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Al-Ahmadi AF, Almatrafi MA, Ali AK, Alsaedi OH, Al-Zalabani AH. Perceptions of health warnings on cigarette sticks among the adult population in Al-Madinah, Saudi Arabia: A cross-sectional survey. Tob Induc Dis 2024; 22:TID-22-44. [PMID: 38384733 PMCID: PMC10879763 DOI: 10.18332/tid/182912] [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: 11/19/2023] [Revised: 01/18/2024] [Accepted: 01/21/2024] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION Health warnings on cigarette sticks are emerging as a tool to control tobacco consumption; hence, understanding how they are perceived is valuable in determining their effectiveness. Our study aimed to evaluate the perception of health-related messages and warnings on individual cigarette sticks. It also aimed to evaluate the perceptions of the effectiveness of cigarette packaging warnings and the acceptance level for the inclusion of health warnings on cigarette sticks. METHODS This cross-sectional survey was conducted on 285 individuals in Al-Madinah, Saudi Arabia. The survey was distributed online using a non-probability convenience sampling technique. The chi-squared test and logistic regression analysis were used to determine the association of sociodemographic characteristics and smoking-related variables with participants' perceptions of health warnings on cigarette sticks and packaging. The responses were also assessed qualitatively using conceptual content analysis. RESULTS In all, 18.6% of participants perceived that the package warnings were either 'quite effective' or 'very effective' in prompting smokers to quit. For health warnings on cigarette sticks, 28.1% of participants perceived that the theme of statistics on mortality was either 'quite effective' or 'very effective' in prompting smokers to quit, compared to 35.0 % for the theme of social and financial consequences. Respondents who had secondary education and lower were almost two times more likely to support the inclusion of health warnings than those who had a university education and higher (OR=1.9; 95% CI: 1.02-3.7, p=0.042). Most of the comments were positive for the inclusion of health warnings on cigarette sticks. CONCLUSIONS Most participants perceived that package warnings were ineffective, but warnings on cigarette sticks were effective methods of dissuasion of cigarette use. Smokers were almost twice as likely to perceive as effective supportive messages to quit than non-smokers. The majority of participants 'agreed' or 'strongly agreed' to the inclusion of health warnings on cigarette sticks.
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Affiliation(s)
- Ahmed F. Al-Ahmadi
- General Directorate of Health Affairs of Medina, Ministry of Health, Al Madinah, Saudi Arabia
- Model of Care, Madinah Health Cluster, Al-Madinah, Saudi Arabia
- Quit Smoking Clinic, Public Health Department, King Salman Medical City, Al-Madinah, Saudi Arabia
- Preventive Medicine Program for Postgraduate Studies, Ministry of Health, Al-Madinah, Saudi Arabia
| | - Mohammed A. Almatrafi
- General Directorate of Health Affairs of Medina, Ministry of Health, Al Madinah, Saudi Arabia
| | - Ahmed K. Ali
- General Directorate of Health Affairs of Medina, Ministry of Health, Al Madinah, Saudi Arabia
- Model of Care, Madinah Health Cluster, Al-Madinah, Saudi Arabia
| | - Osama H. Alsaedi
- General Directorate of Health Affairs of Medina, Ministry of Health, Al Madinah, Saudi Arabia
- Model of Care, Madinah Health Cluster, Al-Madinah, Saudi Arabia
| | - Abdulmohsen H. Al-Zalabani
- Department of Family and Community Medicine, College of Medicine, Taibah University, Al Madinah, Saudi Arabia
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Guindon GE, Mentzakis E, Buckley NJ. Cigarette packaging, warnings, prices, and contraband: A discrete choice experiment among smokers in Ontario, Canada. ECONOMICS AND HUMAN BIOLOGY 2024; 52:101340. [PMID: 38134576 DOI: 10.1016/j.ehb.2023.101340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 11/22/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023]
Abstract
