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Hughes JP, Weick M, Vasiljevic M. Can environmental traffic light warning labels reduce meat meal selection? A randomised experimental study with UK meat consumers. Appetite 2024; 200:107500. [PMID: 38763297 DOI: 10.1016/j.appet.2024.107500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/14/2024] [Accepted: 05/15/2024] [Indexed: 05/21/2024]
Abstract
An important area for tackling climate change and health improvement is reducing population meat consumption. Traffic light labelling has successfully been implemented to reduce the consumption of unhealthy foods and sugary drinks. The present research extends this work to meat selection. We tested 1,300 adult UK meat consumers (with quotas for age and gender to approximate a nationally representative sample). Participants were randomised into one of four experimental groups: (1) a red traffic light label with the text 'High Climate Impact' displayed on meat meal options only; (2) a green traffic light label with the text 'Low Climate Impact' displayed on vegetarian and vegan meal options only; (3) red/orange/green (ROG) traffic light labels displayed on relevant meals; and (4) control (no label present). Participants made meal selections within their randomised group across 20 meal trials. A beta-regression was performed to ascertain the change in primary outcome (proportion of meat meals selected across the 20 trials) across the different groups. The red-only label and ROG labels significantly reduced the proportion of meat meals selected compared to the unlabelled control group, by 9.2% and 9.8% respectively. The green-only label did not differ from control. Negatively framed traffic light labels seem to be effective at discouraging meat selection. The labels appeared to be moderately acceptable to meat eaters, who did not think the labels impacted the appeal of the products. These encouraging findings require replication in real-life settings.
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Affiliation(s)
- Jack P Hughes
- Department of Psychology, Durham University, Durham, UK.
| | - Mario Weick
- Department of Psychology, Durham University, Durham, UK
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Cruz-Cano R, Shi R, Parker MA, Kidanu AW. Differences in Presenting Health Warning Labels on Hookah Venue Menus Between Immersive Virtual Reality and Online Surveys. Subst Use Misuse 2024; 59:1972-1980. [PMID: 39205373 DOI: 10.1080/10826084.2024.2392513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024]
Abstract
BACKGROUND Virtual reality (VR) platforms can simulate the real world, whereas online surveys are efficient settings for assessing and testing information. In this study, the effects of presenting health warning labels (HWLs) on hookah venue menus were compared between these two message-testing settings. METHODS Separate studies were conducted in VR (n = 96) and online survey (n = 213) settings. Participants in both studies were randomly assigned to view menus with or without HWLs. This secondary data analysis compared outcomes between settings after propensity score weighting to account for differences in age, race, marital status, and education between studies. RESULTS Significant between-study differences were noted for the effects of HWLs on people's perceptions of the absolute harm of hookah smoking (p = 0.0363), the relative harm of hookah compared to cigarettes (p < 0.001), the absolute addictiveness of hookah (p < 0.001), and the relative addictiveness of hookah compared to cigarettes (p = 0.0352). When outcome variables differed significantly between the HWL and control conditions in only one of the two studies, smaller p-values were identified for the online survey setting than for the VR setting. CONCLUSIONS This study represents the first direct comparison of the effects of hookah HWLs between two message-testing settings. HWLs tested in the online survey setting were associated with larger shifts in attitudes and beliefs than those tested in the VR setting, suggesting that the effectiveness of hookah HWLs on attitudes and beliefs may be moderated by the message-testing platform. Additional real-world experiments remain necessary to determine whether either setting can accurately assess the effectiveness of HWLs.
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Affiliation(s)
- Raul Cruz-Cano
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana, USA
| | - Rui Shi
- College of Communication & Creative Arts, Rowan University, Glassboro, New Jersey, USA
| | - Maria A Parker
- Department of Epidemiology and Biostatistics, Indiana University, Bloomington, Indiana, USA
| | - Azieb W Kidanu
- Department of Behavioral and Community Health, University of Maryland, College Park, Maryland, USA
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Lambert VC, Ferguson SG, Niederdeppe J, Sun Y, Hackworth EE, Kim M, Yang CH, Vidaña D, Hardin JW, Thrasher JF. Self-reported attention and responses to cigarette package labels at the end of a two-week randomized trial of cigarette package labeling configurations. Tob Induc Dis 2024; 22:TID-22-109. [PMID: 38887598 PMCID: PMC11181013 DOI: 10.18332/tid/189198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Cigarette package inserts that describe quitting benefits and tips may promote cessation; however, research is needed to understand better their effects, including potentially enhancing the effects of pictorial health warning labels (PHWLs). METHODS A randomized trial with a 2×2 factorial design was conducted with adult smokers (n=356) assigned to either small text-only health warning labels (HWLs; control); inserts with cessation messages, and the small text-only HWLs (inserts-only); large PHWLs (PHWLs-only); both inserts and PHWLs (inserts + PHWLs). Participants received a 14-day supply of their preferred cigarettes with packs labeled to reflect their group. Upon finishing the trial, participants reported their past 14-day frequency of noticing, reading, thinking about smoking harms and cessation benefits, talking about labels, and forgoing cigarettes because of the labels. Ordered logistic models regressed these outcomes on labeling groups, and mediation analyses assessed whether attention (i.e. noticing, reading) to labels mediated effects of labeling exposure on other outcomes (i.e. thinking about harms/benefits, talking, forgoing). RESULTS The inserts + PHWLs group reported higher frequencies than the control group for all outcomes. Compared to the control group, both the inserts-only and PHWLs-only groups reported higher frequency of noticing (AOR=3.53 and 2.46, respectively) and reading labels (AOR=2.89 and 1.71), thinking about smoking risks because of the labels (AOR=1.93 and 1.82), and talking about labels (AOR=2.30 and 2.70). Participants in the inserts-only group also reported more frequent thinking about quitting benefits (AOR=1.98). Attention mediated all labeling effects except for the contrast between PHWLs only and control. CONCLUSIONS Compared to text-only HWLS, cigarette labeling that involves inserts, PHWLs, or both appears more effective at drawing attention to warnings, which mediated the effects on cessation-related psychosocial and behavioral outcomes.
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Affiliation(s)
- Victoria C. Lambert
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Stuart G. Ferguson
- College of Health and Medicine, University of Tasmania, Hobart, Australia
| | - Jeff Niederdeppe
- Jeb E. Brooks School of Public Policy and Department of Communication, Cornell University, Ithaca, United States
| | - Yanwen Sun
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Emily E. Hackworth
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Minji Kim
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - Desiree Vidaña
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - James W. Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, United States
| | - James F. Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, United States
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Noar SM, Jang Y, Nguyen Zarndt A, Zhao X, Ross JC, Cappella JN. Achieving Public Health Impact: Health Communication Research to Inform Tobacco Regulatory Science. HEALTH COMMUNICATION 2024:1-8. [PMID: 38478963 PMCID: PMC11393175 DOI: 10.1080/10410236.2024.2326250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Health communication research applies communication science to develop generalizable knowledge capable of improving the health and well-being of individuals and communities. But to what extent does the knowledge generated by the health communication field actually achieve public health impact? To answer this question, we discuss the application of health communication science and research within a tobacco regulatory science framework. We describe three areas in which health communication research funded by the Food and Drug Administration (FDA) Center for Tobacco Products (CTP) contributed to 1) youth tobacco prevention campaigns, 2) cigarette health warnings, and 3) regulation of labeling, advertising, and marketing claims. These examples demonstrate how communication regulatory science achieves public health impact in the real world by informing national policies, regulatory actions, and public health practice.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
| | - Youjin Jang
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill
| | - Anh Nguyen Zarndt
- Office of Health Communication and Education, FDA Center for Tobacco Products
| | - Xiaoquan Zhao
- Office of Health Communication and Education, FDA Center for Tobacco Products
- Department of Communication, George Mason University
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Malaeb D, Hassan BAR, Mohammed AH, Farhan SS, Al-Ani OA, Sarray El Dine A, Fekih-Romdhane F, Obeid S, Hallit S. Association between textual and pictorial warnings on tumbac (waterpipe tobacco) boxes and motivation to quit waterpipe smoking among Lebanese and Iraqi adolescents. BMC Pediatr 2024; 24:169. [PMID: 38459469 PMCID: PMC10921803 DOI: 10.1186/s12887-024-04649-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 02/15/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Waterpipe tobacco smoking has increased tremendously at a global level among all age groups, particularly young people. Previous studies have examined the impact of waterpipe tobacco pictorial health warnings on adults but scarce studies were done on adolescents. The aim of this study was to assess the association of textual versus pictorial warnings on tumbac boxes and the motivation to quit waterpipe smoking among adolescents located in two Eastern Mediterranean countries Lebanon and Iraq. METHODS A cross-sectional study was conducted between May and November 2022, involving 294 adolescents waterpipe smokers from Lebanon and Iraq. The questionnaire included the Lebanese Waterpipe Dependence Smoking-11, the Depression, Anxiety and Stress Scale, the Waterpipe Harm Perception Scale, Waterpipe Knowledge Scale, Waterpipe Attitude Scale, the Fagerstrom Test for Nicotine Dependence, and the Motivation to Stop Scale. RESULTS When adjusting the results over confounding variables, the results showed that compared to finding the warnings to stop smoking not efficacious at all, adolescents who find the warnings moderately (aOR = 2.83) and very (aOR = 6.64) efficacious had higher motivation to quit. Compared to finding the warnings not increasing their curiosity for information about how to stop waterpipe smoking at all, participants who confessed that warnings increased their curiosity a little (aOR = 2.59), moderately (aOR = 3.34) and very (aOR = 3.58) had higher motivation to quit. Compared to not considering changing the tumbac brand if the company uses pictorial warnings, adolescents who would consider changing the tumbac brand (aOR = 2.15) had higher motivation to quit. CONCLUSION Pictorial and textual warnings on waterpipe packs were associated with higher motivation to stop waterpipe smoking. Public health education programs for this purpose seem warranted.
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Affiliation(s)
- Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | | | - Ali Haider Mohammed
- Department of Pharmacy, Al Rafidain University College, Baghdad, Iraq
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia, Selangor, 47500, Malaysia
| | - Sinan Subhi Farhan
- Department of Anesthesia, College of Medical Science Technology, University of Mashreq, Baghdad, Iraq
| | | | | | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Jaswal H, Sohi I, Rehm J, Churchill S, Sherk A, Stockwell T, Levesque C, Sanger N, Edalati H, Butt PR, Paradis C, Shield KD. A drink equals how many cigarettes? Equating mortality risks from alcohol and tobacco use in Canada. Front Public Health 2024; 12:1331190. [PMID: 38476483 PMCID: PMC10928000 DOI: 10.3389/fpubh.2024.1331190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Accepted: 01/22/2024] [Indexed: 03/14/2024] Open
Abstract
Objective To quantify and communicate risk equivalencies for alcohol-and tobacco-attributable mortality by comparing per standard drinks consumed to per number of cigarettes smoked in Canada. Methods Alcohol-and tobacco-attributable premature deaths (≤75 years of age) and years of life lost (YLL) were estimated using a lifetime risk modeling approach. Alcohol-attributable death statistics were obtained from the 2023 Canadian Guidance on Alcohol and Health data source. Tobacco-attributable death statistics were derived from the Mortality Population Risk Tool (MPoRT) model. Results The risk of alcohol use on premature death and YLL increased non-linearly with the number of drinks consumed, while the risk for tobacco use on these two measures increased linearly with the number of cigarettes smoked. Males who consumed 5 drinks/day-a standard drink contains 13.45 grams of alcohol in Canada-had an equivalent risk as smoking 4.9 cigarettes/day (when modeling for premature death) and 5.1 cigarettes/day (when modeling for YLL). Females who consumed 5 drinks/day experienced an equivalent risk as smoking 4.2 cigarettes/day for premature deaths and YLL. At all levels of alcohol consumption females and males who consumed <5 drinks/day have less risks from consuming a standard drink than from smoking a cigarette. For males who consumed 5 drinks/day, the increased risks of death from per drink consumed and per cigarette smoked were equal. Conclusion Risk equivalencies comparing alcohol use to tobacco use could help people who drink improve their knowledge and understanding of the mortality risks associated with increased number of drinks consumed per day.
