TY - JOUR
T1 - Independent or synergistic? Effects of varying size and using pictorial images in tobacco health warning labels
AU - Skurka, Chris
AU - Kalaji, Motasem
AU - Dorf, Michael C.
AU - Kemp, Deena
AU - Greiner Safi, Amelia
AU - Byrne, Sahara
AU - Mathios, Alan D.
AU - Avery, Rosemary J.
AU - Niederdeppe, Jeff
N1 - Funding Information:
This work was supported by the National Institute of Child Health and Human Development (NICHD) and FDA Center for Tobacco Products (CTP) (grant number R01-HD079612 ). The funders played no role in the study design; collection, analysis and interpretation of data; the writing of the manuscript; or the decision to submit the manuscript for publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Food and Drug Administration.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - Introduction: Legal challenges have blocked the implementation of large, pictorial health warning labels (HWLs) in the U.S. In light of future legal questions the U.S. Food and Drug Administration may face in proposing alternative HWLs, we examined whether less restrictive HWL versions on the front of packs—smaller HWLs and/or text-only HWLs that do not include pictorial imagery—may be sufficient to promote cognitive and affective outcomes associated with smoking cessation. Methods: We recruited low-income smokers in two separate experiments through field-based recruitment methods (Study 1, N = 497) or Amazon Mechanical Turk (MTurk) (Study 2, N = 495). In both studies, we randomly assigned participants to a no-HWL control condition or one of four HWL conditions in a 2 (pictorial vs. text-only) × 2 (50% vs. 30% size) between-subjects design. Results: Relative to text-only HWLs, pictorial HWLs increased negative affect but not risk belief acceptance, cognitive elaboration about smoking harms, or quit intentions. The 50% HWLs increased quit intentions relative to the control condition in both studies. The 50% HWLs also outperformed the 30% HWLs in promoting quit intentions in Study 2. Subsequent analyses revealed that this effect in Study 2 may have been driven by the 50% HWLs strengthening the relationship between risk-related thoughts and intentions, although there was no evidence for this pattern in Study 1. We found no evidence for interaction effects between the pictorial and size manipulations. Conclusions: Our findings suggest that 50% HWLs, whether pictorial or text-only, can encourage low-income smokers to consider quitting under some conditions.
AB - Introduction: Legal challenges have blocked the implementation of large, pictorial health warning labels (HWLs) in the U.S. In light of future legal questions the U.S. Food and Drug Administration may face in proposing alternative HWLs, we examined whether less restrictive HWL versions on the front of packs—smaller HWLs and/or text-only HWLs that do not include pictorial imagery—may be sufficient to promote cognitive and affective outcomes associated with smoking cessation. Methods: We recruited low-income smokers in two separate experiments through field-based recruitment methods (Study 1, N = 497) or Amazon Mechanical Turk (MTurk) (Study 2, N = 495). In both studies, we randomly assigned participants to a no-HWL control condition or one of four HWL conditions in a 2 (pictorial vs. text-only) × 2 (50% vs. 30% size) between-subjects design. Results: Relative to text-only HWLs, pictorial HWLs increased negative affect but not risk belief acceptance, cognitive elaboration about smoking harms, or quit intentions. The 50% HWLs increased quit intentions relative to the control condition in both studies. The 50% HWLs also outperformed the 30% HWLs in promoting quit intentions in Study 2. Subsequent analyses revealed that this effect in Study 2 may have been driven by the 50% HWLs strengthening the relationship between risk-related thoughts and intentions, although there was no evidence for this pattern in Study 1. We found no evidence for interaction effects between the pictorial and size manipulations. Conclusions: Our findings suggest that 50% HWLs, whether pictorial or text-only, can encourage low-income smokers to consider quitting under some conditions.
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U2 - 10.1016/j.drugalcdep.2019.01.034
DO - 10.1016/j.drugalcdep.2019.01.034
M3 - Article
C2 - 30889524
AN - SCOPUS:85062900574
VL - 198
SP - 87
EP - 94
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
SN - 0376-8716
ER -