In Canada, despite substantial decline, tobacco use remains the leading risk factor responsible for mortality and morbidity. There is overwhelming evidence that higher tobacco taxes reduce tobacco use, even if high taxes create an incentive to avoid or evade tobacco taxes. Recently, in addition to taxes, plain and standardized packaging and printing a warning on each cigarette have been lauded to reduce tobacco use. In November 2019, Canada became the country with the most comprehensive cigarette packaging regulations; and in June 2022, Canada proposed to print health warnings on individual cigarettes, the first jurisdiction to ever do so. The regulations came into force on August 1, 2023, and are being implemented through a stepwise approach. Our objective was to examine the effects of plain and standardized packaging, warning on cigarettes, price, and the availability of illicit cigarettes on intention to purchase and risk perceptions. We conducted a discrete choice experiment, and examined heterogeneity in preferences using latent class models among smokers in Ontario, Canada. We found that using latent class analyses was essential in quantifying preferences for attributes of cigarettes and cigarette packs. First, nearly half of smokers stated a preference for cheaper illicit cigarettes in a branded pack without any health warnings, regardless of the licit cigarette alternatives. For about 20% of respondents, plain packaging and especially warning on cigarette sticks decreased the probability of stating a purchasing preference for these alternatives. Third, about a third of respondents chose competing alternatives with mostly one attribute in mind, price. Lastly, none of the products and attributes seem to have significantly influenced risk perception. Our findings attest to the importance of prices and taxes, to the potential of warnings on cigarette sticks to control tobacco use, and indicate that efforts to restrict the availability of illicit cigarettes may yield substantial benefits.
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Affiliation(s)
- G Emmanuel Guindon
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada; Department of Economics, McMaster University, Hamilton, ON, Canada.
| | | | - Neil J Buckley
- Department of Economics, York University, Toronto, ON, Canada
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Amul GGH, Mallari EU, Arda JRY, Santiago AJA. Graphic health warnings and plain packaging in the Philippines: results of online and household surveys. Front Public Health 2023; 11:1207779. [PMID: 37822542 PMCID: PMC10562603 DOI: 10.3389/fpubh.2023.1207779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/29/2023] [Indexed: 10/13/2023] Open
Abstract
In line with Article 11 of the WHO Framework Convention on Tobacco Control, the Philippines has implemented graphic health warnings on cigarette packs. To date, there has been no published literature evaluating the perceived effectiveness of GHWs in the Philippines. This study aims to contribute to the evidence on the perceived effects of graphic health warnings (GHWs) in cigarette packaging and the potential impact of plain packaging in the Philippines. The study involved an online convenience survey and a nationwide household survey. Mock-up sets of cigarette packs based on the Philippines' law on GHWs, and Thailand's and Singapore's plain packaging were shown to respondents to rate their attractiveness, quality, taste, cost, social appeal, appeal to youth, noticeability, appeal to non-smokers, attempt to quit, ease of quitting, discouraging smoking, and perceived harm to health on a five-point Lickert scale. The online and household surveys recruited 2,701 respondents in total. Online and household survey respondents considered plain packaging with larger graphic health warnings and visible quitlines from Thailand and Singapore to be more effective in discouraging them from smoking. Both sets of survey respondents also found mock-ups from Thailand and Singapore more motivating for them to attempt quitting than cigarette pack mock-ups from the Philippines. The study concludes that current graphic health warnings in the Philippines are ineffective in instilling health consciousness among Filipinos. Policymakers should consider larger graphic health warnings and plain packaging of cigarettes to motivate smokers to quit and discourage Filipinos from smoking.