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Affiliation(s)
- Harpreet Jaswal
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Ivneet Sohi
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Samuel Churchill
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Adam Sherk
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | - Tim Stockwell
- Canadian Institute for Substance Use Research, University of Victoria, Victoria, BC, Canada
| | | | - Nitika Sanger
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Hanie Edalati
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Peter R. Butt
- College of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Kevin D. Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Thrasher JF, Ferguson SG, Hackworth EE, Wu CL, Lambert VC, Porticella N, Kim M, Hardin JW, Niederdeppe J. Combining Inserts With Warning Labels on Cigarette Packs to Promote Smoking Cessation: A 2-Week Randomized Trial. Ann Behav Med 2024; 58:56-66. [PMID: 37738629 PMCID: PMC10729784 DOI: 10.1093/abm/kaad052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND Cigarette pack inserts with messages on cessation benefits and advice are a promising labeling policy that may help promote smoking cessation. PURPOSE To assess insert effects, with and without accompanying pictorial health warning labels(HWLs), on hypothesized psychosocial and behavioral outcomes. METHODS We conducted a 2 × 2 between-subject randomized trial (inserts with efficacy messages vs. no inserts; large pictorial HWLs vs. small text HWLs), with 367 adults who smoked at least 10 cigarettes a day. Participants received a 14-day supply of their preferred cigarettes with packs modified to reflect their experimental condition. Over 2 weeks, we surveyed participants approximately 4-5 times a day during their smoking sessions, querying feelings about smoking, level of worry about harms from smoking, self-efficacy to cut down on cigarettes, self-efficacy to quit, hopefulness about quitting, and motivation to quit. Each evening, participants reported their perceived susceptibility to smoking harms and, for the last 24 hr, their frequency of thinking about smoking harms and cessation benefits, conversations about smoking cessation or harms, and foregoing or stubbing out cigarettes before they finished smoking. Mixed-effects ordinal and logistic models were estimated to evaluate differences between groups. RESULTS Participants whose packs included inserts were more likely than those whose packs did not include inserts to report foregoing or stubbing out of cigarettes (OR = 2.39, 95% CI = 1.36, 4.20). Otherwise, no statistically significant associations were found between labeling conditions and outcomes. CONCLUSIONS This study provides some evidence, albeit limited, that pack inserts with efficacy messages can promote behaviors that predict smoking cessation attempts.
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Affiliation(s)
- James F Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Stuart G Ferguson
- College of Health & Medicine, University of Tasmania, Hobart, Australia
| | - Emily E Hackworth
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Chung-Li Wu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Victoria C Lambert
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Norman Porticella
- Jeb E. Brooks School of Public Policy and Department of Communication, Cornell University, Ithaca, NY, USA
| | - Minji Kim
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - James W Hardin
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jeff Niederdeppe
- Jeb E. Brooks School of Public Policy and Department of Communication, Cornell University, Ithaca, NY, USA
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Hughes JP, Weick M, Vasiljevic M. Impact of pictorial warning labels on meat meal selection: A randomised experimental study with UK meat consumers. Appetite 2023; 190:107026. [PMID: 37689371 DOI: 10.1016/j.appet.2023.107026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 08/30/2023] [Accepted: 09/02/2023] [Indexed: 09/11/2023]
Abstract
Meat consumption has been linked to adverse health consequences, worsening climate change, and the risk of pandemics. Meat is however a popular food product and dissuading people from consuming meat has proven difficult. Outside the realm of meat consumption, previous research has shown that pictorial warning labels are effective at curbing tobacco smoking and reducing the consumption of sugary drinks and alcohol. The present research extends this work to hypothetical meat meal selection, using an online decision-making task to test whether people's meal choices can be influenced by pictorial warning labels focused on the health, climate, or pandemic risks associated with consuming meat. Setting quotas for age and gender to approximate a UK nationally representative sample, a total of n = 1001 adult meat consumers (aged 18+) were randomised into one of four experimental groups: health pictorial warning label, climate pictorial warning label, pandemic pictorial warning label, or control (no warning label present). All warning labels reduced the proportion of meat meals selected significantly compared to the control group, with reductions ranging from -7.4% to -10%. There were no statistically significant differences in meat meal selection between the different types of warning labels. We discuss implications for future research, policy, and practice.
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Affiliation(s)
- Jack P Hughes
- Department of Psychology, Durham University, Upper Mountjoy, South Road, Durham, DH1 3LE, UK.
| | - Mario Weick
- Department of Psychology, Durham University, Upper Mountjoy, South Road, Durham, DH1 3LE, UK
| | - Milica Vasiljevic
- Department of Psychology, Durham University, Upper Mountjoy, South Road, Durham, DH1 3LE, UK.
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Stone M, Dimofte C, Strong D, Pulvers K, Crespo NC, Leas EC, Pierce JP. Evaluating US smokers' willingness to pay for different cigarette packaging designs before and after real-world exposure in a randomised trial. Tob Control 2023; 32:689-695. [PMID: 35232793 DOI: 10.1136/tobaccocontrol-2021-057071] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 02/20/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION Removal of tobacco industry branding from cigarette packs may reduce their appeal. Adding graphic warning labels (GWLs) should enhance this effect. We investigate whether willingness to pay for various packaging designs changes after 3 months' use of: (1) US branded packs without GWLs (US), (2) non-branded packs without GWLs (Blank), and (3) rotating non-branded packs with GWLs (gangrene; throat cancer; neonatal baby) covering >75% of pack (GWL). METHODS Californian adult daily smokers not planning to quit (n=287; 56% female; mean age=39.6) completed a discrete choice purchase task before and after 3 months' experience using one of three packaging options. Conjoint analysis and pre-post modelling evaluated the change in importance of pack attributes and willingness to pay for US, Blank or GWL (blindness; teeth; gangrene) pack designs. RESULTS Price determined ~70% of purchase choices, while pack design determined ~22%. Irrespective of intervention arm, US packaging generated appeal valuations compared with Blank packaging, while GWLs consistently provoked strong aversive valuations at baseline and follow-up. Compared with the US pack arm, using GWL packs for 3 months decreased willingness to pay for US packaging (β=-$0.38, 95% CI -0.76 to 0.00). Wear-out effects were detected in the discount needed to willingly purchase the gangrene-GWL pack (β=$0.49, 95% CI 0.16 to 0.82) and Blank pack (β=$0.42, 95% CI 0.09 to 0.74) but not for GWLs (blindness, teeth) not used in trial. CONCLUSION Compared with US branded packs, the negative valuation of non-branded GWL packs attenuates with even 3 months' use but does not generalise to non-used GWLs. This suggests that GWLs should be regularly refreshed. The appeal valuation of industry imagery suggests that the US plan to retain such imagery on packs may ameliorate the effect of GWLs.
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Affiliation(s)
- Matthew Stone
- Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Claudiu Dimofte
- Marketing, San Diego State University, San Diego, California, USA
| | - David Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, University of California San Diego Moores Cancer Center, La Jolla, California, USA
| | - Kim Pulvers
- Psychology, California State University San Marcos, San Marcos, California, USA
| | - Noe C Crespo
- School of Public Health, San Diego State University, San Diego, California, USA
| | - Eric C Leas
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, University of California San Diego Moores Cancer Center, La Jolla, California, USA
| | - John P Pierce
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, University of California San Diego Moores Cancer Center, La Jolla, California, USA
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Jebai R, Asfar T, Nakkash R, Chehab S, Wu W, Bursac Z, Maziak W. Impact of pictorial health warning labels on smoking beliefs and perceptions among waterpipe smokers: an online randomised cross-over experimental study. Tob Control 2023; 32:715-722. [PMID: 35444030 PMCID: PMC9582042 DOI: 10.1136/tobaccocontrol-2021-057202] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 04/04/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Waterpipe tobacco smoking (WTS) has substantially increased among young people in Lebanon, who perceive WTS as safer than cigarettes. Health warning labels (HWLs) can inform the adverse effects associated with smoking. Thus, their application to waterpipe offers a favourable policy to limit WTS epidemic. This study assessed the effectiveness of pictorial HWLs and their placements on waterpipe parts (device, tobacco and charcoal package) on several communication outcomes. METHODS We conducted a randomised cross-over experimental study among 276 waterpipe smokers (aged 18-34) between 13 and 26 August 2021. Participants observed three conditions: pictorial HWLs on tobacco packages, pictorial HWLs on three parts of the waterpipe (device, tobacco and charcoal package) and text only on tobacco package in random order. Participants completed baseline and postexposure assessments evaluating HWL effectiveness on attention, reaction, attitudes and beliefs, perceived effectiveness of HWLs and intention to quit WTS. Planned comparisons using Friedman test followed by pairwise Wilcoxon signed-rank test for multiple comparisons were conducted. RESULTS Compared with text only, pictorial HWLs elicited greater attention (p=0.011), higher cognitive elaboration (p=0.021), perceived message effectiveness (p=0.007), negative affect reactions (p<0.01) and greater psychological reactance (p=0.01). No significant differences were found for most communication outcomes between pictorial HWLs on three parts of the waterpipe compared with tobacco package only. CONCLUSIONS Pictorial HWLs on tobacco package were superior to text only for several communication outcomes. These findings provide strong evidence for potential implementation of pictorial HWLs on waterpipe tobacco packages to increase smokers' awareness of the health effects of WTS and correct false safety perceptions.
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Affiliation(s)
- Rime Jebai
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Taghrid Asfar
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida, USA
- Syrian Center for Tobacco Studies, Aleppo, Syria
| | - Rima Nakkash
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Global and Community Health, College of Health and Human Services, George Mason University, Fairfax, Virginia, USA
| | - Sara Chehab
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Wensong Wu
- Department of Mathematics and Statistics, College of Arts, Sciences & Education, Florida International University, Miami, Florida, USA
| | - Zoran Bursac
- Department of Biostatistics, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, Florida, USA
- Syrian Center for Tobacco Studies, Aleppo, Syria
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Stone MD, Mercincavage M, Wileyto EP, Tan ASL, Audrain-McGovern J, Villanti AC, Strasser AA. Effects of cigarette package colors and warning labels on marlboro smokers' risk beliefs, product appraisals, and smoking behavior: a randomized trial. BMC Public Health 2023; 23:2111. [PMID: 37891513 PMCID: PMC10605973 DOI: 10.1186/s12889-023-17024-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE Plain packaging and graphic warning labels are two regulatory strategies that may impact cigarette risk beliefs and reduce consumption, but data are needed to better understand how smokers respond to such regulations. METHODS Adult, daily, Marlboro non-menthol smokers (Red [n = 141] or Gold [n = 43]) completed a mixed factorial randomized trial. Participants smoked their usual cigarettes during baseline (5-days) and were randomized to receive cigarette packs with a warning label manipulation (graphic vs. text-only). Within each warning label condition, participants completed three within-subjects pack color manipulations (red, gold, plain), each lasting 15 days. Participants were blinded to the fact that all packs contained their usual cigarettes. Mixed-effects models examined between- and within-subject differences on risk beliefs, product perceptions, and smoking behavior. RESULTS Warning type and package color did not impact cigarette consumption or subjective ratings. However, use increased in all conditions (2.59-3.59 cigarettes per day) relative to baseline. While smokers largely held correct risk beliefs at baseline (Mean = 6.02, SE = 0.17, Range:0-8), the cumulative number of incorrect or uncertain cigarette risk beliefs increased from baseline in all pack color manipulations in the text (IRR range = 1.70-2.16) and graphic (IRR range = 1.31-1.70) warning conditions. Across all pack color periods, those in the graphic (vs. text) warning condition had reduced odds of reporting their study cigarettes as 'safer' than regular cigarettes (OR range = 0.22-0.32). CONCLUSIONS Pack color modification may increase uncertainty about several key cigarette risk beliefs, though graphic warnings may attenuate these effects. Regulatory agencies could consider supporting policy changes with information campaigns to maximize public knowledge. TRIAL REGISTRATION November 25, 2014; Registration number: NCT02301351.
