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Appears in Collections:Faculty of Health Sciences and Sport Journal Articles
Peer Review Status: Refereed
Title: Impact of graphic and text warnings on cigarette packs: findings from four countries over five years
Authors: Borland, Ron
Wilson, Nicholas
Fong, Geoffrey T
Hammond, David
Cummings, K Michael
Yong, Hua-Hie
Hosking, Warwick
Hastings, Gerard
Thrasher, James F
McNeill, Ann
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Issue Date: Oct-2009
Publisher: BMJ Publishing Group
Citation: Borland R, Wilson N, Fong GT, Hammond D, Cummings KM, Yong H, Hosking W, Hastings G, Thrasher JF & McNeill A (2009) Impact of graphic and text warnings on cigarette packs: findings from four countries over five years, Tobacco Control, 18 (5), pp. 358-364.
Abstract: Objectives: To examine the impact of health warnings on smokers by comparing the short-term impact of new graphic (2006) Australian warnings with: (i) earlier (2003) United Kingdom larger text-based warnings; (ii) and Canadian graphic warnings (late 2000); and also to extend our understanding of warning wear-out. Methods: The International Tobacco Control Policy Evaluation Survey (ITC Project) follows prospective cohorts (with replenishment) of adult smokers annually (five waves: 2002-2006), in Canada, United States, UK and Australia (around 2000 per country per wave; total n = 17 773). Measures were of pack warning salience (reading and noticing); cognitive responses (thoughts of harm and quitting); and two behavioural responses: forgoing cigarettes and avoiding the warnings. Results: All four indicators of impact increased markedly among Australian smokers following the introduction of graphic warnings. Controlling for date of introduction, they stimulated more cognitive responses than the UK (text-only) changes, and were avoided more, did not significantly increase forgoing cigarettes, but were read and noticed less. The findings also extend previous work showing partial wear-out of both graphic and text-only warnings, but the Canadian warnings have more sustained effects than UK ones. Conclusions: Australia's new health warnings increased reactions that are prospectively predictive of cessation activity. Warning size increases warning effectiveness and graphic warnings may be superior to text-based warnings. While there is partial wear-out in the initial impact associated with all warnings, stronger warnings tend to sustain their effects for longer. These findings support arguments for governments to exceed minimum FCTC requirements on warnings.
Type: Journal Article
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Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: Cancer Council Victoria
University of Bradford
University of Waterloo
University of Waterloo
Roswell Park Cancer Institute
Cancer Council Victoria
Victoria University
Institute for Social Marketing
University of South Carolina
University of Nottingham

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