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Affiliation(s)
- Gianna Gayle H. Amul
- Ateneo Policy Center, School of Government, Ateneo de Manila University, Quezon City, Philippines
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Al-Zalabani AH, Monshi SS, Al-Ahmadi AF, Ali AKA, Mirdad GA, Alanazi MM, Alsaedi MQ, Alanazi AM. Dissuasive cigarettes as a tobacco control measure: a scoping review. Tob Control 2023:tc-2023-057974. [PMID: 37414527 DOI: 10.1136/tc-2023-057974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/28/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE The aim was to identify and review the research literature on dissuasive cigarettes, including key concepts, types, sources of evidence and research gaps. DATA SOURCES PubMed, Scopus and Web of Science databases were searched up to January 2023 with no language or date restrictions. All study designs were included. Reference lists of the identified studies were manually searched. Studies on tobacco products other than cigarettes or on external cigarette packaging alone were excluded. STUDY SELECTION Two reviewers screened titles and abstracts independently using eligibility criteria. The full text of the selected articles was subsequently screened independently by two reviewers to confirm eligibility. DATA EXTRACTION Two reviewers independently extracted data from all studies using data abstraction forms. Results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. DATA SYNTHESIS We identified 24 original studies, 3 review articles and 4 commentary articles. Research on dissuasive cigarettes was reported from Australia, New Zealand, Europe and North America. We presented results in four themes: the concept of dissuasive cigarettes; approaches and types; potential benefits, barriers and concerns; and current research gaps. CONCLUSIONS Dissuasive cigarettes represent a promising strategy that could be used in tobacco control. Parallel implementation with plain packaging would be feasible and synergistic.
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Affiliation(s)
| | - Sarah S Monshi
- Department of Health Services Management, College of Public Health and Health Informatics, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | - Ahmed Khalid A Ali
- Model of Care, Al-Madinah Health Cluster, Al-Madinah Al-Munawarah, Saudi Arabia
| | | | - Manal Muteb Alanazi
- Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Mawada Qabl Alsaedi
- Saudi Board Preventive Medicine Program, Al-Madinah Al-Munawarah, Saudi Arabia
| | - Abdullah M Alanazi
- Respiratory Therapy, College of Applied Medical Sciences, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Mechili EA, Przewoźniak K, Driezen P, Kyriakos CN, Girvalaki C, Mons U, Quah ACK, Fernández E, Trofor AC, Demjén T, Katsaounou PA, Zatoński W, Fong GT, Vardavas CI. Smokers' support for the ban on sale of slim cigarettes in six European countries: findings from the EUREST-PLUS ITC Europe Surveys. OPEN RESEARCH EUROPE 2023; 1:52. [PMID: 37645112 PMCID: PMC10446023 DOI: 10.12688/openreseurope.13405.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 08/31/2023]
Abstract
Background: Efforts to regulate tobacco products and reduce consumption in the European Union (EU) include the European Tobacco Products Directive (TPD), which went into force in May 2016. Despite the initial discussion to include a ban on sale of slim cigarettes, it was excluded in the final TPD. The main goal of this study was to examine support for a ban on slim cigarettes among smokers in six European Countries. Methods: Data from the 2018 (Wave 2) International Tobacco Control Policy Evaluation Project 6 European Country (ITC 6E) EUREST-PLUS project survey, a cross sectional study of adult smokers (n=5592) from Germany, Greece, Hungary, Poland, Romania, and Spain, was analysed. Descriptive statistics were used to estimate support for a ban on slim cigarettes by sociodemographic characteristics and smoking behaviors. Logistic regression analysis was used to examine factors associated with support for a ban on slim cigarettes and perceptions of harm. Results: Support for a ban on slims varied across countries, with highest support in Romania (33.8%), and lowest in Greece (18.0%). Female smokers (OR=0.78; 95%CI=0.67-0.91, daily smokers (OR=0.68; 95%CI=0.47-0.97), menthol smokers (OR=0.55; 95%CI=0.36-0.86), and smokers who did not have plans to quit within next six months (OR=0.45; 95%CI=0.36-0.56) had significantly lower odds of supporting a ban on slim cigarettes. Overall, 21% of smokers perceived slim cigarettes as less harmful than regular cigarettes. Conclusions: Support for a ban of slim cigarettes was relatively low among smokers, while misperceptions that slim cigarettes are less harmful is high, particularly among countries where slim cigarette use is more prevalent. Findings support a ban on slim cigarettes to reduce misperceptions around slim cigarettes being less harmful.