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Affiliation(s)
- Matthew D Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, San Diego, CA, USA
| | - Melissa Mercincavage
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - E Paul Wileyto
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andy S L Tan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, PA, USA
| | - Janet Audrain-McGovern
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrea C Villanti
- Rutgers, School of Public Health, The State University of New Jersey, New Brunswick, NJ, USA
| | - Andrew A Strasser
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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Hall MG, Grummon AH, Queen T, Lazard AJ, Higgins ICA, Richter APC, Taillie LS. How pictorial warnings change parents' purchases of sugar-sweetened beverage for their children: mechanisms of impact. Int J Behav Nutr Phys Act 2023; 20:76. [PMID: 37353823 PMCID: PMC10290296 DOI: 10.1186/s12966-023-01469-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 05/22/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND Pictorial health warnings on sugar-sweetened beverages (SSBs) are a promising policy for preventing diet-related disease in children. A recent study found that pictorial warnings reduced parents' purchases of SSBs for their children by 17%. However, the psychological mechanisms through which warnings affect parental behavior remain unknown. We aimed to identify the mechanisms that explain how pictorial warnings affect parents' SSB purchasing behavior for their children using secondary data from a randomized trial. METHODS In 2020-2021, parents of children ages 2 to 12 years (n = 325) completed a shopping task in a convenience store laboratory in North Carolina, USA. Participants were randomly assigned to a pictorial warnings arm (SSBs displayed pictorial health warnings about type 2 diabetes and heart damage) or a control arm (SSBs displayed a barcode label). Parents then bought a beverage for their child and took a survey measuring 11 potential psychological mediators, selected based on health behavior theories and a model explaining the impact of tobacco warnings. We conducted simple mediation analyses to identify which of the 11 mechanisms mediated the impact of exposure to pictorial warnings on purchasing any SSBs for their children. RESULTS Two of the 11 constructs were statistically significant mediators. First, the impact of pictorial warnings on the likelihood of purchasing any SSB was mediated by parents' perceptions that SSBs were healthier for their child (mediated effect= -0.17; 95% CI = - 0.33, - 0.05). Second, parents' intentions to serve SSBs to their children also mediated the effect of warnings on likelihood of purchasing any SSB (mediated effect= -0.07, 95% CI=-0.21, - 0.003). CONCLUSIONS Pictorial warnings reduced parents' purchases of SSBs for their children by making parents think SSBs are less healthful for their children and reducing their intentions to serve SSBs to their children. Communication approaches that target healthfulness perceptions and intentions to serve SSBs may motivate parents to buy fewer SSBs for their children.
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Affiliation(s)
- Marissa G Hall
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Anna H Grummon
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Tara Queen
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison J Lazard
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Isabella C A Higgins
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ana Paula C Richter
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lindsey Smith Taillie
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Silverstein MC, Lee CN, Scherer LD, Phommasathit C, Merrill AL, Peters E. Operating on Anxiety: Negative Affect toward Breast Cancer and Choosing Contralateral Prophylactic Mastectomy. Med Decis Making 2023; 43:152-163. [PMID: 36059240 PMCID: PMC9898882 DOI: 10.1177/0272989x221121134] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Rates of contralateral prophylactic mastectomy (CPM)-removal of the healthy breast following breast cancer diagnosis-have increased, particularly among women for whom CPM provides no survival benefit. Affective (i.e., emotional) decision making is often blamed for this increase. We studied whether greater negative breast cancer affect could motivate uptake of CPM through increased cancer risk perceptions and biased treatment evaluations. METHODS We randomly assigned healthy women with average breast-cancer risk (N = 1030; Mage = 44.14, SD = 9.23 y) to 1 of 3 affect conditions (negative v. neutral v. positive narrative manipulation) in a hypothetical online experiment in which they were asked to imagine being diagnosed with cancer in one breast. We assessed 1) treatment choice, 2) affect toward CPM, and 3) perceived risk of future breast cancer in each breast (cancer affected and healthy) following lumpectomy, single mastectomy, and CPM. RESULTS The manipulation caused women in the negative and neutral narrative conditions (26.9% and 26.4%, respectively) to choose CPM more compared with the positive narrative condition (19.1%). Across conditions, women's CPM affect did not differ. However, exploratory analyses addressing a possible association of affect toward cancer-related targets suggested that women in the negative narrative condition may have felt more positively toward CPM than women in the positive narrative condition. The manipulation did not have significant effects on breast cancer risk perceptions. LIMITATIONS The manipulation of affect had a small effect size, possibly due to the hypothetical nature of this study and/or strong a priori knowledge and attitudes about breast cancer and its treatment options. CONCLUSION Increased negative affect toward breast cancer increased choice of CPM over other surgical options and might have motivated more positive affective evaluations of CPM. HIGHLIGHTS This study used narratives to elicit different levels of negative integral affect toward breast cancer to investigate the effects of affect on breast cancer treatment choices.Increased negative affect toward breast cancer increased the choice of double mastectomy over lumpectomy and single mastectomy to treat a hypothetical, early-stage cancer.The narrative manipulation of negative affect toward breast cancer did not change the perceived risks of future cancer following any of the surgical interventions.Negative affect toward breast cancer may have biased affective evaluations of double mastectomy.
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Affiliation(s)
- Michael C. Silverstein
- Department of Psychology, Center for Science Communication Research, University of Oregon, Eugene, OR, USA
| | - Clara N. Lee
- Department of Plastic and Reconstructive Surgery, College of Medicine, Division of Health Services Management and Policy, College of Public Health, OSU Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Laura D. Scherer
- School of Medicine on the Anschutz Medical Campus, University of Colorado, VA Denver Center for Innovation, Aurora, CO, USA
| | | | | | - Ellen Peters
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, OR, USA
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Brennan E, Dunstone K, Vittiglia A, Mancuso S, Durkin S, Slater MD, Hoek J, Pettigrew S, Wakefield M. Testing the effectiveness of alcohol health warning label formats: An online experimental study with Australian adult drinkers. PLoS One 2022; 17:e0276189. [PMID: 36476743 PMCID: PMC9729007 DOI: 10.1371/journal.pone.0276189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 09/30/2022] [Indexed: 12/12/2022] Open
Abstract
Health warning labels (HWLs) on alcohol containers may help reduce population-level alcohol consumption. However, few studies have examined the most effective formats for alcohol HWLs. This study tested the effects of three different types of alcohol HWLs. In an online experiment, N = 1,755 Australian adult drinkers were randomly assigned to one of five conditions: (a) No HWL control; (b) DrinkWise control (industry-developed labels currently on some containers); (c) Text-Only HWLs; (d) Text + Pictogram HWLs; or (e) Text + Photograph HWLs. In the three intervention conditions, participants were exposed to eight HWLs, each depicting a different long-term harm. Exposure occurred during an initial session, and repeatedly over the subsequent eight days. Differences between conditions were assessed immediately following initial exposure and at nine-day follow-up. Compared to participants in the No HWL control, participants exposed to Text + Pictogram HWLs were more likely to have intentions to avoid drinking alcohol completely in the next month (post-exposure) and intentions to drink less alcohol in the next week (follow-up), and participants in all three intervention conditions reported stronger negative emotional arousal (follow-up) and weaker positive emotional arousal (follow-up). Compared to participants in the DrinkWise control, those exposed to Text + Pictogram HWLs had stronger intentions to drink less alcohol in the next week and intentions to avoid drinking alcohol completely in the next month (follow-up), participants in the Text + Photograph condition reported significantly weaker positive emotional arousal, and all three intervention conditions resulted in stronger negative emotional arousal. There would likely be benefits to public health if any of the three types of intervention HWLs were implemented. However, there is some evidence that Text + Pictogram HWLs should be recommended over Text-Only or Text + Photograph HWLs, given they were the only HWLs to increase intentions to drink less.
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Affiliation(s)
- Emily Brennan
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
- * E-mail:
| | - Kimberley Dunstone
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Amanda Vittiglia
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sam Mancuso
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Sarah Durkin
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
| | - Michael D. Slater
- School of Communication, The Ohio State University, Columbus, Ohio, United States of America
| | - Janet Hoek
- Department of Public Health, University of Otago, Wellington, New Zealand
| | - Simone Pettigrew
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Melanie Wakefield
- Centre for Behavioural Research in Cancer, Cancer Council Victoria, Melbourne, Victoria, Australia
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15
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Magnan RE, Song AV, Cameron LD. Worry as a mechanism of the relationship between perceived new knowledge and discouragement to smoke elicited from graphic cigarette warnings. J Behav Med 2022; 45:818-824. [DOI: 10.1007/s10865-022-00344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
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16
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Li W, Vargas-Rivera M, Kalan ME, Taleb ZB, Asfar T, Osibogun O, Noar SM, Maziak W. The Effect of Graphic Health Warning Labels Placed on the ENDS Device on Young Adult Users' Experience, Exposure and Intention to Use: A Pilot Study. HEALTH COMMUNICATION 2022; 37:842-849. [PMID: 33475000 PMCID: PMC8292444 DOI: 10.1080/10410236.2021.1872158] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This proof-of-concept study aims to evaluate the effect of placing graphic health warning labels (GHWLs) on the ENDS device on users' experience, puffing patterns, harm perception, nicotine exposure, and intention to quit or use in the future. JUUL users (n = 26, age 18-24 years; 69% male; 85% Hispanic) were recruited to complete two 60 minutes ad libitum sessions that differed by GHWL on the device (GHWL vs. no-GHWL control) in an experimental clinical lab study. Compared to the control session, using JUUL with GHWL on the device was significantly associated with reduced positive experiences such as pleasure, product liking, and user satisfaction (p-value < 0.05 for all). Also, after exposure to GHWL, participants were less interested in using the same product again (p-value = 0.007), even if it was the only product available on the market compared to control (p-value = 0.03). Trends toward reduced puffing behavior and nicotine boost were also noted during the GHWL, compared to control sessions. This pilot study shows that placing GHWL on the ENDS device may be an effective and promising strategy to reduce ENDS use among young people.
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Affiliation(s)
- Wei Li
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University
| | - Mayra Vargas-Rivera
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University
| | - Ziyad Ben Taleb
- Department of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington
| | - Taghrid Asfar
- Department of Public Health Sciences, Miller School of Medicine, University of Miami
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University
| | - Seth M. Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University
- Syrian Center for Tobacco Studies, Aleppo
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Kadu VD, Khadul SP, Kothe GJ, Mali GA. Rapid One‐Pot Aerobic Oxidative
N
‐α‐C(sp
3
)‐
H
Functionalization of Arylmethylamines to Access Tetrasubstituted Imidazoles. ASIAN J ORG CHEM 2022. [DOI: 10.1002/ajoc.202200162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Vikas D. Kadu
- School of Chemical Sciences Punyashlok Ahilyadevi Holkar Solapur University Solapur 413255 Maharashtra India
| | - Siddheshwar P. Khadul
- School of Chemical Sciences Punyashlok Ahilyadevi Holkar Solapur University Solapur 413255 Maharashtra India
| | - Gokul J. Kothe
- School of Chemical Sciences Punyashlok Ahilyadevi Holkar Solapur University Solapur 413255 Maharashtra India
| | - Ganesh A. Mali
- School of Chemical Sciences Punyashlok Ahilyadevi Holkar Solapur University Solapur 413255 Maharashtra India
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18
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Peters E, Boyd P, Cameron LD, Contractor N, Diefenbach MA, Fleszar-Pavlovic S, Markowitz E, Salas RN, Stephens KK. Evidence-based recommendations for communicating the impacts of climate change on health. Transl Behav Med 2022; 12:543-553. [PMID: 35613000 DOI: 10.1093/tbm/ibac029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Climate change poses a multifaceted, complex, and existential threat to human health and well-being, but efforts to communicate these threats to the public lag behind what we know how to do in communication research. Effective communication about climate change's health risks can improve a wide variety of individual and population health-related outcomes by: (1) helping people better make the connection between climate change and health risks and (2) empowering them to act on that newfound knowledge and understanding. The aim of this manuscript is to highlight communication methods that have received empirical support for improving knowledge uptake and/or driving higher-quality decision making and healthier behaviors and to recommend how to apply them at the intersection of climate change and health. This expert consensus about effective communication methods can be used by healthcare professionals, decision makers, governments, the general public, and other stakeholders including sectors outside of health. In particular, we argue for the use of 11 theory-based, evidence-supported communication strategies and practices. These methods range from leveraging social networks to making careful choices about the use of language, narratives, emotions, visual images, and statistics. Message testing with appropriate groups is also key. When implemented properly, these approaches are likely to improve the outcomes of climate change and health communication efforts.
