Effects of 30% and 50% cigarette pack graphic warning labels on visual attention, negative affect, quit intentions, and smoking susceptibility among disadvantaged populations in the United States

Chris Skurka, Deena Kemp, Julie Davydova, James F. Thrasher, Sahara Byrne, Amelia Greiner Safi, Rosemary J. Avery, Michael C. Dorf, Alan D. Mathios, Leah Scolere, Jeff Niederdeppe

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Introduction: Though the WHO Framework Convention for Tobacco Control (FCTC) calls for the implementation of large graphic warning labels (GWLs) on cigarette boxes, the courts have blocked the implementation of 50% labels in the United States. We conducted an experiment to explore whether changing the size of GWLs is associated with changes in visual attention, negative affect, risk beliefs, and behavioral intentions. Method: We recruited adult smokers (N = 238) and middle-school youth (N = 237) throughout the state of New York in May 2016. We randomly assigned participants to one of three between-subject conditions (no GWL [control], 30% GWL, 50% GWL). Results: Adult and youth participants looked at the GWLs longer when the GWL covered 50% versus 30% of the pack's front. Increasing GWL size from 30% to 50% did not influence negative affect or risk beliefs, though both GWL sizes increased negative affect relative to the no-GWL control group. Exposure to 50% GWLs increased adult smokers' intentions to quit compared to no-GWL, but smokers exposed to 30% GWLs did not differ from control. There were no differences between 50% GWLs, 30% GWLs, and control on youth smoking susceptibility. Conclusions: Findings provide some evidence of the benefits of a 50% versus 30% GWL covering the front of the pack for adult smokers and at-risk youth from socioeconomically disadvantaged backgrounds-though not on all outcomes. Implications: This research shows that 30% GWLs on cigarette packages increase negative affect relative to packages without front-of-package GWLs. Larger GWLs on cigarette packages (50% vs. 30%) increase visual attention to the warning and its pictorial content among low-SES smokers and at-risk youth but do not further increase negative affect. A 50% GWL increased adults' quit intention compared to no GWL at all, but we were underpowered to detect modest differences in quit intentions between a 50% and 30% GWL. Future work should thus continue to explore the boundary conditions under which relatively larger GWLs influence cognitive, affective, and behavioral outcomes.

Original languageEnglish (US)
Pages (from-to)859-866
Number of pages8
JournalNicotine and Tobacco Research
Volume20
Issue number7
DOIs
StatePublished - Jun 7 2018

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Vulnerable Populations
Tobacco Products
Smoking
Population
Tobacco
Control Groups
Research

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health

Cite this

Skurka, Chris ; Kemp, Deena ; Davydova, Julie ; Thrasher, James F. ; Byrne, Sahara ; Safi, Amelia Greiner ; Avery, Rosemary J. ; Dorf, Michael C. ; Mathios, Alan D. ; Scolere, Leah ; Niederdeppe, Jeff. / Effects of 30% and 50% cigarette pack graphic warning labels on visual attention, negative affect, quit intentions, and smoking susceptibility among disadvantaged populations in the United States. In: Nicotine and Tobacco Research. 2018 ; Vol. 20, No. 7. pp. 859-866.
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title = "Effects of 30{\%} and 50{\%} cigarette pack graphic warning labels on visual attention, negative affect, quit intentions, and smoking susceptibility among disadvantaged populations in the United States",
abstract = "Introduction: Though the WHO Framework Convention for Tobacco Control (FCTC) calls for the implementation of large graphic warning labels (GWLs) on cigarette boxes, the courts have blocked the implementation of 50{\%} labels in the United States. We conducted an experiment to explore whether changing the size of GWLs is associated with changes in visual attention, negative affect, risk beliefs, and behavioral intentions. Method: We recruited adult smokers (N = 238) and middle-school youth (N = 237) throughout the state of New York in May 2016. We randomly assigned participants to one of three between-subject conditions (no GWL [control], 30{\%} GWL, 50{\%} GWL). Results: Adult and youth participants looked at the GWLs longer when the GWL covered 50{\%} versus 30{\%} of the pack's front. Increasing GWL size from 30{\%} to 50{\%} did not influence negative affect or risk beliefs, though both GWL sizes increased negative affect relative to the no-GWL control group. Exposure to 50{\%} GWLs increased adult smokers' intentions to quit compared to no-GWL, but smokers exposed to 30{\%} GWLs did not differ from control. There were no differences between 50{\%} GWLs, 30{\%} GWLs, and control on youth smoking susceptibility. Conclusions: Findings provide some evidence of the benefits of a 50{\%} versus 30{\%} GWL covering the front of the pack for adult smokers and at-risk youth from socioeconomically disadvantaged backgrounds-though not on all outcomes. Implications: This research shows that 30{\%} GWLs on cigarette packages increase negative affect relative to packages without front-of-package GWLs. Larger GWLs on cigarette packages (50{\%} vs. 30{\%}) increase visual attention to the warning and its pictorial content among low-SES smokers and at-risk youth but do not further increase negative affect. A 50{\%} GWL increased adults' quit intention compared to no GWL at all, but we were underpowered to detect modest differences in quit intentions between a 50{\%} and 30{\%} GWL. Future work should thus continue to explore the boundary conditions under which relatively larger GWLs influence cognitive, affective, and behavioral outcomes.",
author = "Chris Skurka and Deena Kemp and Julie Davydova and Thrasher, {James F.} and Sahara Byrne and Safi, {Amelia Greiner} and Avery, {Rosemary J.} and Dorf, {Michael C.} and Mathios, {Alan D.} and Leah Scolere and Jeff Niederdeppe",
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Effects of 30% and 50% cigarette pack graphic warning labels on visual attention, negative affect, quit intentions, and smoking susceptibility among disadvantaged populations in the United States. / Skurka, Chris; Kemp, Deena; Davydova, Julie; Thrasher, James F.; Byrne, Sahara; Safi, Amelia Greiner; Avery, Rosemary J.; Dorf, Michael C.; Mathios, Alan D.; Scolere, Leah; Niederdeppe, Jeff.

