Videos, 2013-2017

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