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Mercincavage M, Sidhu AK, Waugh L, Kreider C, Souprountchouk V, Delnevo CD, Villanti AC, Strasser AA. Effects of pictorial warning labels depicting lesser-known and well-known risks of smoking on viewing patterns, recall, and knowledge of smoking harms. Drug Alcohol Depend 2023; 251:110939. [PMID: 37660524 PMCID: PMC10538381 DOI: 10.1016/j.drugalcdep.2023.110939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 07/20/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND In 2019, the Food and Drug Administration introduced 11 pictorial warning labels (PWLs) for inclusion on cigarette packages, created in compliance with court recommendations and tailored to increase knowledge of smoking harms. Several highlighted lesser-known risks of smoking. No behavioral studies have yet evaluated how risk content in PWLs impacts viewing patterns, recall, and knowledge of smoking harms. METHODS Seventy adults who reported smoking cigarettes daily (62.9% male, 57.1% African American, mean age = 50.3, mean cigarettes per day = 14.4) completed a single-session laboratory study. They were randomized to view a set of four PWLs depicting either lesser-known or well-known risks of smoking while having eye movements recorded, then completed post-exposure recall and knowledge measures. RESULTS Participants exposed to PWLs depicting lesser-known smoking risks viewed the text of the warning sooner and for longer than the image (p's <0.05); those exposed to PWLs depicting well-known risks viewed the image longer than text (p <0.001). PWL condition did not affect recall of text or image (p's >0.1). Those viewing lesser-known (vs. well-known) risks had greater knowledge of smoking causing lesser-known risks of bladder cancer, blindness, bloody urine, cataracts, diabetes, and head and neck cancer (p's <0.001). CONCLUSIONS Individuals viewing PWLs depicting lesser-known (vs. well-known) smoking risks visually engaged with the PWL text more than image, had similarly high recall of PWL content, and had greater knowledge of lesser-known risks of smoking. Findings suggest including lesser-known risk information on PWLs improves overall knowledge of smoking health risks.
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Affiliation(s)
- Melissa Mercincavage
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, United States.
| | - Anupreet K Sidhu
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, United States
| | - Lizza Waugh
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Catherine Kreider
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Valentina Souprountchouk
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Cristine D Delnevo
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, United States; Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, NJ, United States
| | - Andrea C Villanti
- University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, United States; Rutgers Institute for Nicotine & Tobacco Studies, New Brunswick, NJ, United States
| | - Andrew A Strasser
- Center for Interdisciplinary Research on Nicotine Addiction, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States; University of Pennsylvania-Rutgers University Tobacco Center of Regulatory Science, Philadelphia, PA, United States; Annenberg School of Communication, University of Pennsylvania, Philadelphia, PA, United States
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