Educational differences in the impact of pictorial cigarette warning labels on smokers. Findings from the International Tobacco Control (ITC) Europe Surveys.

G.E. Nagelhout; M.C. Willemsen; H. de Vries; U. Mons; S.C. Hitchman; A.E. Kunst; R. Guignard; M. Siahpush; H.H. Yong; B. van den Putte; G.T. Fong; J.F. Thrasher

doi:10.1136/tobaccocontrol-2014-051971

Educational differences in the impact of pictorial cigarette warning labels on smokers. Findings from the International Tobacco Control (ITC) Europe Surveys.

G.E. Nagelhout^*, M.C. Willemsen, H. de Vries, U. Mons, S.C. Hitchman, A.E. Kunst, R. Guignard, M. Siahpush, H.H. Yong, B. van den Putte, G.T. Fong, J.F. Thrasher

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

Objective To examine (1) the impact of pictorial cigarette warning labels on changes in self-reported warning label responses: warning salience, cognitive responses, forgoing cigarettes and avoiding warnings, and (2) whether these changes differed by smokers' educational level.

Methods Longitudinal data of smokers from two survey waves of the International Tobacco Control (ITC) Europe Surveys were used. In France and the UK, pictorial warning labels were implemented on the back of cigarette packages between the two survey waves. In Germany and the Netherlands, the text warning labels did not change.

Findings Warning salience decreased between the surveys in France (OR=0.81, p=0.046) and showed a non-significant increase in the UK (OR=1.30, p=0.058), cognitive responses increased in the UK (OR=1.34, p

Conclusions The warning labels implemented in France in 2010 and in the UK in 2008 with pictures on one side of the cigarette package did not succeed in increasing warning salience, but did increase avoidance. The labels did not increase educational inequalities among continuing smokers.

Original language	English
Pages (from-to)	325-332
Number of pages	8
Journal	Tobacco Control
Volume	25
Issue number	3
Early online date	14 Jan 2015
DOIs	https://doi.org/10.1136/tobaccocontrol-2014-051971
Publication status	Published - May 2016

Keywords

HEALTH WARNINGS
UNITED-STATES
SMOKING
ADULTS
PACKS
TIME

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10.1136/tobaccocontrol-2014-051971

Full TextFinal published version, 1.76 MBLicence: Taverne

Cite this

Nagelhout, G. E., Willemsen, M. C., de Vries, H., Mons, U., Hitchman, S. C., Kunst, A. E., Guignard, R., Siahpush, M., Yong, H. H., van den Putte, B., Fong, G. T., & Thrasher, J. F. (2016). Educational differences in the impact of pictorial cigarette warning labels on smokers. Findings from the International Tobacco Control (ITC) Europe Surveys. Tobacco Control, 25(3), 325-332. https://doi.org/10.1136/tobaccocontrol-2014-051971

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title = "Educational differences in the impact of pictorial cigarette warning labels on smokers. Findings from the International Tobacco Control (ITC) Europe Surveys.",

abstract = "Objective To examine (1) the impact of pictorial cigarette warning labels on changes in self-reported warning label responses: warning salience, cognitive responses, forgoing cigarettes and avoiding warnings, and (2) whether these changes differed by smokers' educational level.Methods Longitudinal data of smokers from two survey waves of the International Tobacco Control (ITC) Europe Surveys were used. In France and the UK, pictorial warning labels were implemented on the back of cigarette packages between the two survey waves. In Germany and the Netherlands, the text warning labels did not change.Findings Warning salience decreased between the surveys in France (OR=0.81, p=0.046) and showed a non-significant increase in the UK (OR=1.30, p=0.058), cognitive responses increased in the UK (OR=1.34, pConclusions The warning labels implemented in France in 2010 and in the UK in 2008 with pictures on one side of the cigarette package did not succeed in increasing warning salience, but did increase avoidance. The labels did not increase educational inequalities among continuing smokers.",

keywords = "HEALTH WARNINGS, UNITED-STATES, SMOKING, ADULTS, PACKS, TIME",

author = "G.E. Nagelhout and M.C. Willemsen and {de Vries}, H. and U. Mons and S.C. Hitchman and A.E. Kunst and R. Guignard and M. Siahpush and H.H. Yong and {van den Putte}, B. and G.T. Fong and J.F. Thrasher",

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Nagelhout, GE , Willemsen, MC , de Vries, H, Mons, U, Hitchman, SC, Kunst, AE, Guignard, R, Siahpush, M, Yong, HH, van den Putte, B, Fong, GT & Thrasher, JF 2016, 'Educational differences in the impact of pictorial cigarette warning labels on smokers. Findings from the International Tobacco Control (ITC) Europe Surveys.', Tobacco Control, vol. 25, no. 3, pp. 325-332. https://doi.org/10.1136/tobaccocontrol-2014-051971

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AU - Nagelhout, G.E.

AU - Willemsen, M.C.

AU - de Vries, H.

AU - Mons, U.

AU - Hitchman, S.C.

AU - Kunst, A.E.

AU - Guignard, R.

AU - Siahpush, M.

AU - Yong, H.H.

AU - van den Putte, B.

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AU - Thrasher, J.F.

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N2 - Objective To examine (1) the impact of pictorial cigarette warning labels on changes in self-reported warning label responses: warning salience, cognitive responses, forgoing cigarettes and avoiding warnings, and (2) whether these changes differed by smokers' educational level.Methods Longitudinal data of smokers from two survey waves of the International Tobacco Control (ITC) Europe Surveys were used. In France and the UK, pictorial warning labels were implemented on the back of cigarette packages between the two survey waves. In Germany and the Netherlands, the text warning labels did not change.Findings Warning salience decreased between the surveys in France (OR=0.81, p=0.046) and showed a non-significant increase in the UK (OR=1.30, p=0.058), cognitive responses increased in the UK (OR=1.34, pConclusions The warning labels implemented in France in 2010 and in the UK in 2008 with pictures on one side of the cigarette package did not succeed in increasing warning salience, but did increase avoidance. The labels did not increase educational inequalities among continuing smokers.

AB - Objective To examine (1) the impact of pictorial cigarette warning labels on changes in self-reported warning label responses: warning salience, cognitive responses, forgoing cigarettes and avoiding warnings, and (2) whether these changes differed by smokers' educational level.Methods Longitudinal data of smokers from two survey waves of the International Tobacco Control (ITC) Europe Surveys were used. In France and the UK, pictorial warning labels were implemented on the back of cigarette packages between the two survey waves. In Germany and the Netherlands, the text warning labels did not change.Findings Warning salience decreased between the surveys in France (OR=0.81, p=0.046) and showed a non-significant increase in the UK (OR=1.30, p=0.058), cognitive responses increased in the UK (OR=1.34, pConclusions The warning labels implemented in France in 2010 and in the UK in 2008 with pictures on one side of the cigarette package did not succeed in increasing warning salience, but did increase avoidance. The labels did not increase educational inequalities among continuing smokers.

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