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Affiliation(s)
- Enkeleint A. Mechili
- Department of Health Care, Faculty of Health,, University of Vlora, Vlora, 9401, Albania
- European Network for Smoking and Tobacco Prevention, Chausse d'lxelles 144, Brussels, 1050, Belgium
- School of Medicine, University of Crete, Voutes, Heraklion, 71409, Greece
| | - Krzysztof Przewoźniak
- Maria Skłodowska-Curie National Research Institute of Oncology, 15B Wawelska Street, Warsaw, 02-034, Poland
- Health Promotion Foundation, Mszczonowska, Nadarzyn, 05-830, Poland
- Collegium Civitas, plac Defilad 1, Warsaw, 00-901, Poland
| | - Pete Driezen
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
- School of Public Health Sciences, University of Waterloo, University Avenue West 200, Waterloo, Ontario, N2L 3G1, Canada
| | - Christina N Kyriakos
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, 310 Reynolds Building, St. Dunstan's Road, London, W6 9RP, UK
| | - Charis Girvalaki
- European Network for Smoking and Tobacco Prevention, Chausse d'lxelles 144, Brussels, 1050, Belgium
- School of Medicine, University of Crete, Voutes, Heraklion, 71409, Greece
| | - Ute Mons
- Cancer Prevention Unit and WHO Collaborating Centre for Tobacco Control, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, Heidelberg, 69120, Germany
- Heart Center, Faculty of Medicine and University Hospital Cologne, University of Cologne, Kerpener Straße 62, Cologne, 50937, Germany
| | - Anne CK Quah
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
| | - Esteve Fernández
- Tobacco Control Unit, Catalan Institute of Oncology (ICO), Av Gran Via De L’Hospitalet 199-203, L’Hospitalet de Llobregat, Catalonia, 08908, Spain
- Tobacco Control Research Group, Bellvitge Biomedical Research Institute (IDIBELL), Av Gran Via De L’Hospitalet 199-203, L’Hospitalet de Llobregat, Catalonia, 08908, Spain
- School of Medicine and Health Sciences, Bellvitge Campus, Universitat de Barcelona, L’Hospitalet de Llobregat, Catalonia, 08908, Spain
- Center for Biomedical Research in Respiratory Diseases (CIBER of Respiratory Diseases, CIBERES), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5, Madrid, 28029, Spain
| | - Antigona C Trofor
- University of Medicine and Pharmacy ‘Grigore T. Popa’ Iasi, Strada Universității 16, Iași, 700115, Romania
- AerPur Romania, Street Argentina 35 Sector 1, Bucharest, 011753, Romania
| | - Tibor Demjén
- Smoking or Health Hungarian Foundation, Fiumei 18/B IB IV LPH I 2, Budapest, 1044, Hungary
| | - Paraskevi A Katsaounou
- First ICU Evaggelismos Hospital Athens, National and Kapodistrian University of Athens, Ipsilantou 45-47, Athens, 10676, Greece
| | - Witold Zatoński
- Health Promotion Foundation, Mszczonowska, Nadarzyn, 05-830, Poland
- European Observatory of Health Inequalities, President Stanisław Wojciechowski State University of Applied Sciences, Nowy Świat 4 st, Kalisz, 62-800, Poland
| | - Geoffrey T Fong
- Department of Psychology, University of Waterloo, Waterloo, Ontario, N2L 3G1, Canada
- School of Public Health Sciences, University of Waterloo, University Avenue West 200, Waterloo, Ontario, N2L 3G1, Canada
- Ontario Institute for Cancer Research, 661 University Avenue, Toronto, Ontario, M5G 0A3, Canada
| | - Constantine I Vardavas
- European Network for Smoking and Tobacco Prevention, Chausse d'lxelles 144, Brussels, 1050, Belgium
- School of Medicine, University of Crete, Voutes, Heraklion, 71409, Greece