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Affiliation(s)
- Ellen Peters
- Center for Science Communication Research, School of Journalism and Communication, University of Oregon, Eugene, OR, USA
| | - Patrick Boyd
- Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - Linda D Cameron
- Department of Psychological Sciences, University of California, Merced, Merced, CA, USA
| | - Noshir Contractor
- Departments of Industrial Engineering and Management Sciences, Management and Organizations, and Communication Studies, Northwestern University, Evanston, IL, USA
| | - Michael A Diefenbach
- Institute for Health System Science at the Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Sara Fleszar-Pavlovic
- Department of Psychological Sciences, University of California, Merced, Merced, CA, USA
| | - Ezra Markowitz
- Department of Environmental Conservation, University of Massachusetts, Amherst, MA, USA
| | - Renee N Salas
- Harvard Medical School, Harvard University, Boston, MA, USA
| | - Keri K Stephens
- Technology & Information Policy Institute, Communication Studies, The University of Texas at Austin, Austin, TX, USA
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Yau MTK, Yau KW, Hussaini T, Yoshida EM. A Narrative Review of the Efficacy and Design of Safety Labels on Tobacco Products to Promote the Use of Safety Labels on Alcohol Products in Canada. Cureus 2022; 14:e25306. [PMID: 35755528 PMCID: PMC9226242 DOI: 10.7759/cureus.25306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2022] [Indexed: 11/07/2022] Open
Abstract
Alcohol is consumed by approximately three-quarters of Canadians. Alcohol causes acquired liver disease, increases the risk of cancer, has detrimental effects on mental health, and leads to adverse pregnancy outcomes. Alcohol-related morbidity and mortality are high, and urgent public health measures are warranted to prevent and control these. Tobacco safety labels have been shown in numerous studies to reduce tobacco consumption. Much can be learned from the design of tobacco safety labels in creating promising alcohol safety labels that can possibly help reduce alcohol consumption. The aim of this paper is to review the efficacy of tobacco safety labels in reducing tobacco consumption and the design of tobacco safety labels and to propose a promising design for alcohol safety labels based on our findings. English peer-reviewed papers published in western countries since 2000 were searched on PubMed and Google Scholar. Keywords and synonyms were used to search pertinent papers, which were subsequently screened by title and abstract and fully reviewed if relevant. Findings from studies comparing designs of safety labels on alcohol and tobacco products are similar. Graphics, higher emotion content, and greater size are associated with greater attention, awareness, negative emotions, intention to quit, and reduction in consumption. Mixed results are found for testimonials containing safety labels on tobacco products. It is unclear whether testimonials on alcohol safety labels reduce alcohol consumption or not. Safety labels with specific information, such as tobacco-related costs and alcohol-related cancer risks, are more effective in reducing tobacco consumption. In conclusion, preliminary alcohol safety labels show promise. Large safety labels with graphics and high emotional content appear to be most effective and may reduce alcohol consumption.
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Affiliation(s)
| | - Kiana W Yau
- Faculty of Medicine, McGill University, Montreal, CAN
| | - Trana Hussaini
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, CAN
| | - Eric M Yoshida
- Division of Gastroenterology, Faculty of Medicine, University of British Columbia, Vancouver, CAN
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Thrasher JF, Islam F, Arillo-Santillán E, Rodriguez-Bolaños R, de Miera Juarez BS, Hardin JW, Barrientos-Gutierrez I. Strategies to enhance the effects of pictorial warnings for cigarettes: results from a discrete choice experiment. Addiction 2022; 117:1095-1104. [PMID: 34697845 PMCID: PMC8904287 DOI: 10.1111/add.15725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 09/28/2021] [Indexed: 11/30/2022]
Abstract
AIMS To measure the effects of changing attributes of pictorial health warning labels (HWLs) on cigarette packs in a country that has already implemented pictorial HWLs. MEASURES For each choice set, participants were presented with two cigarette packs and asked the following three questions: (1) 'If only these two cigarette packs were available, which would you buy?'; (2) 'Each of these two packs has warnings on the front and back about the health effects of smoking. Which of these warnings best informs you about the dangers from smoking?'; and (3) 'Which warning most makes you think about quitting smoking?'. As recommended for best practices in discrete choice experiments, each of these questions was followed by an 'opt-out' question for participants to indicate whether they really believed there was a difference between the options presented (i.e. 'Would you really choose one of them?'; 'Do you really think that either of these warnings informs you about dangers from smoking?'; or 'Do you really think that either of these warnings would make you think about quitting smoking?', respectively). Each choice set could be viewed for as long as the participant wished. For each choice question (i.e. willingness to buy, informative, motivating to quit), the pack chosen was coded as 1 and the other pack as 0, with both packs being given a value of 0 if the participant 'opted out'. DESIGN A within-subject discrete choice experiment that involved systematic manipulation of pictorial HWL size [75 versus 30% (current policy)]; inclusion of imagery on the back of the pack [versus none (current policy)]; and color formatting [black on yellow versus yellow on black (current policy)]. SETTING Mexico, on-line panel. PARTICIPANTS Adult smokers (n = 705). MEASUREMENTS For each choice set, participants selected one pack as having the most informative HWL about smoking harms, the one that makes them think the most about quitting and the one they were most willing to buy. We assessed the independent and interactive effects of HWL attributes on choices. FINDINGS Larger HWL size on the pack front (75 versus 30%) and inclusion of a pictorial image on the pack back were both independently associated with lower willingness to buy a pack [b = -0.228, standard error (SE) = 0.023 and -0.089, SE = 0.016, respectively] and greater perception of an HWL as informative (b = 0.214, SE = 0.022, and 0.191, SE = 0.017, respectively) and motivating to quit (b = 0.251, SE = 0.023 and 0.194, SE = 0.017, respectively). HWL with black text and yellow background were perceived as less informative (b = -0.037, SE = 0.016) and less motivating to quit (b = -0.032, SE = 0.015) compared with yellow text on a black background. CONCLUSIONS Among adult Mexican smokers, pictorial health warning labels on cigarette packages that are larger or cover both sides of the pack appear more effective at lowering purchase intentions and increasing risk perceptions and motivation to quit than smaller health warning labels or health warning labels with imagery only on the pack front.
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Affiliation(s)
- James F. Thrasher
- Department of Health Promotion, Education & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.,Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Farahnaz Islam
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Edna Arillo-Santillán
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | - Rosibel Rodriguez-Bolaños
- Department of Tobacco Research, Center for Population Health Research, National Institute of Public Health, Cuernavaca, Mexico
| | | | - James W. Hardin
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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22
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Mutti-Packer S, Kim HS, McGrath DS, Ritchie EV, Wohl MJA, Rockloff M, Hodgins DC. An experiment on the perceived efficacy of fear-based messages in online roulette. INTERNATIONAL GAMBLING STUDIES 2022. [DOI: 10.1080/14459795.2022.2038655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Hyoun S. Kim
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Daniel S. McGrath
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Emma V. Ritchie
- Department of Psychology, York University, Toronto, ON, Canada
| | | | - Matthew Rockloff
- Department of Psychology, Central Queensland University, Rockhampton, QD, Australia
| | - David C. Hodgins
- Department of Psychology, University of Calgary, Calgary, AB, Canada
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Johnson AC, Simmens SJ, Turner MM, Evans WD, Strasser AA, Mays D. Longitudinal effects of cigarette pictorial warning labels among young adults. J Behav Med 2022; 45:124-132. [PMID: 34554369 PMCID: PMC8821134 DOI: 10.1007/s10865-021-00258-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 09/08/2021] [Indexed: 02/03/2023]
Abstract
Young adults are influenced by cigarette package marketing. Pictorial warning labels are a recommended intervention. Evidence demonstrates pictorial warnings impact negative emotion, risk perceptions, and motivation to quit smoking, but there is limited research on their effects over time. This study analyzes data from a randomized trial of young adult smokers (N = 229) exposed to a pictorial or text-only cigarette warning. We assessed changes in fear, anger, risk perceptions, and motivation to quit smoking after 4 weeks using latent change score modeling and over 3 months using latent growth modeling. Latent change results showed exposure was associated with increases in fear, anger, and motivation to quit after 4 weeks. Latent growth showed exposure was associated with increases in motivation to quit smoking over 3 months, but not other outcomes. Findings suggest pictorial warning labels produce an emotional response and increase motivation to quit among young adult smokers.
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Affiliation(s)
- Andrea C. Johnson
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Samuel J. Simmens
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Monique M. Turner
- Department of Communication, Michigan State University, East Lansing, Michigan
| | - W. Douglas Evans
- Prevention and Community Health Department, Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Andrew A. Strasser
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Darren Mays
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH
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Sidhu AK, Johnson AC, Souprountchouk V, Wackowski O, Strasser AA, Mercincavage M. Cognitive and emotional responses to pictorial warning labels and their association with quitting measures after continued exposure. Addict Behav 2022; 124:107121. [PMID: 34583271 PMCID: PMC8603253 DOI: 10.1016/j.addbeh.2021.107121] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Previous research has highlighted the role of cognitive and affective mediators in facilitating the effectiveness of pictorial warning labels (PWLs). This study examines smokers' responses towards PWLs after 10 days of use and their associations with changes in quitting attitudes, beliefs, and intentions during this period. METHODS Non-treatment-seeking, daily smokers completed a randomized, parallel design trial. Participants were randomized to either a PWL or control (i.e., text only or no warning label) group and received their preferred brand cigarettes affixed with their assigned label for 10 days. We assessed quitting attitudes, intentions, and beliefs at the onset and end of the study. At study end, smokers rated their PWL on a 5-point scale for 8 cognitive and emotional attributes: memorable, understandable, shocking, informative, offensive, boring, relevant, and interesting. RESULTS Mean ratings of the PWLs were high for memorable, understandable, informative, relevant, and interesting (range = 3.4 to 4.0), moderate for shocking (2.9), and low for offensive (1.7), and boring (1.5). Among the PWLs, quitting-related attitudes, positive beliefs, and intentions increased over the study period (p < .001) and these changes were positively associated with most attributes except offensive and boring (p < .05). For the text-only label group, attitudes and intentions increased significantly but these changes were not associated with any attributes. CONCLUSION Smokers generally have favorable evaluations of PWLs following repeated exposures. Further, these evaluations are associated with increased quitting attitudes and intentions, which may facilitate cessation attempts over longer periods of exposure.
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Affiliation(s)
- Anupreet K Sidhu
- University of Pennsylvania Tobacco Center of Regulatory Science (UPenn TCORS) and Center for Interdisciplinary Research on Nicotine Addiction (CIRNA), Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States.
| | - Andrea C Johnson
- University of Pennsylvania Tobacco Center of Regulatory Science (UPenn TCORS) and Center for Interdisciplinary Research on Nicotine Addiction (CIRNA), Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Valentina Souprountchouk
- University of Pennsylvania Tobacco Center of Regulatory Science (UPenn TCORS) and Center for Interdisciplinary Research on Nicotine Addiction (CIRNA), Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Olivia Wackowski
- Department of Health Behavior, Society and Policy, Rutgers School of Public Health, and Rutgers Center for Tobacco Studies, Rutgers University, New Brunswick, NJ, United States
| | - Andrew A Strasser
- University of Pennsylvania Tobacco Center of Regulatory Science (UPenn TCORS) and Center for Interdisciplinary Research on Nicotine Addiction (CIRNA), Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Melissa Mercincavage
- University of Pennsylvania Tobacco Center of Regulatory Science (UPenn TCORS) and Center for Interdisciplinary Research on Nicotine Addiction (CIRNA), Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
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Johnson AC, Turner MM, Simmens SJ, Evans WD, Strasser AA, Mays D. Mediational Effects on Motivation to Quit Smoking After Exposure to a Cigarette Pictorial Warning Label Among Young Adults. Ann Behav Med 2021; 56:737-748. [PMID: 34415010 DOI: 10.1093/abm/kaab073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Young adults are vulnerable to cigarette package marketing. Pictorial warning labels are recommended for tobacco control. Research should address questions raised in legal challenges including causal mechanisms. Evidence is mixed and understudied among young adults (e.g., discrete emotions and risk perceptions). PURPOSE This study investigated mediators of pictorial warning label effects on motivation to quit smoking among young adult smokers. METHODS This study analyzed data from a randomized trial with a 4 week exposure to a cigarette pictorial warning among young adult smokers (N = 229) aged 18-30 with assessments at baseline, immediately post-intervention, and 3 months. Mediation analyses used latent change scores to test the effects post-intervention on fear, anger, and risk perceptions. We also examined whether post-intervention measures predicted change in motivation to quit smoking at 3 months. The first model assessed aggregate risk perceptions and the second model assessed discrete risk perceptions (deliberative, affective). RESULTS Pictorial warning label exposure led to increases in fear which led to increased motivation to quit smoking for the first (B = 0.12, 95% CI = 0.04, 0.26) and second (B = 0.12, 95% CI = 0.03, 0.25) model. Exposure modestly increased motivation to quit by way of fear and affective risk perceptions (B = 0.01, 95% CI = 0.00, 0.04). Exposure had a direct relationship on increased motivation to quit as well. CONCLUSIONS Findings demonstrate factors contributing to change in motivation to quit smoking among young adult smokers after pictorial warning label exposure. Affective processes are mediators of pictorial warning label effects.