In: Nicotine and Tobacco Research, Vol. 20, No. 7, 07.06.2018, p. 859-866.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of 30% and 50% cigarette pack graphic warning labels on visual attention, negative affect, quit intentions, and smoking susceptibility among disadvantaged populations in the United States

AU - Skurka, Chris

AU - Kemp, Deena

AU - Davydova, Julie

AU - Thrasher, James F.

AU - Byrne, Sahara

AU - Safi, Amelia Greiner

AU - Avery, Rosemary J.

AU - Dorf, Michael C.

AU - Mathios, Alan D.

AU - Scolere, Leah

AU - Niederdeppe, Jeff

PY - 2018/6/7

Y1 - 2018/6/7

N2 - Introduction: Though the WHO Framework Convention for Tobacco Control (FCTC) calls for the implementation of large graphic warning labels (GWLs) on cigarette boxes, the courts have blocked the implementation of 50% labels in the United States. We conducted an experiment to explore whether changing the size of GWLs is associated with changes in visual attention, negative affect, risk beliefs, and behavioral intentions. Method: We recruited adult smokers (N = 238) and middle-school youth (N = 237) throughout the state of New York in May 2016. We randomly assigned participants to one of three between-subject conditions (no GWL [control], 30% GWL, 50% GWL). Results: Adult and youth participants looked at the GWLs longer when the GWL covered 50% versus 30% of the pack's front. Increasing GWL size from 30% to 50% did not influence negative affect or risk beliefs, though both GWL sizes increased negative affect relative to the no-GWL control group. Exposure to 50% GWLs increased adult smokers' intentions to quit compared to no-GWL, but smokers exposed to 30% GWLs did not differ from control. There were no differences between 50% GWLs, 30% GWLs, and control on youth smoking susceptibility. Conclusions: Findings provide some evidence of the benefits of a 50% versus 30% GWL covering the front of the pack for adult smokers and at-risk youth from socioeconomically disadvantaged backgrounds-though not on all outcomes. Implications: This research shows that 30% GWLs on cigarette packages increase negative affect relative to packages without front-of-package GWLs. Larger GWLs on cigarette packages (50% vs. 30%) increase visual attention to the warning and its pictorial content among low-SES smokers and at-risk youth but do not further increase negative affect. A 50% GWL increased adults' quit intention compared to no GWL at all, but we were underpowered to detect modest differences in quit intentions between a 50% and 30% GWL. Future work should thus continue to explore the boundary conditions under which relatively larger GWLs influence cognitive, affective, and behavioral outcomes.

AB - Introduction: Though the WHO Framework Convention for Tobacco Control (FCTC) calls for the implementation of large graphic warning labels (GWLs) on cigarette boxes, the courts have blocked the implementation of 50% labels in the United States. We conducted an experiment to explore whether changing the size of GWLs is associated with changes in visual attention, negative affect, risk beliefs, and behavioral intentions. Method: We recruited adult smokers (N = 238) and middle-school youth (N = 237) throughout the state of New York in May 2016. We randomly assigned participants to one of three between-subject conditions (no GWL [control], 30% GWL, 50% GWL). Results: Adult and youth participants looked at the GWLs longer when the GWL covered 50% versus 30% of the pack's front. Increasing GWL size from 30% to 50% did not influence negative affect or risk beliefs, though both GWL sizes increased negative affect relative to the no-GWL control group. Exposure to 50% GWLs increased adult smokers' intentions to quit compared to no-GWL, but smokers exposed to 30% GWLs did not differ from control. There were no differences between 50% GWLs, 30% GWLs, and control on youth smoking susceptibility. Conclusions: Findings provide some evidence of the benefits of a 50% versus 30% GWL covering the front of the pack for adult smokers and at-risk youth from socioeconomically disadvantaged backgrounds-though not on all outcomes. Implications: This research shows that 30% GWLs on cigarette packages increase negative affect relative to packages without front-of-package GWLs. Larger GWLs on cigarette packages (50% vs. 30%) increase visual attention to the warning and its pictorial content among low-SES smokers and at-risk youth but do not further increase negative affect. A 50% GWL increased adults' quit intention compared to no GWL at all, but we were underpowered to detect modest differences in quit intentions between a 50% and 30% GWL. Future work should thus continue to explore the boundary conditions under which relatively larger GWLs influence cognitive, affective, and behavioral outcomes.

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