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Perez CDA, Camacho LAB, Mendes FL, Oliveira da Silva AL, Figueiredo VC, Latuf GMDO, Fernandes AMMS, Albertassi PGD, Castello Branco PA, Branco PF, Piras SS, Suarez MC. 'If I hadn't seen this picture, I'd be smoking'-perceptions about innovations in health warnings for cigarette packages in Brazil: a focus group study. Tob Control 2023; 32:13-18. [PMID: 34290136 DOI: 10.1136/tobaccocontrol-2020-056360] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 04/03/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the perceptions of young people and adults, smokers and non-smokers about the current set of innovations introduced in 2018 into the Brazilian tobacco products' health warnings. METHODS Twenty focus groups were conducted in five state capitals in Brazil. The participants (n=163) were segmented by smoking status, age (15-17 years, 18-55 years) and social grade (C, D-E classes) to examine cigarette packaging and explore the participants' perceptions of health warnings. RESULTS Health warnings capture attention, eliciting apprehension, fear, disgust and concern about the negative consequences of cigarette consumption. The 2018 Brazil health warnings are spontaneously recalled by participants, even without the presence of cigarette packages. However, the analysis also reveals the challenges of overcoming communication barriers and distorted interpretations, especially among smokers. The inclusion of direct and provocative stimuli, such as the use of the word 'you', attracts attention and creates more proximity to the recipient of the message. The results also highlight the interest and fear elicited by warnings on toxic constituents and the importance of using contrasting colours in warnings, which differentiate them from the colours of cigarette packs. CONCLUSION Introducing innovative components in health warnings can catch consumers' attention but considering that the interviewees encountered difficulties interpreting textual warnings about toxic constituents in cigarettes, the study reinforces the importance of adopting direct language and pictures, instead of text, which can visually transmit the warning messages and the use of specific wording that generates proximity between the emitter and receiver.
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Affiliation(s)
- Cristina de Abreu Perez
- National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | | | | | | | - Valeska Carvalho Figueiredo
- Center for Studies on Tobacco and Health. National School of Public Health Sérgio Arouca, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
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Su Z, McDonnell D, Cheshmehzangi A, Ahmad J, Šegalo S, da Veiga CP. A call to ban the sale of tobacco products. Front Public Health 2022; 10:904971. [PMID: 36438262 PMCID: PMC9684640 DOI: 10.3389/fpubh.2022.904971] [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: 03/28/2022] [Accepted: 07/26/2022] [Indexed: 11/12/2022] Open
Abstract
Tobacco is both toxic and addictive. Mounting evidence shows that tobacco use has a detrimental impact on almost every aspect of human health, causing or worsening deadly public health crises from the cancer epidemic to the COVID-19 pandemic. However, while tobacco use is a threat to both personal and public health, it continues to surge across the world, especially in China and other low- and middle-income countries. To this end, this article argues in favor of using a ban on the sale of all tobacco products as a practical solution to the global tobacco use epidemic. It is our hope that insights provided by our work will inspire swift policy actions in countries such as China and beyond to curb the tide of rising tobacco consumption, so that populations around the world could be better shielded from the pervasive and long-lasting damage that tobacco products cause or compound.