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Affiliation(s)
- Andrea C Johnson
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Monique M Turner
- Department of Communication, Michigan State University, East Lansing, MI, USA
| | - Samuel J Simmens
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - W Douglas Evans
- Prevention and Community Health Department, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Andrew A Strasser
- Department of Psychiatry and Tobacco Center of Regulatory Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Darren Mays
- Department of Internal Medicine, Wexner Medical Center, Center for Tobacco Research, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
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Strong DR, Pierce JP, Pulvers K, Stone MD, Villaseñor A, Pu M, Dimofte CV, Leas EC, Oratowski J, Brighton E, Hurst S, Kealey S, Chen R, Messer K. Effect of Graphic Warning Labels on Cigarette Packs on US Smokers' Cognitions and Smoking Behavior After 3 Months: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2121387. [PMID: 34347057 PMCID: PMC8339936 DOI: 10.1001/jamanetworkopen.2021.21387] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE The US Food and Drug Administration's implementation of graphic warning labels (GWLs) on cigarette packs is under challenge in US courts. OBJECTIVE To determine whether GWLs can affect US smokers' perceptions about their cigarettes or health consequences and changes in smoking behavior. DESIGN, SETTING, AND PARTICIPANTS This study was a randomized clinical trial of the effect of a 3-month, real-world experience of cigarettes with GWL packaging. Community recruitment was done from September 2016 through December 2019 of daily smokers from San Diego, California, aged 21 to 65 years, who were not ready to quit. Participants were randomized to purchase and receive cigarettes in 1 of 3 pack designs: GWL, blank, or standard US pack. Data analysis was performed from July 2020 to February 2021. INTERVENTIONS The study manufactured GWL cigarette packs (3 versions with Australian-licensed images) and packs devoid of marketing. For 3 months, participants purchased GWL, blank, or standard US pack cigarettes that were delivered to their home. MAIN OUTCOMES AND MEASURES Smoking-related cognitions and behavior were queried by daily and weekly interactive text messages. Smoking behavior was self-reported before and after the intervention by 96% of randomized participants and was biochemically validated on a subsample. RESULTS The study sample included 357 participants (195 women [54.6%]; mean [SD] age, 39.5 [11.9] years); 116 were randomized to the standard US pack group, 118 were randomized to the GWL pack group, and 125 were randomized to the blank pack group. Over the 3 months, participants who received the GWL packs had reduced positive perceptions of recent cigarettes smoked compared with participants who received the branded US pack (mean difference, -0.46 SD; 95% CI, -0.73 SD to -0.20 SD; P < .001). Health concerns increased in all groups, with a significant increase in the GWL group vs the US pack group (mean difference, 0.35 SD; 95% CI, 0.09 SD to 0.62 SD; P = .002). Quitting cognitions increased in all study groups, with a peak mean change of 0.60 SD for GWL participants vs 0.34 SD for US pack participants (mean difference, 0.55 SD; 95% CI, 0.28 SD to 0.81 SD; P < .001). GWL participants had slightly more cigarette abstinence periods per week than the US pack group, but the difference was not significant (adjusted odds ratio, 1.06; 95% CI, 0.99 to 1.13). At 3 months, there was no between-group difference in any smoking behavior. The blank pack group was similar to the US pack group on all measures. CONCLUSIONS AND RELEVANCE These findings suggest that the introduction of GWL packs appears to decrease positive perceptions of cigarettes and increase quitting cognitions in the short term. However, additional complementary tobacco control strategies may be necessary for GWL packs to be associated with reduced smoking behavior. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02676193.
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Affiliation(s)
- David R. Strong
- Cancer Control Program, Moores Cancer Center, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - John P. Pierce
- Cancer Control Program, Moores Cancer Center, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos
| | - Matthew D. Stone
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Adriana Villaseñor
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Department of Epidemiology, Public Health Services, San Diego County, San Diego, California
| | - Minya Pu
- Cancer Control Program, Moores Cancer Center, University of California, San Diego, La Jolla
| | - Claudiu V. Dimofte
- Department of Marketing, San Diego State University, San Diego, California
| | - Eric C. Leas
- Cancer Control Program, Moores Cancer Center, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Jesica Oratowski
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Elizabeth Brighton
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Samantha Hurst
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Sheila Kealey
- Cancer Control Program, Moores Cancer Center, University of California, San Diego, La Jolla
| | - Ruifeng Chen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Karen Messer
- Cancer Control Program, Moores Cancer Center, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
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Mostafa A, El Houssinie M, Hussein RS. Perceived efficacy of existing waterpipe tobacco warning labels versus novel enhanced generic and waterpipe-specific sets. PLoS One 2021; 16:e0255244. [PMID: 34314460 PMCID: PMC8315518 DOI: 10.1371/journal.pone.0255244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/12/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Since 2008, Egypt has four existing generic bi-annually rotating warning labels (WLs) on 50% of the waterpipe tobacco packs (WTPs). The Ministry of Health Tobacco Control Unit proposed increasing WL size to 80%, removing colours and flavour imagery from WTPs, and plain packaging to help curb the rising epidemic of waterpipe tobacco smoking. Therefore, we measured the perceived efficacy of existing against novel enhanced (generic and waterpipe-specific) WTP WLs and the associated factors among Egyptian waterpipe smokers and nonsmokers. METHODS A purposive quota sample of 2014 adults was surveyed in two rounds using face interviews. At each round, participants were randomly shown one of four existing WLs, then one of four novel WLs. Participants rated the perceived efficacy of existing and novel WLs regarding the salience, depth of processing, affective reactions, credibility, relevance, perceived harm and perceived behavioural control. Data were analysed using Generalized Estimating Equations. RESULTS Participants rated novel WTP WLs with higher mean perceived efficacy scores than existing WLs for all measures, although both sets collectively scored modestly (59.7; 95% CI: 58.9-60.5 vs 53.0; 95% CI: 52.1-54.0, respectively; p<0.001). Relative to the existing WTP WLs, novel WLs were particularly able to induce higher salience, affective reactions, and depth of processing. Relative to the generic novel WTP WLs, waterpipe-specific WLs induced higher relevance, perceived harm, and affective reactions. Nonsmokers scored higher than waterpipe tobacco smokers, specifically for perceived behavioral control (65.0±32.5 vs 43.6±19.8, respectively; p<0.001). WTP WLs featuring proximal risks, such as dental effects (β = 9.70; 95% CI: 7.00-12.40), fetal harm (β = 9.42; 95% CI: 6.75-12.10), or toxic contents (β = 9.14; 95% CI: 6.58-11.70) were strongly associated with participants' perceived efficacy scores. Among other independent factors, rural residence (β = 24.09; 95% CI: 22.21-25.97), being a nonsmoker (β = 10.51; 95% CI: 8.92-12.10), survey round 2 (β = 6.96, 95% CI: 5.73-8.19), the novel WTP WL set (β = 6.68; 95% CI: 6.19-7.17), and having higher education (β = 6.31; 95% CI: 4.34-8.27) were highly associated with participants' perceived efficacy scores. CONCLUSIONS Waterpipe-specific WLs on plain WTPs that feature proximal risks and address different population subgroups need to be developed in conjunction with awareness raising campaigns on WTS harms to reinforce the credibility of WTP WLs. Our findings suggest the proposed WTP WL enhancements by the Tobacco Control Unit may support a more effective WTP labelling policy within a comprehensive waterpipe-specific tobacco control framework.
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Affiliation(s)
- Aya Mostafa
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
- * E-mail:
| | - Moustafa El Houssinie
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Rasha Saad Hussein
- Department of Community, Environmental, and Occupational Medicine, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Examining the effect of waterpipe specific pictorial health warning labels among young adults in Lebanon and Tunisia: Protocol of a factorial experiment study design. Contemp Clin Trials Commun 2021; 23:100797. [PMID: 34235290 PMCID: PMC8249778 DOI: 10.1016/j.conctc.2021.100797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 05/23/2021] [Accepted: 06/03/2021] [Indexed: 02/06/2023] Open
Abstract
Waterpipe tobacco smoking (WTS) has increased substantially in the Eastern Mediterranean Region (EMR), affecting young adults who perceive waterpipe as safer than cigarette smoking. Applying pictorial health warning labels (HWLs) on tobacco products has been effective in communicating health risks associated with tobacco smoking. However, there are few experimental studies that examined pictorial HWLs specific to WTS. Methods/design: This report describes the design and protocol of the first factorial experimental study that aims to test the effectiveness of pictorial HWLs based on their placement on waterpipe device, tobacco, and charcoal packages among young adult smokers and non-smokers residing in Lebanon and Tunisia. After completing a baseline assessment, participants will be randomly assigned to 3 experimental conditions in a 3 (HWL: pictorial HWL on tobacco package vs. pictorial HWL on 3 placements [device, tobacco, and charcoal packages] vs. text-only HWL on tobacco package) x 4 (pictorial HWLs) x 2 (waterpipe smokers vs. non-smokers) factorial design. We will use a within/between-subject design, where pictorial HWLs and time (pre vs. post-exposure) are the within-subject factors and waterpipe smoking status as the between-subjects factor. Participants will complete post-exposure measures that include attention, perceived harm, intention to quit (smokers) or initiate smoking (non-smokers). Discussion: This is the first international study examining the placements of pictorial HWLs using efficient within/between subject design. Findings will provide additional evidence to convince policymakers to consider three placements of HWLs specific to WTS as a promising regulatory target to curb WTS.
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Stone MD, Dimofte CV, Strong DR, Villasenor A, Pulvers K, Messer K, Pierce JP. Tool to assess appeal-aversion response to graphic warning labels on cigarette packs among US smokers. Tob Control 2021; 30:312-319. [PMID: 32345609 PMCID: PMC7606326 DOI: 10.1136/tobaccocontrol-2019-055520] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/10/2020] [Accepted: 03/23/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Graphic warning labels on cigarette packaging are mandated in 118 countries and are under consideration in the USA. We propose an appeal-aversion assessment tool to help regulators choose among graphic packaging options. METHODS After familiarisation with different cigarette packaging, adult daily smokers (n=338) from San Diego, California, USA completed a discrete choice appeal-aversion purchasing task and provided information on nicotine dependence and sociodemographics (2017-2019). The conjoint analysis estimated the importance and price utility for product attributes (ie, packaging, price, tobacco origin and quitline number). The price premiums that smokers would be willing to pay to avoid purchasing graphic packaging were calculated. RESULTS Among purchase determinants, the price was the most important attribute (65.5%), followed by packaging design (27.1%). Compared with blank packaging without marketing, branded industry packs had appeal valuations (US$0.54; 95% CI: US$0.44 to US$0.65), whereas graphic warning packs had aversion valuations that varied with the salience of the image (blindness=-US$2.53, 95% CI: -US$2.76 to -US$2.31; teeth damage=-US$2.90, 95% CI: -US$3.17 to -US$2.63; and gangrenous foot=-US$3.70, 95% CI: -US$4.01 to -US$3.39). The aversion was such that 46.2% of participants were willing to pay a 50+% premium over their current cigarette price to have their branded packs rather than a graphic pack. These appeal-aversion valuations were moderated by sex, income and nicotine dependence (p<0.05). CONCLUSIONS Smokers indicated a willingness to pay substantial premiums to avoid purchasing graphic packaging. Results suggest that mandating graphic warnings on US cigarette packs would induce price aversion and may deter cigarette purchasing. Price valuations from this appeal-aversion tool could be useful for regulators to differentiate between graphic warning labels.
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Affiliation(s)
- Matthew D Stone
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Claudiu V Dimofte
- Department of Marketing, San Diego State University, San Diego, California, USA
| | - David R Strong
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Adriana Villasenor
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - Kim Pulvers
- Department of Psychology, California State University San Marcos, San Marcos, California, USA
| | - Karen Messer
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
| | - John P Pierce
- Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California, USA
- Cancer Prevention and Control Program, Moores Cancer Center, University of California San Diego, La Jolla, California, USA
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Chudech S, Janmaimool P. Effectiveness of warning graphic labels on cigarette packs in enhancing late-teenagers' perceived fear of smoking-related harms in Bangkok, Thailand. J Public Health Res 2021; 10:1912. [PMID: 33553059 PMCID: PMC7856827 DOI: 10.4081/jphr.2021.1912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 12/12/2020] [Indexed: 12/04/2022] Open
Abstract
Background: This study investigated the level of fear of smoking- related harms for teenagers of different gender, different levels of smoking behaviour, and difference in smoking levels of friends and family members, as influenced by warning graphic images on cigarette packs. The study also compared levels of this fear in categories based on participants' perception (e.g., scarier or less scary images). Design and Methods: The sample group was 353 undergraduate students at King Mongkut's University of Technology Thonburi in Bangkok, Thailand. Questionnaires containing 21 warning graphic images, aimed at measuring levels of fear of smoking-related harms, were conducted. Both descriptive statistics and inferential statistics, such as independent and dependent ttest, were used to analyse the data. Results: The results showed that warning graphic images exhibiting patients suffering from cancers (e.g., lung cancer or laryngeal cancer) and images of damaged body parts were perceived as the scariest warning images. In contrast, images that did not illustrate serious disease suffered by smokers were perceived as the least scary images. The scariest images generated a significant higher level of fear of smoking-related harms than the least scary images. In addition, non-smoking participants were more sensitive to scary warning images than smoking participants. It was also found that the level of fear of smoking-related harms was significantly based on individual cognitive judgment, and it was not affected by the influence of social groups such as friends and family members. Conclusions: Developing effective warning graphic images could directly contribute to individuals' perceived health risks and danger associated with smoking.
