Cigarette graphic health warning labels and information avoidance among individuals from low socioeconomic position in the U.S.

ObjectivesThis study examined the effect of pictorial health warning labels (HWLs) on the waterpipe (WP) device on smokers’ experience, puffing behaviour, harm perception and exposure to respiratory toxicants.MethodsThirty WP smokers completed two 45 min ad libitum smoking sessions (WP without HWL vs WP with HWL) in a crossover design study. Exhaled carbon monoxide (eCO) was measured before and after each smoking session. Puff topography was recorded throughout the smoking session, and participants completed survey questionnaires assessing subjective smoking experiences and harm perception.ResultsSignificant differences were observed in eCO levels between the two study conditions, with lower levels of eCO boost recorded following smoking the WP fitted with HWL (16 ppm) compared with WP without HWL (22.7 ppm). Participants had more puffs, shorter interpuff intervals and a higher total puff volume during smoking the WP without HWL relative to WP with HWL (p values <0.05). We documented enhanced reports of satisfaction, taste and puff liking following smoking the WP without HWL compared with the WP with HWL. WP harm perception was significantly higher among participants after smoking the WP with HWL compared with WP without HWL.ConclusionThis pilot study shows that placing HWL on the WP device is effective in reducing WP smoker’s positive experiences, puffing parameters and exposure to carbon monoxide. HWLs lead also to more appreciation of WP harmful effects, making them a promising regulatory approach for addressing the spread of WP smoking among young adults in the USA.

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Smokers' Neurological Responses to Novel and Repeated Health Warning Labels (HWLs) From Cigarette Packages

Frontiers in Psychiatry ◽

10.3389/fpsyt.2018.00319 ◽

2018 ◽

Vol 9 ◽

Author(s):

Johann F. Fridriksson ◽

Chris Rorden ◽

Roger D. Newman-Norlund ◽

Brett Froeliger ◽

James F. Thrasher

Keyword(s):

Warning Labels ◽

Health Warning

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The silent burden of stigmatisation: a qualitative study among Dutch people with a low socioeconomic position

BMC Public Health ◽

10.1186/s12889-018-5210-6 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 3

Author(s):

Audrey M. W. Simons ◽

Inge Houkes ◽

Annemarie Koster ◽

Daniëlle A. I. Groffen ◽

Hans Bosma

Keyword(s):

Qualitative Study ◽

Socioeconomic Position ◽

Low Socioeconomic ◽

Dutch People

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GPs' views on how low socioeconomic position affects diabetes management: an exploratory study

Australian Journal of Primary Health ◽

10.1071/py04055 ◽

2004 ◽

Vol 10 (3) ◽

pp. 120 ◽

Cited By ~ 4

Author(s):

Vanessa Rose ◽

Mark Harris ◽

Maria Theresa Ho

Keyword(s):

Socioeconomic Position ◽

Diabetes Management ◽

Financial Incentive ◽

Educational Materials ◽

Negative Attitudes ◽

Low Socioeconomic ◽

Low Health Literacy ◽

Patient Barriers

Little is known about general practitioners? (GP) capacity to effectively manage diabetes among patients of low socioeconomic position (SEP), despite the high burden of type 2 diabetes in this group. Nine GPs involved in a diabetes program and practising in an area of socioeconomic disadvantage participated in a focus group on low-SEP patient barriers to diabetes management, GP problems in managing diabetes among this group, and strategies for improving diabetes management with low-SEP patients. GPs perceived that low health literacy, poverty and psychosocial issues, and negative attitudes towards health were barriers to diabetes management among low-SEP patients. Difficulties in providing care to low-SEP patients were related to the availability of allied health services and GP perceptions of increased stress in providing care to this group. Suggestions for improvements in diabetes management were focussed on providing educational materials to low-SEP patients that matched literacy levels, and initiating patient financial incentive schemes to assist diabetes management and attendance at follow-up consultations.

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Reduced prevalence of small-for-gestational-age and preterm birth for women of low socioeconomic position: a population-based cohort study comparing antenatal midwifery and physician models of care

BMJ Open ◽

10.1136/bmjopen-2018-022220 ◽

2018 ◽

Vol 8 (10) ◽

pp. e022220 ◽

Cited By ~ 8

Author(s):

Daphne N McRae ◽

Patricia A Janssen ◽

Saraswathi Vedam ◽

Maureen Mayhew ◽

Deborah Mpofu ◽

...

Keyword(s):

