Pictorial Health Warning Label Content and Smokers' Understanding of Smoking-related Risks-a Cross-country Comparison

Overview

Journal Health Educ Res

Publisher Oxford University Press

Specialty Medical Education

Date 2014 May 23

PMID 24848554

Citations 43

Authors

Kamala Swayampakala

James F Thrasher

David Hammond

Hua-Hie Yong

Maansi Bansal-Travers

Dean Krugman

Abraham Brown

Ron Borland

James Hardin

Affiliations

Soon will be listed here.

Abstract

The aim of the present study was to assess smokers' level of agreement with smoking-related risks and toxic tobacco constituents relative to inclusion of these topics on health warning labels (HWLs). 1000 adult smokers were interviewed between 2012 and 2013 from online consumer panels of adult smokers from each of the three countries: Australia (AU), Canada (CA) and Mexico (MX). Generalized estimating equation models were estimated to compare agreement with smoking-related risks and toxic tobacco constituents. For disease outcomes described on HWLs across all three countries, there were few statistical differences in agreement with health outcomes (e.g. emphysema and heart attack). By contrast, increases in agreement where the HWLs were revised or introduced on HWLs for the first time (e.g. blindness in AU and CA, bladder cancer in CA). Similarly, samples from countries that have specific health content or toxic constituents on HWLs showed higher agreement for that particular disease or toxin than countries without (e.g. higher agreement for gangrene and blindness in AU, higher agreement for bladder cancer and all toxic constituents except nitrosamines and radioactive polonium in CA). Pictorial HWL content is associated with greater awareness of smoking-related risks and toxic tobacco constituents.

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References

Siahpush M, McNeill A, Hammond D, Fong G . Socioeconomic and country variations in knowledge of health risks of tobacco smoking and toxic constituents of smoke: results from the 2002 International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006; 15 Suppl 3:iii65-70. PMC: 2593062. DOI: 10.1136/tc.2005.013276. View

Thrasher J, Niederdeppe J, Farrelly M, Davis K, Ribisl K, Haviland M . The impact of anti-tobacco industry prevention messages in tobacco producing regions: evidence from the US truth campaign. Tob Control. 2004; 13(3):283-8. PMC: 1747883. DOI: 10.1136/tc.2003.006403. View

Costello M, Logel C, Fong G, Zanna M, McDonald P . Perceived risk and quitting behaviors: results from the ITC 4-country survey. Am J Health Behav. 2012; 36(5):681-92. PMC: 4009356. DOI: 10.5993/AJHB.36.5.10. View

Thrasher J, Arillo-Santillan E, Villalobos V, Perez-Hernandez R, Hammond D, Carter J . Can pictorial warning labels on cigarette packages address smoking-related health disparities? Field experiments in Mexico to assess pictorial warning label content. Cancer Causes Control. 2012; 23 Suppl 1:69-80. PMC: 3339765. DOI: 10.1007/s10552-012-9899-8. View

Hammond D, Fong G, McNeill A, Borland R, Cummings K . Effectiveness of cigarette warning labels in informing smokers about the risks of smoking: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control. 2006; 15 Suppl 3:iii19-25. PMC: 2593056. DOI: 10.1136/tc.2005.012294. View

Stockwell T, Rutley R, Clark K . Pesticides and other chemicals in cigarette tobacco. Med J Aust. 1992; 157(1):68. DOI: 10.5694/j.1326-5377.1992.tb121624.x. View

Borland R, Hill D . Initial impact of the new Australian tobacco health warnings on knowledge and beliefs. Tob Control. 1997; 6(4):317-25. PMC: 1759588. DOI: 10.1136/tc.6.4.317. View

Kennedy R, Spafford M, Behm I, Hammond D, Fong G, Borland R . Positive impact of Australian 'blindness' tobacco warning labels: findings from the ITC four country survey. Clin Exp Optom. 2012; 95(6):590-8. PMC: 4009362. DOI: 10.1111/j.1444-0938.2012.00789.x. View

Hyland A, Li Q, Bauer J, Giovino G, Steger C, Cummings K . Predictors of cessation in a cohort of current and former smokers followed over 13 years. Nicotine Tob Res. 2005; 6 Suppl 3:S363-9. DOI: 10.1080/14622200412331320761. View

10.

Borland R, Wilson N, Fong G, Hammond D, Cummings K, Yong H . Impact of graphic and text warnings on cigarette packs: findings from four countries over five years. Tob Control. 2009; 18(5):358-64. PMC: 4527864. DOI: 10.1136/tc.2008.028043. View

11.

Thrasher J, Murukutla N, Perez-Hernandez R, Alday J, Arillo-Santillan E, Cedillo C . Linking mass media campaigns to pictorial warning labels on cigarette packages: a cross-sectional study to evaluate effects among Mexican smokers. Tob Control. 2012; 22(e1):e57-65. DOI: 10.1136/tobaccocontrol-2011-050282. View

12.

Partos T, Borland R, Yong H, Thrasher J, Hammond D . Cigarette packet warning labels can prevent relapse: findings from the International Tobacco Control 4-Country policy evaluation cohort study. Tob Control. 2012; 22(e1):e43-50. PMC: 3963175. DOI: 10.1136/tobaccocontrol-2011-050254. View

13.

Schoenbaum M . Do smokers understand the mortality effects of smoking? Evidence from the Health and Retirement Survey. Am J Public Health. 1997; 87(5):755-9. PMC: 1381045. DOI: 10.2105/ajph.87.5.755. View

14.

Thrasher J, Perez-Hernandez R, Arillo-Santillan E, Barrientos-Gutierrez I . [Impact of cigarette package health warnings with pictures in Mexico: results from a survey of smokers in Guadalajara]. Salud Publica Mex. 2012; 54(3):254-63. View

15.

Farrelly M, Davis K, Duke J, Messeri P . Sustaining 'truth': changes in youth tobacco attitudes and smoking intentions after 3 years of a national antismoking campaign. Health Educ Res. 2008; 24(1):42-8. DOI: 10.1093/her/cym087. View

16.

Sussman S, Levy D, Hassmiller Lich K, Cene C, Kim M, Rohrbach L . Comparing effects of tobacco use prevention modalities: need for complex system models. Tob Induc Dis. 2013; 11(1):2. PMC: 3567972. DOI: 10.1186/1617-9625-11-2. View

17.

Borland R, Yong H, Wilson N, Fong G, Hammond D, Cummings K . How reactions to cigarette packet health warnings influence quitting: findings from the ITC Four-Country survey. Addiction. 2009; 104(4):669-75. PMC: 4394051. DOI: 10.1111/j.1360-0443.2009.02508.x. View

18.

Oncken C, McKee S, Krishnan-Sarin S, OMalley S, Mazure C . Knowledge and perceived risk of smoking-related conditions: a survey of cigarette smokers. Prev Med. 2005; 40(6):779-84. DOI: 10.1016/j.ypmed.2004.09.024. View

19.

Hammond D, Thrasher J, Reid J, Driezen P, Boudreau C, Arillo Santillan E . Perceived effectiveness of pictorial health warnings among Mexican youth and adults: a population-level intervention with potential to reduce tobacco-related inequities. Cancer Causes Control. 2012; 23 Suppl 1:57-67. PMC: 4586036. DOI: 10.1007/s10552-012-9902-4. View

20.

Thrasher J, Perez-Hernandez R, Arillo-Santillan E, Barrientos-Gutierrez I . [Towards informed tobacco consumption in Mexico: effect of pictorial warning labels in smokers]. Salud Publica Mex. 2012; 54(3):242-53. PMC: 4600969. View