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Affiliation(s)
- Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China,*Correspondence: Zhaohui Su
| | - Dean McDonnell
- Department of Humanities, Institute of Technology Carlow, Carlow, Ireland
| | - Ali Cheshmehzangi
- Faculty of Science and Engineering, University of Nottingham Ningbo China, Ningbo, China,Network for Education and Research on Peace and Sustainability, Hiroshima University, Hiroshima, Japan
| | | | - Sabina Šegalo
- Faculty of Health Studies, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Sawyer K, Burke C, Ng RLY, Freeman TP, Adams S, Taylor G. Effectiveness of Mental Health Warnings on Tobacco Packaging in People With and Without Common Mental Health Conditions: An Online Randomised Experiment. Front Psychiatry 2022; 13:869158. [PMID: 35911223 PMCID: PMC9331922 DOI: 10.3389/fpsyt.2022.869158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Health warning labels on tobacco packaging are a cost-effective means of health risk communication. However, while an extensive range of physical health risks are well-portrayed via current tobacco health warnings in the UK, there are none that currently portray the negative impact of smoking on mental health. Aims (i) develop novel mental health warning labels for tobacco packaging and (ii) test perceptions of these warnings in smokers and non-smokers, with and without mental health problems. Methods Six mental health warning labels were developed with a consultancy focus group. These warning labels were tested in an online randomised experiment, where respondents (N = 687) rated six Mental Health Warning Labels (MHWLs) and six Physical Health Warning Labels (PHWLs) on measures of perceived effectiveness, believability, arousal, valence, acceptability, reactance and novelty of information. Results MHWLs were perceived as low to moderately effective (mean = 4.02, SD = 2.40), but less effective than PHWLs (mean = 5.78, SD = 2.55, p < 0.001, η p 2 = 0.63). MHWLs were perceived as less believable, arousing, unpleasant, and acceptable than PHWLs. MHWLs evoked more reactance and were rated as more novel. Perceptions of MHWLs did not differ in people with and without mental health problems except for reactance and acceptability, but consistent with the PHWL literature, perceptions of MHWLs differed between non-smokers and smokers. Conclusion MHWLs could be an effective means to communicate novel information about the effects of smoking on mental health. MHWLs are perceived as less effective, believable, arousing, unpleasant, and acceptable than PHWLs, but MHWLs evoke more reactance and are rated as more novel.
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Affiliation(s)
- Katherine Sawyer
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Chloe Burke
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Ronnie Long Yee Ng
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Tom P. Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
| | - Sally Adams
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Gemma Taylor
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, Bath, United Kingdom
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9
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van der Eijk Y. Standardised cigarettes: the next step for tobacco policy? Tob Control 2022:tobaccocontrol-2022-057417. [PMID: 35768214 DOI: 10.1136/tc-2022-057417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/20/2022] [Indexed: 11/03/2022]
Abstract
As tobacco marketing restrictions intensify, tobacco companies increasingly turn to the cigarette product itself as a marketing medium with new flavours, capsules, novelty filter features and attractive cigarette stick designs. This paper considers a 'standardised cigarettes' policy as a potential next step in restricting tobacco marketing. This policy would remove from cigarette products all the elements that increase their appeal and addictiveness: added flavours, nicotine, and visual designs and branding. The result would be a cigarette that is flavourless, not especially addicting, and visually off-putting. This paper discusses what a standardised cigarettes policy might look like from a regulatory standpoint, and how it fits into current policy obligations under the WHO Framework Convention on Tobacco Control.
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Affiliation(s)
- Yvette van der Eijk
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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10
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van Mourik DJA, Nagelhout GE, Poole NL, Willemsen MC, Candel MJ, Moodie C, van den Putte B, Thrasher JF, de Vries H. Non-smoking adolescents’ perceptions of dissuasive cigarettes. Addict Behav Rep 2022; 15:100433. [PMID: 35620217 PMCID: PMC9127256 DOI: 10.1016/j.abrep.2022.100433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 04/13/2022] [Accepted: 05/13/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Dirk Jan A. van Mourik
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Gera E. Nagelhout
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
- IVO Research Institute, The Hague, The Netherlands
- Corresponding author at: Maastricht University, Department of Health Promotion, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
| | | | - Marc C. Willemsen
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
- Netherlands Expertise Centre for Tobacco Control (NET), Trimbos Institute, Utrecht, The Netherlands
| | - Math J.J.M. Candel
- Department of Methodology and Statistics, Maastricht University (CAPHRI), Maastricht, The Netherlands
| | - Crawford Moodie
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Bas van den Putte
- Department of Communication, University of Amsterdam (ASCoR), Amsterdam, The Netherlands