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Affiliation(s)
- Surapong Chudech
- Department of Social Sciences and Humanities, School of Liberal Arts, King Mongkut’s University of Technology Thonburi, Bangkok, Thailand
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Ma H, Miller CH. The Effects of Agency Assignment and Reference Point on Responses to COVID-19 Messages. HEALTH COMMUNICATION 2021; 36:59-73. [PMID: 33198533 DOI: 10.1080/10410236.2020.1848066] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As the COVID-19 pandemic poses severe threats to human life around the globe, effective risk messages are needed to warn the public and encourage recommended actions for avoiding infection, especially as steps are taken to ease physical restrictions and restart economies. The present study examines the effects of agency assignment and reference point on perceptions of SARS-CoV-2 threat and assesses key message responses, including psychological reactance, source derogation, counterarguing, and behavioral intentions. Participants (N = 207) were randomly assigned to one of four conditions crossing agency assignment (SARS-CoV-2/human) and reference point (self/self-other). Results show, relative to human agency, SARS-CoV-2 agency assignment generated significantly more psychological reactance in the form of greater perceptions of freedom threat, anger, and negative cognitions, as well as more source derogation and counterarguing. No significant effects were found for reference point, and the interaction between agency assignment and reference point was not significant. The study findings, limitations, and implications are discussed.
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Affiliation(s)
- Haijing Ma
- Department of Communication, University of Oklahoma
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Pierce JP, Strong DR, Stone MD, Villaseñor A, Dimofte CV, Leas EC, Oratowski J, Brighton E, Hurst S, Pulvers K, Kealey S, Chen R, Messer K. Real-world exposure to graphic warning labels on cigarette packages in US smokers: The CASA randomized trial protocol. Contemp Clin Trials 2020; 98:106152. [PMID: 32966877 PMCID: PMC7502239 DOI: 10.1016/j.cct.2020.106152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 01/29/2023]
Abstract
BACKGROUND The US lags behind >120 countries in implementing graphic warning labels (GWLs) on cigarette packs. US courts prevented implementation of FDA's 2012 rule requiring GWLs citing the need for more evidence on effectiveness. After more research, in 2020, the FDA proposed a revised rule mandating GWLs. This trial will test how the introduction of GWLs influence cognitions and behavior in US smokers. METHOD To investigate the "real-world" impact of GWLs in US smokers, we are conducting a randomized trial involving a 3-month intervention and 8-month follow-up. The study recruited California smokers between September 2016 through December 2019 and randomly assigned them into 3 groups (1) Blank Pack devoid of any cigarette branding; (2) GWL Pack featuring 1 of 3 rotating images added to blank pack; or (3) their usual Standard US Pack. Throughout the 3-month intervention, participants purchased study-packaged cigarettes and reported daily cognitions and behavior through ecological momentary assessments. We will validate self-reported tobacco use with saliva cotinine concentrations following the 3-month intervention and 8-month follow-up. RESULTS The trial enrolled 359 participants (average age 39 years; average cigarette consumption half a pack/day). The 3 study groups were balanced on age, gender, race-ethnicity, education and income (17% low income) as well as on smoking related variables. CONCLUSIONS This 3-month real-world randomized trial will test the effect of repackaging cigarettes from standard US packs to GWL plain packs on smokers' perceptions of the risks of smoking, their perception of the appeal of their cigarettes, and on their smoking behavior.
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Affiliation(s)
- John P. Pierce
- Cancer Control Program, Moores Cancer Center, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0901, United States,Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States,Corresponding author at: Cancer Control Program, Moores Cancer Center, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0901, United States
| | - David R. Strong
- Cancer Control Program, Moores Cancer Center, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0901, United States,Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Matthew D. Stone
- Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Adriana Villaseñor
- Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Claudiu V. Dimofte
- Department of Marketing, San Diego State University, 5500 Campanile Dr, San Diego, CA 92182, United States
| | - Eric C. Leas
- Cancer Control Program, Moores Cancer Center, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0901, United States,Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Jesica Oratowski
- Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Elizabeth Brighton
- Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Samantha Hurst
- Cancer Control Program, Moores Cancer Center, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0901, United States
| | - Kimberley Pulvers
- Department of Psychology, Social and Behavioral Sciences Building, California State University, San Marcos 200 E Barham Dr, San Marcos, CA, 92096, United States
| | - Sheila Kealey
- Cancer Control Program, Moores Cancer Center, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0901, United States
| | - Ruifeng Chen
- Division of Biostatistics, Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
| | - Karen Messer
- Cancer Control Program, Moores Cancer Center, UC San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0901, United States,Division of Biostatistics, Department of Family Medicine and Public Health, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093, United States
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Chan HF, Bodiuzzman SM, Torgler B. The power of social cues in the battle for attention: Evidence from an online platform for scholarly commentary. J Informetr 2020. [DOI: 10.1016/j.joi.2020.101077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Pepper JK, Zarndt AN, Eggers ME, Nonnemaker JM, Portnoy DB. Impact of Pictorial Cigarette Warnings Compared With Surgeon General's Warnings on Understanding of the Negative Health Consequences of Smoking. Nicotine Tob Res 2020; 22:1795-1804. [PMID: 32202624 PMCID: PMC10557086 DOI: 10.1093/ntr/ntaa032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 02/03/2020] [Indexed: 10/08/2023]
Abstract
INTRODUCTION The Family Smoking Prevention and Tobacco Control Act requires cigarette packages and advertisements to bear health warnings with "color graphics depicting the negative health consequences of smoking." AIMS AND METHODS This study assessed whether new US Food and Drug Administration developed pictorial cigarette warnings (PCW) increased understanding of smoking-related risks relative to the current Surgeon General's (SG) warnings. In March-May 2019, adolescent and adult smokers and nonsmokers participated in an online experiment with three sessions completed over approximately 2 weeks. Participants viewed 1 of 16 PCW (treatment conditions) or an SG warning (control) on mock cigarette packages and advertisements. Measures assessed whether warnings provided new information, induced thinking about risks, changed smoking-related health beliefs, and were accurately recalled, among other outcomes. RESULTS The majority of PCW (≥13 conditions) resulted in greater learning of new information, higher self-reported learning, and greater reports of thinking about smoking risks; they were viewed as more informative, understandable, and attention-drawing compared with the control condition. Most participants believed the warning were factual, although 8 PCW were perceived as less factual than the control. There were changes toward more agreement with health beliefs for 11 PCW between Sessions 1 and 2 and 7 PCW between Sessions 1 and 3. Participants in all treatment conditions were more likely than control condition participants to correctly recall the warning. Across outcomes, PCW related to addiction, death, and quitting did not perform as well as other PCW. CONCLUSIONS Many of the PCW tested increased understanding of the risks associated with cigarette smoking relative to current SG warnings. IMPLICATIONS The Tobacco Control Act requires cigarette packages and advertisements to bear PCW depicting the negative health consequences of smoking. This study tested whether any of 16 newly proposed PCW increased understanding of smoking-related risks relative to existing SG warnings. Results suggest that most PCW tested, particularly those related to less widely known health effects, resulted in greater learning of new information, higher self-reported learning, and greater reports of thinking about smoking risks compared with SG warnings. These results, along with other factors, informed the US Food and Drug Administration's selection of proposed PCW.
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Affiliation(s)
- Jessica K. Pepper
- Center for Health Policy Science & Tobacco Research, RTI International, Research Triangle Park, NC
| | - Anh Nguyen Zarndt
- US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD
| | - Matthew E. Eggers
- Center for Health Policy Science & Tobacco Research, RTI International, Research Triangle Park, NC
| | - James M. Nonnemaker
- Center for Health Policy Science & Tobacco Research, RTI International, Research Triangle Park, NC
| | - David B. Portnoy
- US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD
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Pepper JK, Zarndt AN, Eggers ME, Nonnemaker JM, Portnoy DB. Influence of Warning Statements on Understanding of the Negative Health Consequences of Smoking. Nicotine Tob Res 2020; 22:1805-1815. [PMID: 32202620 PMCID: PMC10552677 DOI: 10.1093/ntr/ntaa031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 02/03/2020] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Pursuant to the Tobacco Control Act (TCA), the US Food and Drug Administration (FDA) is developing new cigarette health warnings to convey the negative health consequences of cigarette smoking. AIMS AND METHODS This study assessed which of 15 revised warning statements (10 on topics similar to TCA statements and 5 on other topics) promoted greater understanding of cigarette smoking risks relative to TCA statements. In February 2018, adolescent and adult smokers and adolescents susceptible to smoking (n = 2505) completed an online experiment. Control condition participants viewed TCA statements; treatment condition participants viewed combinations of TCA and revised statements. Analyses compared revised statements to TCA statements on the same health topic or to randomly selected TCA statements if there were no statements on the same topic. RESULTS Relative to TCA statements, 12 of 15 revised statements were more likely to be considered new information, and 12 resulted in more self-reported learning. Three revised statements made participants think more about health risks than TCA statements; the reverse was true for one revised statement. Participants rated most TCA and revised statements as moderately believable and informative. Seven revised statements were found to be less believable and factual, and one revised statement more believable and factual. Treatment condition participants correctly selected more smoking-related health conditions than control condition participants (13.79 versus 12.42 of 25). CONCLUSIONS Findings suggest that revised statements can promote greater understanding of cigarette smoking risks. Results informed FDA's selection of warning text that was paired with images for testing in a follow-up study. IMPLICATIONS The US FDA may adjust the text of the cigarette warning statements provided in the TCA if the revised statements promote greater public understanding of the negative health consequences of cigarette smoking. Most of the revised warning statements tested were more likely to be considered new information and resulted in more self-reported learning compared with paired TCA statements, providing support for using revised statements as part of cigarette health warnings. These results informed the development of pictorial cigarette warnings by FDA that were tested in a follow-up study and included in a proposed rule.
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Affiliation(s)
- Jessica K. Pepper
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC
| | - Anh Nguyen Zarndt
- US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD
| | - Matthew E. Eggers
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC
| | - James M. Nonnemaker
- Center for Health Policy Science and Tobacco Research, RTI International, Research Triangle Park, NC
| | - David B. Portnoy
- US Food and Drug Administration, Center for Tobacco Products, Silver Spring, MD
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Cho HY, Chun S, Choi Y. The Paradox of Smoking & Perceived Stress: Do Graphic Health Warnings Influence Smokers under High Stress in Adverse Ways? HEALTH COMMUNICATION 2020; 35:1368-1375. [PMID: 31267794 DOI: 10.1080/10410236.2019.1636339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The positive effects of graphic health warnings (GHWs) on quitting smoking have been widely demonstrated in the literature on cigarette warning. However, recent findings of smoker reactance to GHWs demand investigations of factors that may constrain the effects of GHWs. The current study sought to identify conditions in which GHWs do not have a positive impact on smokers' desire to quit with a focus on smokers' perceived stress. Two hundred and forty-four smokers in South Korea were exposed to either a text-only or a GHW cigarette pack in a between-subjects experiment. Results from this study suggest that the GHW condition is effective in increasing attention to the GHW, enhancing perceived usefulness of information, and desire to quit only among those with low (vs. high) perceived stress. In addition, an interaction effect between warning type and perceived stress on the desire to quit was sequentially mediated by attention and perceived information effectiveness. Based on the results, we suggest that GHWs were less effective for smokers with high levels of perceived stress because their stress appeared to exhaust the cognitive resources necessary to process the information.
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Affiliation(s)
- Hyun Young Cho
- Department of Business Administration, Dongguk University
| | - Seungwoo Chun
- Department of Business Administration, Dongguk University
| | - Youjin Choi
- Department of Advertising and Public Relations, Dongguk University
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Katyal T, Durazo A, Hartman-Filson M, Vijayaraghavan M. Responses to Graphic Warning Labels among Low-income Smokers. Am J Health Behav 2020; 44:603-616. [PMID: 33121579 PMCID: PMC7994008 DOI: 10.5993/ajhb.44.5.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: Graphic warning labels (GWLs) are effective in communicating tobacco-related harms. Methods: In this mixed-methods study, we used purposive sampling to recruit 100 low-income smokers in the San Francisco Bay Area between October 2017 and February 2018 to participate in an intervention promoting smoke-free homes. We presented the 2009 Food and Drug Administration-proposed GWLs and explored perceptions of affect, efficacy, and appeal using questionnaires at baseline, 3- and 6-months follow-up. Because of participants' interest in this topic, we subsequently conducted a qualitative sub-study among 20 participants exploring perceived efficacy of GWLs on smoking cessation. Results: In all, 87.3% and 59.2% agreed that GWLs were useful and would motivate cessation behaviors, respectively, at baseline. We found that the most common responses were shock (61.8%) and disgust (55.3%), whereas anger (29.0%) and annoyance (19.7%) were less common. Participants also reported that GWLs unequivocally illustrating smoking's harmful effects were more appealing than non-specific images, as were images that depicted positive cessation-related effects. Conclusions: GWLs appear to be an important health communication among low-income smokers. Future studies on GWLs should examine the association of negative affect and cessation among this population.
