scholarly journals Effectiveness of tobacco warning labels before and after implementation of the European Tobacco Products Directive—findings from the longitudinal EUREST-PLUS ITC Europe surveys

2020 ◽  
Vol 30 (Supplement_3) ◽  
pp. iii84-iii90
Author(s):  
Sarah Kahnert ◽  
Pete Driezen ◽  
James Balmford ◽  
Christina N Kyriakos ◽  
Sarah Aleyan ◽  
...  
Keyword(s):  
Tobacco Product ◽  
The European Union ◽  
Warning Label ◽  
Warning Labels ◽  
Health Warnings ◽  
Tobacco Products ◽  
Product Packaging ◽  
Highly Educated ◽  
Before And After ◽  
The Impact

Abstract Background Tobacco product packaging is a key part of marketing efforts to make tobacco use appealing. In contrast, large, prominent health warnings are intended to inform individuals about the risks of smoking. In the European Union, since May 2016, the Tobacco Products Directive 2014/40/EU (TPD2) requires tobacco product packages to carry combined health warnings consisting of a picture, a text warning and information on stop smoking services, covering 65% of the front and back of the packages. Methods Key measures of warning label effectiveness (salience, cognitive reactions and behavioural reaction) before and after implementation of the TPD2, determinants of warning labels’ effectiveness and country differences were examined in a longitudinal sample of 6011 adult smokers from Germany, Greece, Hungary, Poland, Romania and Spain (EUREST-PLUS Project) using longitudinal Generalized Estimating Equations (GEE) models. Results In the pooled sample, the warning labels’ effectiveness increased significantly over time in terms of salience (adjusted OR = 1.18; 95% CI: 1.03–1.35), while cognitive and behavioural reactions did not show clear increases. Generally, among women, more highly educated smokers and less addicted smokers, the effectiveness of warning labels tended to be higher. Conclusion We found an increase in salience, but no clear increases for cognitive and behavioural reactions to the new warning labels as required by the TPD2. While it is likely that our study underestimated the impact of the new pictorial warning labels, it provides evidence that health messages on tobacco packaging are more salient when supported by large pictures.

scholarly journals Global review of tobacco product flavour policies

2020 ◽  
pp. tobaccocontrol-2019-055454 ◽  
Author(s):  
Olufemi Erinoso ◽  
Katherine Clegg Smith ◽  
Michael Iacobelli ◽  
Sejal Saraf ◽  
Kevin Welding ◽  
...  
Keyword(s):  
Grey Literature ◽  
Tobacco Product ◽  
Future Research ◽  
Specific Reference ◽  
The European Union ◽  
Tobacco Products ◽  
Product Packaging ◽  
Policy Documents ◽  
Policy Domain ◽  
The Usa

ObjectiveWe determined which countries prohibit flavoured tobacco products and the details of those restrictions in order to identify possible gaps and opportunities for these and other countries to address.MethodsWe reviewed the grey literature, scanned news articles and consulted with key informants and identified 11 countries and the European Union (EU) that ban or restrict tobacco product flavours. We reviewed policy documents for their stated policy rationale, terms and definitions of flavours, tobacco products covered and restrictions on the use of flavour imagery and terms on tobacco product packaging.ResultsCountries with a tobacco product flavour policy include the USA, Canada, Brazil, Ethiopia, Uganda, Senegal, Niger, Mauritania, EU (28 Member States), Moldova, Turkey and Singapore. Most of the countries’ policies provide a rationale of dissuading youth from taking up tobacco use. Ten of the 12 policies use the terms ‘flavours’ (n=6) or ‘characterising flavours’ (n=4). Six policies cover all products made entirely or partly of tobacco leaf. Countries consistently prohibit flavours associated with fruits, vanilla and spices. The USA and Niger make an exception for menthol, while Mauritania and Uganda do not specify the scope of flavours or ingredients covered by their policies. Eight policies make no specific reference to restricting flavour descriptors on tobacco product packaging.ConclusionCountries looking to implement policies restricting flavours in tobacco products can build on existing comprehensive policies. Future research could examine the implementation and impacts of these policies, to inform other countries interested in acting in this policy domain.

scholarly journals Changes in electronic cigarette use and label awareness among smokers before and after the European Tobacco Products Directive implementation in six European countries: findings from the EUREST-PLUS ITC Europe Surveys

2020 ◽  
Vol 30 (Supplement_3) ◽  
pp. iii62-iii67 ◽  
Author(s):  
Katerina Nikitara ◽  
Charis Girvalaki ◽  
Christina N Kyriakos ◽  
Pete Driezen ◽  
Filippos T Filippidis ◽  
...  
Keyword(s):  
Electronic Cigarettes ◽  
Safety Information ◽  
Tobacco Product ◽  
Binary Outcomes ◽  
Cigarette Use ◽  
The European Union ◽  
Warning Labels ◽  
Eu Member States ◽  
Design Attributes ◽  
Before And After