| | - James F Thrasher
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Hein de Vries
- Department of Health Promotion, Maastricht University (CAPHRI), Maastricht, The Netherlands
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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] [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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Australian Perceptions of Warnings on Cigarette Sticks. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00605-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Agaku I, Odani S, Gordon J. State-specific changes in receipt of cessation counseling from dentist and physician offices, 2011–2015. POPULATION MEDICINE 2021. [DOI: 10.18332/popmed/136451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Moodie C, Angus K, Stead M. Consumer Response to Standardized Tobacco Packaging in the United Kingdom: A Synthesis of Evidence from Two Systematic Reviews. Risk Manag Healthc Policy 2021; 14:1465-1480. [PMID: 33883953 PMCID: PMC8053612 DOI: 10.2147/rmhp.s272259] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 03/20/2021] [Indexed: 11/23/2022] Open
Abstract
Standardized packaging of tobacco products has now been fully implemented in 15 countries. However, there is limited evidence, apart from in Australia, on how consumers have responded to the policy. Two systematic reviews explored consumer, tobacco industry and retailer response to standardized packaging in the United Kingdom (UK), which became mandatory for cigarettes (factory-made and hand-rolled) from May 2017, following a twelve-month transition period. In the first review, electronic databases were searched for published primary research from January 2016 to February 2019. The second review used the same methods, with searches conducted between February 2019 and September 2020. The current study conducted a narrative synthesis of the findings exploring consumer response from these two systematic reviews. Eleven studies met the inclusion criteria. Studies examined consumer response to on-pack warnings (n=7 studies), appeal of packs and smoking (n=4), perceptions of harm (n=5), and behavioral responses (n=8). There was consistent evidence that standardized packaging was associated with increased warning salience and effectiveness, and reduced appeal. Findings were mixed with respect to whether standardized packs were associated with increased perceptions of harm. Standardized packaging was generally thought to deter never or occasional smokers. Standardized packaging was associated with increased thoughts of quitting during the transition period, but no study directly explored cessation or relapse prevention. Some smokers switched to cheaper cigarettes. Standardized packaging in the UK seems to be reducing the appeal of packaging and smoking and making warnings more salient, but the behavioral impact is unclear. More consumer research is needed to assess longer-term behavioral response.
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Affiliation(s)
- Crawford Moodie
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland
| | - Kathryn Angus
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland
| | - Martine Stead
- Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, FK9 4LA, Scotland
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Haddad C, Sacre H, Hajj A, Lahoud N, Akiki Z, Akel M, Saade D, Zeidan RK, Farah R, Hallit S, Salameh P. Comparing cigarette smoking knowledge and attitudes among smokers and non-smokers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:19352-19362. [PMID: 32212070 DOI: 10.1007/s11356-020-08162-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 02/19/2020] [Indexed: 06/10/2023]
Abstract
Smoking prevalence in Lebanon was reported by the World Health Organization to be 43%, which is among the highest rates in the Arab nation. The objectives of this study were to assess cigarette smoking knowledge and attitude among smokers and non-smokers using validated scales in the Lebanese general population and evaluate their association with current cigarette smoking; a secondary objective is to assess the dose effect relationship of knowledge and attitude with cumulative smoking. This cross-sectional took place between May and December 2018, and enrolled a sample of 2623 participants, representative from all Lebanese governorates. A questionnaire about knowledge of the harmful effects of tobacco and attitude toward smoking bans retrieved from other studies was used to collect data. Male gender (ORa = 0.75), having a low monthly income (ORa = 1.56) and a higher passive smoking score (ORa = 1.25), were significantly associated with higher odds of being current smokers. Higher knowledge score (ORa = 0.97) and positive attitude toward smoking ban score (ORa = 0.94) were significantly associated with lower odds of being current smokers. In addition, increased age (ß = 15.21) and higher passive smoking score (ß = 26.58) were significantly associated with higher cumulative cigarette smoking. More positive attitude toward smoking ban score (ß = - 6.51) and having a university degree (ß = - 68.35) were significantly associated with lower cumulative cigarette smoking. Higher knowledge about the smoking-related health problems and better attitudes toward smoking ban were observed among non-smokers compared to smokers. It is important to increase awareness campaigns and to propose effective interventions to put in place an adequate culture of smoking cessation among the general population.
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Affiliation(s)
- Chadia Haddad
- Research Department, Psychiatric Hospital of the Cross, P.O. Box 60096, Jall-Eddib, Lebanon.
- INSERM, U1094, Tropical Neuroepidemiology, Limoges, France.