British Columbia ◽

Cohort Study ◽

Preterm Birth ◽

Gestational Age ◽

Socioeconomic Position ◽

Small For Gestational Age ◽

Models Of Care ◽

Midwifery Care ◽

Low Socioeconomic ◽

Lower Odds

ObjectiveOur aim was to investigate if antenatal midwifery care was associated with lower odds of small-for-gestational-age (SGA) birth, preterm birth (PTB) or low birth weight (LBW) compared with general practitioner (GP) or obstetrician (OB) models of care for women of low socioeconomic position.SettingThis population-level, retrospective cohort study used province-wide maternity, medical billing and demographic data from British Columbia, Canada.ParticipantsOur study included 57 872 pregnant women, with low socioeconomic position, who: were residents of British Columbia, Canada, carried a singleton fetus, had low to moderate medical/obstetric risk, delivered between 2005 and 2012 and received medical insurance premium assistance.Primary and secondary outcome measuresWe report rates, adjusted ORs (aOR), and 95% CIs for the primary outcome, SGA birth (<the 10th percentile), and secondary outcomes, PTB (<37 weeks’ completed gestation) and LBW (<2500 g).ResultsOur sample included 4705 midwifery patients, 45 114 GP patients and 8053 OB patients. Odds of SGA birth were reduced for patients receiving antenatal midwifery versus GP (aOR 0.71, 95% CI 0.62 to 0.82) or OB care (aOR 0.59, 95% CI 0.50 to 0.69). Odds of PTB were lower for antenatal midwifery versus GP (aOR 0.74, 95% CI 0.63 to 0.86) or OB patients (aOR 0.53, 95% CI 0.45 to 0.62). Odds of LBW were reduced for midwifery versus GP (aOR 0.66, 95% CI 0.53 to 0.82) or OB patients (aOR 0.43, 95% CI 0.34 to 0.54).ConclusionAntenatal midwifery care in British Columbia, Canada, was associated with lower odds of SGA birth, PTB and LBW, for women of low socioeconomic position, compared with physician models of care. Results support the development of policy to ensure antenatal midwifery care is available and accessible for women of low socioeconomic position. Future research is needed to determine the underlying mechanisms linking midwifery care to better birth outcomes for women of low socioeconomic position.

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Image-and-text health warning labels on alcohol and food: potential effectiveness and acceptability

10.21203/rs.2.23468/v2 ◽

2020 ◽

Author(s):

Emily Pechey ◽

Natasha Clarke ◽

Eleni Mantzari ◽

Anna Blackwell ◽

Katie De-loyde ◽

...

Keyword(s):

Emotional Arousal ◽

Field Studies ◽

Tobacco Consumption ◽

Bowel Cancer ◽

Free Text ◽

Label Free ◽

Warning Labels ◽

Potential Effectiveness ◽

Health Warning ◽

Alcoholic Drinks

Abstract Background Health warning labels (HWLs) using images and text to depict the negative health consequences of tobacco consumption are effective and acceptable for changing smoking-related outcomes. There is currently limited evidence concerning their potential use for reducing consumption of alcoholic drinks and energy-dense foods. The aim of this research was to describe the potential effectiveness and acceptability of image-and-text (also known as pictorial or graphic) HWLs applied to : i. alcoholic drinks and ii. energy-dense snack foods. Methods Two online studies were conducted using between-subjects designs with general population samples. Participants rated one of 21 image-and-text HWLs on alcoholic drinks (n=5528), or one of 18 image-and-text HWLs on energy-dense snacks (n=4618). HWLs comprised a graphic image with explanatory text, depicting, respectively, seven diseases linked to excess alcohol consumption, and six diseases linked to excess energy intake. Diseases included heart disease and various cancers. Outcomes were negative emotional arousal, desire to consume the labelled product, and acceptability of the label. Free-text comments relating to HWLs were content analysed. Results For both alcoholic drinks and energy-dense snacks, HWLs depicting bowel cancer generated the highest levels of negative emotional arousal and lowest desire to consume the product, but were the least acceptable. Acceptability was generally low for HWLs applied to alcohol, with 3 of 21 rated as acceptable, and was generally high for snacks, with 13 of 18 rated as acceptable. The majority of free-text comments expressed negative reactions to HWLs on alcohol or energy-dense snacks. Conclusions Image-and-text health warning labels depicting bowel cancer showed greatest potential for reducing selection and consumption of alcoholic drinks and energy-dense snacks, although they were the least acceptable. Laboratory and field studies are needed to assess their impact on selection and consumption.

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Country Participation in the WHO Framework Convention on Tobacco Control Health Warnings Database

Tobacco Use Insights ◽

10.1177/1179173x211064214 ◽

2021 ◽

Vol 14 ◽

pp. 1179173X2110642

Author(s):

Christopher M. Seitz ◽

Kenneth D. Ward ◽

Zubair Kabir

Keyword(s):

Tobacco Control ◽

World Health ◽

Warning Labels ◽

Health Warnings ◽

Tobacco Products ◽

Health Warning ◽

Pictorial Warnings ◽

The World ◽

Alternative Tobacco Products ◽

Tobacco Packaging

Background The World Health Organization’s (WHO) Framework Convention on Tobacco Control (FCTC) Health Warnings Database is an online, publicly available resource created for countries to upload and share pictorial health warnings for tobacco packaging. The purpose of this study was to evaluate the extent to which the database is used by countries for the sharing of pictorial warnings. Methods The study’s sample included parties to the FCTC who required graphic health warning labels on cigarette packaging from. Those countries were categorized as having a low, middle, and high Socio-Demographic Index (SDI). The Health Warnings Database was then analyzed for those countries’ unique pictorial images, as well as the number of pictorials that were shared between countries. Results Of the 110 countries that required pictorial warnings on cigarette packaging, only 53 (48%) voluntarily contributed pictorials to the database, with most of those (53%) being high SDI-level countries. There were 342 unique pictorials on the database, with 62 images posted by seven countries that were used by 13 other countries. Conclusion While sharing was evident from the database, there remains a need for more countries to upload the pictorials to the database. There is also a need to expand the database to include alternative tobacco products, such as waterpipe tobacco and e-cigarettes.

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