Trends in noticing and responding to, health warning labels on cigarette packages among adults who smoke: Findings from the ITC Four Country Surveys between 2002 and 2022.

IF 3 2区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Bibha Dhungel, Ron Borland, Hua-Hie Yong, Coral Gartner, Katherine A East, David Hammond, K Michael Cummings, Andrew Hyland, Maansi Bansal-Travers, Ann McNeill, Shannon Gravely, Geoffrey T Fong
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引用次数: 0

Abstract

Introduction: We present data on 20-year (2002-2022) trends in reactions of smokers to Health Warning Label (HWL) changes (e.g., increasing warning size, requiring graphic images, mandating standardized packaging) in Canada, England, and Australia, compared to the US where HWLs did not change.

Methods: We analyzed weighted data from 16 waves of the International Tobacco Control Four Country Survey, comprising 99 438 observations from 49 034 adults (ages 18+) who smoked cigarettes (daily or non-daily), tracking indicators of HWL effectiveness including noticing HWLs and related thoughts about harms from smoking and quitting.

Results: The first HWL change studied in each country (Canada-2001; England-2003; Australia-2006) had the largest impact on all indicators of HWL effectiveness; subsequent changes in all three countries had less or no additional impact. Over 20 years, noticing and quitting thoughts (for daily smoking) decreased significantly in the US. In the last three waves (2018-2022), noticing remained lowest in the US. Thinking about harm and quitting were lower in the US than in Canada and England, but in Australia, levels of "Thinking about harms" were significantly lower than in the US. People smoking non-daily maintained higher levels on some key measures than those smoking daily.

Conclusions: In countries with long histories of public education about smoking harms, periodically strengthening HWLs on cigarette packs appears to have diminishing impacts on smokers' reactions with long-term impacts of strong warnings small, especially for people smoking daily. The findings suggest short-term impacts of HWLs relate to the change from previous HWLs and not their absolute magnitude.

Implications: HWLs on cigarette packs remain important for discouraging smoking, but the effects of strengthening warnings on smokers' reactions decline with time and are smaller where HWLs were already strong. Sustained effects may be greater for non-daily smokers. Countries with weak or no HWLs may benefit in the medium term from stronger HWLs, though returns diminish as HWL coverage increases. Future smoking models should not assume long-term large cessation effects from stronger HWLs as they can do in the short term but allow for a range of smaller impacts. This study did not assess HWLs' impact in preventing uptake.

在吸烟的成年人中,注意和回应香烟包装上健康警告标签的趋势:2002年至2022年间ITC四个国家调查的结果。
引言:我们提供了加拿大、英国和澳大利亚吸烟者对健康警告标签(HWL)变化(例如,增加警告尺寸、要求图形图像、强制标准化包装)的20年(2002-2022)趋势的数据,而美国的健康警告标签没有变化。方法:我们分析了来自国际烟草控制四国调查的16波加权数据,其中包括来自49034名吸烟(每日或非每日)的成年人(18岁以上)的99438个观察结果,跟踪了HWL有效性的指标,包括注意到HWL以及有关吸烟和戒烟危害的相关想法。结果:首次在各国研究了HWL变化(加拿大-2001;英格兰- 2003;澳大利亚(2006年)对社会福利有效性的所有指标影响最大;这三个国家随后的变化产生的额外影响较小或没有。20多年来,在美国,注意和戒烟的想法(每天吸烟)显著减少。在过去的三次浪潮中(2018-2022年),美国的注意力仍然最低。在美国,考虑危害和戒烟的比例低于加拿大和英国,但在澳大利亚,“考虑危害”的水平明显低于美国。非每日吸烟者在某些关键指标上的水平高于每日吸烟者。结论:在对吸烟危害进行公众教育历史悠久的国家,定期加强香烟包装上的有害警告对吸烟者的反应的影响似乎越来越小,强烈警告的长期影响很小,特别是对每天吸烟的人。研究结果表明,高强度血液循环的短期影响与先前高强度血液循环的变化有关,而不是其绝对程度。结论:烟盒上的高警示警示对于劝阻吸烟仍然很重要,但是强化警示对吸烟者反应的影响随着时间的推移而减弱,在高警示警示警示已经很强的地方效果更小。对于不每天吸烟的人来说,持续的影响可能更大。从中期来看,HWL较弱或没有HWL的国家可能会受益于HWL的增强,尽管随着HWL覆盖率的增加,回报会减少。未来的吸烟模型不应假设较强的高强度烟度会产生长期的大的戒烟效果,因为它们可以在短期内做到这一点,但要考虑一系列较小的影响。这项研究没有评估HWLs在预防摄取方面的影响。
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来源期刊
Nicotine & Tobacco Research
Nicotine & Tobacco Research 医学-公共卫生、环境卫生与职业卫生
CiteScore
8.10
自引率
10.60%
发文量
268
审稿时长
3-8 weeks
期刊介绍: Nicotine & Tobacco Research is one of the world''s few peer-reviewed journals devoted exclusively to the study of nicotine and tobacco. It aims to provide a forum for empirical findings, critical reviews, and conceptual papers on the many aspects of nicotine and tobacco, including research from the biobehavioral, neurobiological, molecular biologic, epidemiological, prevention, and treatment arenas. Along with manuscripts from each of the areas mentioned above, the editors encourage submissions that are integrative in nature and that cross traditional disciplinary boundaries. The journal is sponsored by the Society for Research on Nicotine and Tobacco (SRNT). It publishes twelve times a year.
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