- University of Limoges, UMR 1094, Tropical Neuroepidemiology, Institute of Epidemiology and Tropical Neurology,GEIST, 87000, Limoges, France.
- Department of Psychiatry, CH Esquirol, 87025, Limoges, France.
| | - Hala Sacre
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Drug Information Center, Order of Pharmacists of Lebanon, Beirut, Lebanon
| | - Aline Hajj
- Laboratory of Pharmacology, Clinical Pharmacy and Quality Control of Drugs, Faculty of Pharmacy, Pôle Technologie- Santé (PTS), Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon
- Faculty of Pharmacy, Saint-Joseph University, Beirut, 1107 2180, Lebanon
| | - Nathalie Lahoud
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Zeina Akiki
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Health Sciences, University of Balamand (UOB), Beirut, Lebanon
- Faculty of Nursing and Health Sciences, Notre Dame University Louaize (NDU), Zouk, Lebanon
| | - Marwan Akel
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Danielle Saade
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Rouba Karen Zeidan
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Pharmacoepidemiology Surveillance Unit, Faculty of Public Health, Lebanese University, Fanar, Lebanon
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Rita Farah
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
| | - Souheil Hallit
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon.
| | - Pascale Salameh
- INSPECT-LB: Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie, Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Faculty of Medicine, Lebanese University, Beirut, Lebanon
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Moodie C, O’Donnell R, Fleming J, Purves R, McKell J, Dobbie F. Extending health messaging to the consumption experience: a focus group study exploring smokers' perceptions of health warnings on cigarettes. ADDICTION RESEARCH & THEORY 2019; 28:328-334. [PMID: 32939185 PMCID: PMC7454525 DOI: 10.1080/16066359.2019.1653861] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/19/2019] [Accepted: 08/06/2019] [Indexed: 05/16/2023]
Abstract
Introduction: While most countries require health warnings on cigarette packs, the Scottish and Canadian Governments are considering requiring health warnings on cigarette sticks. Methods: Twenty focus groups were conducted in Glasgow and Edinburgh (Scotland) with smokers (n = 120) segmented by age (16-17, 18-24, 25-35, 36-50, >50), gender and social grade, to explore perceptions of cigarettes displaying the warning 'Smoking kills' on the cigarette paper and any demographic differences in how smokers responded to these. Results: A warning on each cigarette was thought to prolong the health message, as it would be visible when a cigarette was taken from a pack, lit, left in an ashtray, and with each draw, and make avoidant behavior more difficult. That it would be visible to others was perceived as off-putting for some. It was felt that a warning on each cigarette would create a negative image and be embarrassing. Within several female groups they were viewed as depressing, worrying and frightening, with it suggested that people would not feel good smoking cigarettes displaying a warning. Within every group there was mention of warnings on cigarettes potentially having an impact on themselves, others or both. Some, mostly younger groups, mentioned stubbing cigarettes out early, reducing consumption or quitting. The consensus was that they would be off-putting for young people, nonsmokers and those starting to smoke. Conclusions: Including a warning on each cigarette stick is a viable policy option and one which would, for the first time, extend health messaging to the consumption experience.
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Affiliation(s)
- Crawford Moodie
- Institute for Social Marketing, School of Health Sciences and Sport, University of Stirling, Stirlingshire, Scotland
| | - Rachel O’Donnell
- Institute for Social Marketing, School of Health Sciences and Sport, University of Stirling, Stirlingshire, Scotland
| | - Joy Fleming
- Institute for Social Marketing, School of Health Sciences and Sport, University of Stirling, Stirlingshire, Scotland
| | - Richard Purves
- Institute for Social Marketing, School of Health Sciences and Sport, University of Stirling, Stirlingshire, Scotland
| | - Jennifer McKell
- Institute for Social Marketing, School of Health Sciences and Sport, University of Stirling, Stirlingshire, Scotland
| | - Fiona Dobbie
- Usher Institute of Population Health, College of Medicine and Veterinary Medicine, University of Edinburgh, Stirlingshire, Scotland
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