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Affiliation(s)
- Toshali Katyal
- School of Public Health, University of California, Berkeley, CA
| | - Arturo Durazo
- Postdoctoral Fellow, Center for Tobacco Control Research and Education, University of California, San Francisco, CA
| | - Marlena Hartman-Filson
- Assistant Professor, Division of General Internal Medicine, University of California, San Francisco, CA
| | - Maya Vijayaraghavan
- Assistant Professor, Division of General Internal Medicine, University of California, San Francisco, CA;,
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Morgan JC, Sutton JA, Yang S, Cappella JN. Impact of Graphic Warning Messages on Intentions to Use Alternate Tobacco Products. JOURNAL OF HEALTH COMMUNICATION 2020; 25:613-623. [PMID: 33063619 PMCID: PMC8262429 DOI: 10.1080/10810730.2020.1827097] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Graphic cigarette warnings increase quit attempts. Perceived message effectiveness and message avoidance are predictive of later quit attempts. We sought to examine whether randomized exposure to warning messages would inadvertently increase intentions to use alternate tobacco products while enhancing attempts to quit cigarettes. An online survey of 1392 adult smokers in the US asked participants to rate six randomly selected tobacco warnings (from a set of 319) on perceived effectiveness and avoidance intentions. These two indicators of message effectiveness were calculated at the message-level and then at the individual campaign-level to facilitate causal inference. After viewing a message campaign of six warning messages, participants indicated their intentions to use alternate tobacco products. Sixty-eight percent of participants reported some intention to use e-cigarettes and intentions to use other alternate tobacco products ranged from 31% to 40%. Campaigns of messages eliciting higher avoidance increased the odds of intending to use hookah (aOR: 4.32), smokeless tobacco (aOR: 4.88), and snus (aOR: 8.06), but not the intention to use electronic cigarettes. These relationships are mediated by intentions to quit smoking (all p <.05). Viewing campaigns with higher campaign-level perceived effectiveness increased the intentions to quit, which in turn increased intentions to try alternate tobacco products. Our findings increase the tobacco control community's understanding of unintended consequences of graphic tobacco warnings.
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Affiliation(s)
- Jennifer C. Morgan
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Jazmyne A. Sutton
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Sijia Yang
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
| | - Joseph N. Cappella
- Annenberg School for Communication, University of Pennsylvania, Philadelphia, USA
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The Role of Negative Emotions Pre- and Post-Implementation of Graphic Health Warnings: Longitudinal Evidence from South Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155393. [PMID: 32727019 PMCID: PMC7432201 DOI: 10.3390/ijerph17155393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/17/2022]
Abstract
This longitudinal study investigated the factors that determine the effectiveness of graphic health warnings (GHWs) by comparing 246 South Korean smoker's responses before and after the introduction of the country's new tobacco control policy wherein GHWs were placed on all cigarette packaging. Even though introducing GHWs did not cause immediate changes in smokers' intention to quit smoking or perception of smoking's health risk, GHWs eventually motivated smokers to quit smoking when they experienced negative emotional responses to the newly introduced graphic warnings on cigarette packaging. More importantly, this study found that positive changes in smokers' perceived risk associated with smoking due to the introduction of GHWs mediated a positive relationship between changes in smokers' negative emotions (NE) from text-only warnings to graphic warnings and changes in their intention to quit smoking during the same period. Based on these results, the authors suggest that, for GHW policy to be more effective in motivating smoking cessation, the warnings need to convey images sufficiently unpleasant to induce negative emotional responses among smokers.
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40
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Noar SM, Rohde JA, Barker JO, Hall MG, Brewer NT. Pictorial Cigarette Pack Warnings Increase Some Risk Appraisals But Not Risk Beliefs: A Meta-Analysis. HUMAN COMMUNICATION RESEARCH 2020; 46:250-272. [PMID: 32565612 PMCID: PMC7291919 DOI: 10.1093/hcr/hqz016] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 10/13/2019] [Accepted: 10/14/2019] [Indexed: 05/28/2023]
Abstract
Pictorial warnings on cigarette packs motivate smokers to quit, and yet the warnings' theoretical mechanisms are not clearly understood. To clarify the role that risk appraisals play in pictorial warnings' impacts, we conducted a meta-analysis of the experimental literature. We meta-analyzed 57 studies, conducted in 13 countries, with a cumulative N of 42,854. Pictorial warnings elicited greater cognitive elaboration (e.g., thinking about the risks of smoking; d = 1.27; p < .001) than text-only warnings. Pictorial warnings also elicited more fear and other negative affect (d = .60; p < .001). In contrast, pictorial warnings had no impact on perceived likelihood of harm (d = .03; p = .064), perceived severity (d = .16; p = .244), or experiential risk (d = .06; p = .449). Thus, while pictorial warnings increase affective and some cognitive risk appraisals, they do not increase beliefs about disease risk. We discuss the role of negative affect in warning effectiveness and the implications for image selection and warning implementation.
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Affiliation(s)
- Seth M Noar
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Jacob A Rohde
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Joshua O Barker
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Noel T Brewer
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
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Lambert VC, Davis RE, Popova L, Thrasher JF. Cessation Conversations and Quit Attempts: Differences by Ethnicity and Language Preference. Am J Health Behav 2020; 44:473-487. [PMID: 32553028 PMCID: PMC10808996 DOI: 10.5993/ajhb.44.4.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objectives: Conversations about pictorial cigarette health warning labels (HWLs) encourage quit attempts, and prior research suggests prevalence of these conversations varies by ethnicity. We assessed the frequency of conversations about text-only HWLs among Latino and non-Latino white smokers and the relationship between conversations and subsequent quit attempts. Methods: Latino and non-Latino white adult smokers in the United States (N = 4403) were surveyed every 4 months over 2 years. Surveys queried smoking behaviors, recent quit attempts, HWL responses, including HWL conversations, and socio-demographic variables. Negative binomial generalized estimating equation (GEE) models regressed the frequency of HWL conversations on study variables. Logistic GEE models regressed quit attempts at follow-up surveys on responses from the prior wave, including frequency of HWL conversations and their interaction with ethnicity. Results: Spanish preference Latinos reported the most HWL conversations (85%), followed by English preference Latinos (59%), and non-Latino Whites (35%). More frequent HWL conversations predicted subsequent quit attempts (AOR = 1.74, 95% CI = 1.32, 2.30), but ethnicity did not moderate this effect. Conclusions: Latinos appear to talk more frequently about HWLs than non-Latino Whites but are no more likely to quit as a result. Cessation campaigns should use messages that encourage conversations about quitting.
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Affiliation(s)
- Victoria C Lambert
- Victoria C. Lambert, Doctoral Candidate, Department of Health Promotion, Education, & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC;,
| | - Rachel E Davis
- Rachel E. Davis, Associate Professor, Department of Health Promotion, Education, & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
| | - Lucy Popova
- Lucy Popova, Assistant Professor, Second Century Initiative (2CI) Scholar, Department of Health Policy and Behavioral Sciences, School of Public Health, Georgia State University, Atlanta, GA
| | - James F Thrasher
- James F. Thrasher, Professor, Department of Health Promotion, Education, & Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC
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Shoots-Reinhard B, Erford B, Romer D, Evans AT, Shoben A, Klein EG, Peters E. Numeracy and memory for risk probabilities and risk outcomes depicted on cigarette warning labels. Health Psychol 2020; 39:721-730. [PMID: 32496078 DOI: 10.1037/hea0000879] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Greater numeracy is associated with higher likelihood to quit smoking. We examined whether numeracy supports learning of numeric health-risk information and, in turn, greater risk perceptions and quit intentions. METHOD Adult smokers (N = 696) viewed text warnings with numeric risk information four times each in one of three warning-label types (text-only, low-emotion pictorial [i.e., with image], high-emotion pictorial). They completed posttest measures immediately or 6 weeks later. Emotional reactions to warnings were reported the second time participants viewed the warnings. Numeracy, memory for risk probabilities and risk outcomes, risk perceptions, and quit intentions were assessed postexposures. RESULTS Memory for risk probabilities and risk outcomes depended on warning-label type and posttest timing. Consistent with memory-consolidation theory, memory for high- versus low-emotion labels was lower immediately, but declined less for high-than low-emotion labels. Label memory was similar between conditions at 6 weeks. Numeracy predicted overall superior memory (especially for risk probabilities) controlling for health literacy and education. It also indirectly predicted greater risk perceptions and quit intentions via memory. In exploratory analyses, however, the superior recall of risk probabilities of smoking among those higher in numeracy was associated with lower risk perceptions. CONCLUSIONS Numeracy is associated with superior risk memory, which relates to greater risk perceptions and quit intentions. More numerate and educated smokers may be better able to quit due to their superior learning of smoking's risks. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Brewer NT, Parada H, Hall MG, Boynton MH, Noar SM, Ribisl KM. Understanding Why Pictorial Cigarette Pack Warnings Increase Quit Attempts. Ann Behav Med 2020; 53:232-243. [PMID: 29850764 DOI: 10.1093/abm/kay032] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Our randomized trial found that pictorial cigarette pack warnings elicited more quit attempts than text-only warnings. PURPOSE In the current study, we sought to identify psychological mechanisms that explain why pictorial cigarette pack warnings change behavior. METHODS In 2014 and 2015, we recruited 2,149 adult smokers in NC and CA, USA. We randomly assigned smokers to receive on their cigarette packs for 4 weeks either a text-only warning (one of the USA's current warnings on the side of cigarette packs) or a pictorial warning (one of the USA's proposed text warnings with pictures on the top half of the front and back of cigarette packs). RESULTS Pictorial warnings increased attention to, reactions to, and social interactions about cigarette pack warnings (all p < .05). However, pictorial warnings changed almost no belief or attitude measures. Mediators of the impact of pictorial warnings included increased attention, negative affect, social interactions, thinking about the warning and harms of smoking, and intentions to quit (all p < .05). Analyses also found that pictorial warnings led to greater avoidance of the warnings, which was associated with more quit attempts (p < .05). CONCLUSIONS Pictorial warnings increased quit attempts by eliciting aversive reactions and by keeping the message vividly in smokers' minds. Contrary to predictions from several theories of health behavior, the warnings exerted little of their influence through changes in beliefs and attitudes and none of their influence through changes in risk perception. We propose the Tobacco Warnings Model based on these findings. CLINICAL TRIAL INFORMATION ClinicalTrials.gov identifier: NCT02247908; https://clinicaltrials.gov/ct2/show/NCT02247908.
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Affiliation(s)
- Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Humberto Parada
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.,Division of Epidemiology and Biostatistics, The Graduate School of Public Health, San Diego State University, CA, USA
| | - Marissa G Hall
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Marcella H Boynton
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Seth M Noar
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.,School of Media and Journalism, University of North Carolina, Carroll, Chapel Hill, NC, USA
| | - Kurt M Ribisl
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
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Peters E, Shoots-Reinhard B, Evans AT, Shoben A, Klein E, Tompkins MK, Romer D, Tusler M. Pictorial Warning Labels and Memory for Cigarette Health-risk Information Over Time. Ann Behav Med 2020; 53:358-371. [PMID: 29947729 DOI: 10.1093/abm/kay050] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pictorial cigarette warning labels are thought to increase risk knowledge, but experimental research has not examined longer-term effects on memory for health risks named in text. PURPOSE To investigate memory-consolidation predictions that high- versus low-emotion warnings would support better long-term memory for named cigarette health risks and to test a mediational model of warning-label effects through memory on risk perceptions and quit intentions. METHODS A combined sample of U.S.-representative adult smokers, U.S.-representative teen smokers/vulnerable smokers, and Appalachian-representative adult smokers were randomly assigned to a warning-label condition (High-emotion pictorial, Low-emotion pictorial, Text-only) in which they were exposed four times to nine warning labels and reported emotional reactions and elaboration. Memory of warning-label risk information, smoking risk perceptions, and quit intentions were assessed immediately after exposures or 6 weeks later. RESULTS Recall of warning-label text was low across the samples and supported memory-consolidation predictions. Specifically, immediate recall was highest for Low-emotion warnings that elicited the least emotion, but recall also declined the most over time in this condition, leaving its 6-week recall lowest; 6-week recall was similar for High-emotion and Text-only warnings. Greater recall was associated with higher risk perceptions and greater quit intentions and mediated part of warning-label effects on these important smoking outcomes. High-emotion warnings had additional non-memory-related effects on risk perceptions and quit intentions that were superior to text-only warnings. CONCLUSIONS High- but not Low-emotion pictorial warning labels may support the Food and Drug Administration's primary goal to "effectively convey the negative health consequences of smoking." CLINICALTRIALS.GOV IDENTIFIER NCT03375840.
