TY - JOUR
T1 - Quasi-experimentally examining the impact of introducing tobacco pictorial health warnings
T2 - Findings from the International Tobacco Control (ITC) 4C and Netherlands surveys in the Netherlands, Australia, Canada, United Kingdom, and the United States
AU - van Mourik, Dirk-Jan A.
AU - Nagelhout, Gera E.
AU - de Vries, Hein
AU - van den Putte, Bas
AU - Cummings, K. Michael
AU - Borland, Ron
AU - Fong, Geoffrey T.
AU - Willemsen, Marc C.
N1 - Funding Information:
The ITC 4 Country Project was supported by grants R01 CA 100362 , P50 CA111236 (Roswell Park Transdisciplinary Tobacco Use Research Center), and P01 CA138389 from the National Cancer Institute of the USA , Canadian Institutes of Health Research ( MOP-79551 and FDN-148477 ), National Health and Medical Research Council of Australia ( 450110 ), and Cancer Research UK ( C321/A11039 and C25586/A19540 ). The ITC Netherlands Surveys were supported by The Netherlands Organisation for Health Research and Development (ZonMw; 200130002) and the Dutch Cancer Foundation (KWF) (UM 2014-7210). The funders had no role in the design, analysis, preparation, or decision to publish the manuscript. Additional support was provided to Geoffrey T. Fong from a Senior Investigator Award from the Ontario Institute for Cancer Research and a Prevention Scientist Award from the Canadian Cancer Society Research Institute.
Funding Information:
The ITC 4 Country Project was supported by grants R01 CA 100362, P50 CA111236 (Roswell Park Transdisciplinary Tobacco Use Research Center), and P01 CA138389 from the National Cancer Institute of the USA, Canadian Institutes of Health Research (MOP-79551 and FDN-148477), National Health and Medical Research Council of Australia (450110), and Cancer Research UK (C321/A11039 and C25586/A19540). The ITC Netherlands Surveys were supported by The Netherlands Organisation for Health Research and Development (ZonMw; 200130002) and the Dutch Cancer Foundation (KWF) (UM 2014-7210). The funders had no role in the design, analysis, preparation, or decision to publish the manuscript. Additional support was provided to Geoffrey T. Fong from a Senior Investigator Award from the Ontario Institute for Cancer Research and a Prevention Scientist Award from the Canadian Cancer Society Research Institute.
Publisher Copyright:
© 2019 The Author(s)
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Background: Our study evaluated the short-term impact of introducing European Union's tobacco pictorial health warnings (PHWs).Methods: Longitudinal data were collected at two time-points from adult smokers, participating in the International Tobacco Control (ITC) surveys, conducted in the Netherlands, Australia, Canada, the United Kingdom and the United States. In the Netherlands, textual health warnings (THWs) were replaced by PHWs between both time-points. Health warning policies did not change in the other countries. Data from continuing smokers were used (N = 3,487) and analyzed using Generalized Estimating Equations.Results: Between both time-points, only Dutch smokers showed increases in noticing health warnings (beta = 0.712, p <0.001), self-reports of health warnings leading to a cognitive response such as thinking about smoking health-risks (SHRs) (OR = 1.834, p <0.001), knowledge about SHRs (beta = 0.369, p <0.001), and avoiding health warnings (OR = 9.869, p <0.001). However, Dutch smokers showed no changes in attitude towards smoking (beta = 0.035, p = 0.518), intention to quit smoking (OR = 0.791, p = 0.157), self-efficacy to quit smoking (beta=-0.072, p = 0.286), or reporting that health warnings helped them to resist having a cigarette (OR = 1.091, p = 0.714).Conclusions: Results suggest that introducing the European PHWs was effective in provoking changes closely related to health warnings, but there was no direct impact on variables more closely related to smoking cessation.
AB - Background: Our study evaluated the short-term impact of introducing European Union's tobacco pictorial health warnings (PHWs).Methods: Longitudinal data were collected at two time-points from adult smokers, participating in the International Tobacco Control (ITC) surveys, conducted in the Netherlands, Australia, Canada, the United Kingdom and the United States. In the Netherlands, textual health warnings (THWs) were replaced by PHWs between both time-points. Health warning policies did not change in the other countries. Data from continuing smokers were used (N = 3,487) and analyzed using Generalized Estimating Equations.Results: Between both time-points, only Dutch smokers showed increases in noticing health warnings (beta = 0.712, p <0.001), self-reports of health warnings leading to a cognitive response such as thinking about smoking health-risks (SHRs) (OR = 1.834, p <0.001), knowledge about SHRs (beta = 0.369, p <0.001), and avoiding health warnings (OR = 9.869, p <0.001). However, Dutch smokers showed no changes in attitude towards smoking (beta = 0.035, p = 0.518), intention to quit smoking (OR = 0.791, p = 0.157), self-efficacy to quit smoking (beta=-0.072, p = 0.286), or reporting that health warnings helped them to resist having a cigarette (OR = 1.091, p = 0.714).Conclusions: Results suggest that introducing the European PHWs was effective in provoking changes closely related to health warnings, but there was no direct impact on variables more closely related to smoking cessation.
KW - Health warnings
KW - Smokers
KW - Quasi-experimental
KW - SMOKERS FINDINGS
KW - CIGARETTE PACKS
KW - ADULT SMOKERS
KW - SMOKING
KW - LABELS
KW - KNOWLEDGE
KW - RISKS
KW - BELIEFS
U2 - 10.1016/j.drugalcdep.2019.107818
DO - 10.1016/j.drugalcdep.2019.107818
M3 - Article
C2 - 31911337
SN - 0376-8716
VL - 207
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
M1 - 107818
ER -