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Affiliation(s)
- Ellen Peters
- Department of Psychology, Ohio State University, Columbus, OH, USA
| | | | - Abigail T Evans
- Department of Psychology, Ohio State University, Columbus, OH, USA.,College of Public Health, Ohio State University, Columbus, OH, USA
| | - Abigail Shoben
- College of Public Health, Ohio State University, Columbus, OH, USA
| | - Elizabeth Klein
- College of Public Health, Ohio State University, Columbus, OH, USA
| | | | - Daniel Romer
- Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Martin Tusler
- Department of Psychology, Ohio State University, Columbus, OH, USA
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A systematic review of nudge theories and strategies used to influence adult health behaviour and outcome in diabetes management. DIABETES & METABOLISM 2020; 46:450-460. [PMID: 32387700 DOI: 10.1016/j.diabet.2020.04.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/07/2020] [Accepted: 04/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Diabetes is a chronic disease associated with a variety of complications, and nudging may be a potential solution to improve diabetes control. Since nudging is a new concept, no review of literature on nudging diabetic patients into improving their health behaviour has been done. Therefore, we aim to collate a list of nudge intervention and determine the context in which nudging is successful. METHODS We adopted a two-arm search strategy comprising the search of literature databases and snowballing using relevant search terms. We summarized patient characteristics, the nudge intervention, according to nudging strategies, delivery mode and their outcomes. The conditions present in effective nudge interventions were assessed and reported. RESULTS We retrieved 11,494 studies from our searches and included 33. An additional five studies were added through snowballing. Studies included utilized framing (n=5), reminders (n=10), gamification (n=2), social modelling (n=5) and social influence (n=16). Studies on reminders and gamification were more likely to have a statistically significant outcome. The targeted health behaviours identified were medication adherence, physical activity, diet, blood glucose monitoring, foot care, self-efficacy, HbA1c and quality of life. Of these, studies with adherence to medication, foot care practice and quality of life as targeted health behaviours were more likely to show a statistically significant outcome. CONCLUSION Nudging has shown potential in changing health behaviour of patients with diabetes in specific context. We identified two possible factors (delivery mode and patient characteristics) that may affect the effectiveness of nudge intervention.
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Bavel JJV, Baicker K, Boggio PS, Capraro V, Cichocka A, Cikara M, Crockett MJ, Crum AJ, Douglas KM, Druckman JN, Drury J, Dube O, Ellemers N, Finkel EJ, Fowler JH, Gelfand M, Han S, Haslam SA, Jetten J, Kitayama S, Mobbs D, Napper LE, Packer DJ, Pennycook G, Peters E, Petty RE, Rand DG, Reicher SD, Schnall S, Shariff A, Skitka LJ, Smith SS, Sunstein CR, Tabri N, Tucker JA, Linden SVD, Lange PV, Weeden KA, Wohl MJA, Zaki J, Zion SR, Willer R. Using social and behavioural science to support COVID-19 pandemic response. Nat Hum Behav 2020. [PMID: 32355299 DOI: 10.31234/osf.io/y38m9] [Citation(s) in RCA: 74] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.
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Affiliation(s)
- Jay J Van Bavel
- Department of Psychology & Neural Science, New York University, New York, NY, USA.
| | - Katherine Baicker
- University of Chicago Harris School of Public Policy, Chicago, IL, USA
| | - Paulo S Boggio
- Social and Cognitive Neuroscience Laboratory, Center for Health and Biological Sciences, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Valerio Capraro
- Department of Economics, Middlesex University London, London, UK
| | - Aleksandra Cichocka
- School of Psychology, University of Kent, Kent, UK
- Department of Psychology, Nicolaus Copernicus University, Toruń, Poland
| | - Mina Cikara
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | | | - Alia J Crum
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | - James N Druckman
- Department of Political Science, Northwestern University, Chicago, IL, USA
| | - John Drury
- Department of Social Psychology, University of Sussex, Sussex, UK
| | - Oeindrila Dube
- University of Chicago Harris School of Public Policy, Chicago, IL, USA
| | - Naomi Ellemers
- Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands
| | - Eli J Finkel
- Department of Psychology and the Kellogg School of Management, Northwestern University, Chicago, IL, USA
| | - James H Fowler
- Division of Infectious Diseases and Global Public Health and Department of Political Science, University of California, San Diego, San Diego, CA, USA
| | - Michele Gelfand
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Shihui Han
- School of Psychological and Cognitive Sciences, PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | | | - Jolanda Jetten
- School of Psychology, University of Queensland, Brisbane, Australia
| | - Shinobu Kitayama
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Dean Mobbs
- Department of Humanities and Social Sciences and Computation and Neural Systems Program, California Institute of Technology, Pasadena, CA, USA
| | - Lucy E Napper
- Department of Psychology and Health, Medicine & Society Program, Lehigh University, Bethlehem, PA, USA
| | | | - Gordon Pennycook
- Hill/Levene Schools of Business, University of Regina, Regina, Saskatchewan, Canada
| | - Ellen Peters
- School of Journalism and Communication, University of Oregon, Eugene, OR, USA
| | - Richard E Petty
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - David G Rand
- Sloan School and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Boston, MA, USA
| | - Stephen D Reicher
- School of Psychology and Neuroscience, University of St. Andrews, St Andrews, UK
| | - Simone Schnall
- Department of Psychology University of Cambridge, Cambridge, UK
- Bennett Institute for Public Policy, University of Cambridge, Cambridge, UK
| | - Azim Shariff
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Linda J Skitka
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Sandra Susan Smith
- Department of Sociology, University of California, Berkeley, Berkeley, CA, USA
| | - Cass R Sunstein
- Harvard Law School, Harvard University, Cambridge, MA, United States
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Joshua A Tucker
- Department of Politics, New York University, New York, NY, USA
| | | | - Paul van Lange
- Institute for Brain and Behavior Amsterdam, Department of Experimental and Applied Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Kim A Weeden
- Department of Sociology, Cornell University, Ithaca, NY, USA
| | - Michael J A Wohl
- Department of Psychology, Carleton University, Ottawa, Ontario, Canada
| | - Jamil Zaki
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Sean R Zion
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Robb Willer
- Department of Sociology, Stanford University, Stanford, CA, USA.
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47
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Using social and behavioural science to support COVID-19 pandemic response. Nat Hum Behav 2020; 4:460-471. [PMID: 32355299 DOI: 10.1038/s41562-020-0884-z] [Citation(s) in RCA: 2096] [Impact Index Per Article: 524.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 04/09/2020] [Indexed: 01/16/2023]
Abstract
The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts. Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.
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48
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Dragojevic M, Savage MW, Scott AM, McGinnis T. Promoting Oral Health in Appalachia: Effects of Threat Label and Source Accent on Message Acceptance. HEALTH COMMUNICATION 2020; 35:297-307. [PMID: 30592223 DOI: 10.1080/10410236.2018.1560581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study examined the effects of threat label (i.e., the name assigned to a health threat) and source accent (i.e., the source's manner of pronunciation) on Appalachian residents' acceptance of oral health promotion messages. Participants (N = 348) listened to an audiotaped oral health promotion message about tooth decay or Mountain Dew Mouth; the message was delivered either in a standard American English or a Southern accent. Compared to the label Mountain Dew Mouth, the label tooth decay elevated perceptions of threat susceptibility, threat severity, and response-efficacy and resulted in higher message acceptance. The effect of threat label on message acceptance was mediated by severity perceptions. Participants attributed more status to the source and agreed more with her message when she spoke in a standard than a Southern accent. The effect of source accent on message acceptance was mediated by status perceptions. These findings suggest that the success of persuasive health messages depends not only on message content (i.e., what is said), but also on how that content is linguistically framed and delivered (i.e., how it is said).
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Affiliation(s)
| | - Matthew W Savage
- School of Communication, College of Professional Studies and Fine Arts, San Diego State University
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49
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Mishra NP, Das SS, Yadav S, Khan W, Afzal M, Alarifi A, Kenawy ER, Ansari MT, Hasnain MS, Nayak AK. Global impacts of pre- and post-COVID-19 pandemic: Focus on socio-economic consequences. SENSORS INTERNATIONAL 2020; 1:100042. [PMID: 34766044 PMCID: PMC7510561 DOI: 10.1016/j.sintl.2020.100042] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/13/2020] [Accepted: 09/14/2020] [Indexed: 01/08/2023] Open
Abstract
On March 11, 2020, the novel Corona virus disease (COVID-19), was described as a pandemic by World Health Organization (WHO). Globally, the COVID-19 has not only affected the public health socially but also has rigorously affected economically. Substantial declines in income, increase in unemployment, and distractions in the transportation, amenities, and industrial sectors are amongst the major concerns of the pandemic disease extenuation. Furthermore, the governments of most of the countries underestimated the menaces of COVID-19 spread and were typically responsive for the calamities in their respective countries. As outbreak of this pandemic is not likely to wane in the nearby future, preventive actions are prerequisite to prevent infection spread, save people lives and also to save the economic affluence. In this review, based on the present knowledge and available literature, we have demonstrated the various aspects of pre-and post-COVID-19 effects over the social and economic phases worldwide. Moreover, the evidence based data have been summarized regarding threats, social influences, scientific upgrades, moral dynamics, stress and adapting in the pre- and post- COVID-19 situations.
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Affiliation(s)
- Nt Pramathesh Mishra
- Department of Pharmacy, Mahatma Gandhi Institute of Pharmacy, Lucknow, 227101, Uttar Pradesh, India
| | - Sabya Sachi Das
- Department of Pharmaceutical Sciences and Technology, Birla Institute of Technology, Mesra, Ranchi, 835 215, Jharkhand, India
| | - Shalini Yadav
- Abha Biotechnology, Noida, 201301, Uttar Pradesh, India
| | - Wasim Khan
- Department of Pharmaceutics, Javitri Institute of Medical Sciences &Pharmacy Division, Lucknow, 227302, Uttar Pradesh, India
| | - Mohd Afzal
- Catalytic Chemistry Chair, Department of Chemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Abdullah Alarifi
- Catalytic Chemistry Chair, Department of Chemistry, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - El-Refaie Kenawy
- Polymer Research Group, Department of Chemistry, Faculty of Science, Tanta University, Tanta, Egypt
| | - Mohammed Tahir Ansari
- School of Pharmacy, University of Nottingham Malaysia, Jalan Broga, Semenyih, Selangor, 43500, Malaysia
| | - Md Saquib Hasnain
- Department of Pharmacy, Shri Venkateshwara University, NH-24, Rajabpur, Gajraula, Amroha, 244236, U.P., India
| | - Amit Kumar Nayak
- Department of Pharmaceutics, Seemanta Institute of Pharmaceutical Sciences, Mayurbhanj, 757086, Odisha, India
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50
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Maziak W, Osibogun O, Asfar T. Waterpipe smoking: the pressing need for risk communication. Expert Rev Respir Med 2019; 13:1109-1119. [PMID: 31519113 PMCID: PMC7004232 DOI: 10.1080/17476348.2019.1668271] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 09/12/2019] [Indexed: 01/21/2023]
Abstract
Introduction: Waterpipe (WP) smoking is an important public health problem that is rapidly evolving globally. Much of WP spread among youth is perpetuated by a misperception of reduced harms compared to cigarettes. Increasing awareness about WP smoking harms through health warning labels (HWLs) represents a promising policy and regulatory strategy to curb WP smoking. Areas covered: Peer-reviewed publications indexed in PubMed and CINAHL were searched in March 2019. This review focuses on the current knowledge of WP smoking characteristics, its spread and patterns of use globally, and some of the major WP-related health effects. This knowledge is utilized to advance a promising policy and regulatory avenue to curb WP smoking by increasing awareness of its potential harms through HWLs. It also addresses product configuration and unique features that influence the adaptation of HWLs for WP smoking. Expert opinion: HWLs are effective in communicating smoking-related risks to WP smokers in a way that affects their smoking behavior and experience as well as interest in quitting. Although based on limited data, the WP device appears to be a promising location for HWLs as it offers prolonged contact with smokers and those surrounding them.
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Affiliation(s)
- Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA
| | - Taghrid Asfar
- Syrian Center for Tobacco Studies, Aleppo, Syrian Arab Republic
- Division of Epidemiology, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
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