Abstract Background Article 20 of the European Tobacco Product Directive (TPD), which went into effect in May 2016, regulates electronic cigarettes (e-cigarettes) in the European Union (EU). The aim of this study was to evaluate changes in e-cigarette use, design attributes of the products used and awareness of e-cigarette labelling and packaging among smokers from six EU Member States (MS) before and after TPD implementation. Methods Data come from Wave 1 (2016, pre-TPD) and Wave 2 (2018, post-TPD) of the ITC Six European Country Survey among a sample of smokers and recent quitters who use e-cigarettes from six EU MS. Weighted logistic generalized estimating equations regression models were estimated to test the change in binary outcomes between Waves 1 and 2 using SAS-callable SUDAAN. Results In 2018, current daily/weekly e-cigarette use among adult smokers was just over 2%, but this varied from the highest in Greece (4%) to lowest in Poland (1.2%). From Waves 1 to 2, there was a significant increase in respondents reporting noticing and reading health and product safety information on leaflets inside e-cigarette packaging (8.39–11.62%, P < 0.001). There were no significant changes between waves of respondents reporting noticing or reading warning labels on e-cigarette packages/vials. Conclusions e-cigarette use among smokers in these six EU countries is low. Although reported noticing and reading leaflets included in the packaging of e-cigarettes increased significantly from before to after the TPD, there was no significant change in reported noticing and reading of warning labels. Findings indicate the importance of continued monitoring of TPD provisions around e-cigarettes.

Effectiveness of Text versus Pictorial Health Warning Labels and Predictors of Support for Plain Packaging of Tobacco Products within the European Union

2014 ◽  
Vol 21 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Israel T. Agaku ◽  
Filippos T. Filippidis ◽  
Constantine I. Vardavas
Keyword(s):  
European Union ◽  
Smoking Behavior ◽  
Tobacco Product ◽  
The Self ◽  
The European Union ◽  
Warning Labels ◽  
Tobacco Products ◽  
Health Warning ◽  
Plain Packaging ◽  
Pictorial Warnings

Background: Tobacco product warning labels are a key health communication medium with plain packaging noted as the next step in the evolution of tobacco packaging. We assessed the self-reported impact of text versus pictorial health warnings and the determinants of support for plain packaging of tobacco products in the European Union (EU). Methods: The Special Eurobarometer 385 survey was analyzed for 26,566 adults from 27 EU countries in 2012. The self-reported impact of warning labels (text or pictorial) and determinants of EU-wide support for plain packaging were assessed using multivariate logistic regression. Results: Current smokers in countries where cigarette pictorial warnings were implemented had higher odds of reporting that health warning labels had any effect on their smoking behavior (making a quit attempt or reducing number of cigarettes smoked per day) compared to respondents in countries with text-only warning labels (adjusted odds ratio, aOR = 1.31; 95% confidence interval, 95% CI: 1.10-1.56). Population support for plain packaging of tobacco packs was higher in countries where cigarette pictorial warnings already existed (aOR = 1.17; 95% CI: 1.07-1.28). Conclusions: These findings indicate that the implementation of pictorial warnings at an EU level may have a positive behavioral impact among smokers and pave the way for population support for plain packaging in the EU.

scholarly journals Apelaciones al miedo en advertencias sanitarias para la prevención del tabaquismo: ¿una imagen vale más que mil palabras? = Appeals to fear in health warnings for the prevention of smoking: is a picture worth more than a thousand words?

2018 ◽  
Vol 9 (2) ◽  
pp. 138
Author(s):  
Laura Rodríguez Contreras ◽  
Juan José Igartua Perosanz
Keyword(s):  
Smoking Habit ◽  
Smoking Behavior ◽  
Smoking Prevention ◽  
Warning Label ◽  
Warning Labels ◽  
Health Warnings ◽  
Text And Image ◽  
Experimental Conditions ◽  
The Impact ◽  
Cigarette Packs

Resumen: Las advertencias sanitarias en las cajetillas de tabaco son uno de los métodos más usados para reducir el consumo de tabaco. Es por ello que se plantea el presente estudio para averiguar si las nuevas imágenes incorporadas en los paquetes de tabaco en mayo de 2016 en España son efica­ces, comprensibles e impactan lo suficiente para cesar el consumo de tabaco. Para ello se crearon tres condiciones experimentales: en la primera condición se utilizaron las cajetillas originales (texto e imagen), en la segunda sólo las imágenes de las cajetillas y en la tercera condición sólo el texto con las advertencias. Participaron un total de 94 sujetos que fueron asignados aleatoriamente a las tres condiciones experimentales. Los resultados mostraron que las advertencias con sólo texto y las combinadas (texto e imagen) se comprendían mejor que las que sólo mostraban la imagen ame­nazante. Por lo tanto, la imagen en solitario reducía la comprensión del mensaje llegando incluso a distorsionar su significado. Los análisis mediacionales mostraron que las emociones negativas no ejercían un papel significativo. En cambio, la compresión del mensaje sí que actuaba como variable mediadora del efecto del tipo de advertencia sanitaria sobre el impacto preventivo.Palabras clave: Tabaco; advertencia sanitaria antitabaco; prevención tabaquismo; cese del tabaquismo; comunicación de la salud.Abstract: The warning labels placed on the cigarette packs are one of the more used methods to reduce the smoking habit among its population. The present study will try to establish whether or not the new images that were incorporated on the cigarette packs in Spain in 2016 are efficient, comprehensible and if they are impacting enough to stop the smoking behavior. On the experiment three questionnai­res were realized, one with the original combined pack (image and text), another one only with the pack image and another one only with the warning text. A total of 94 subjects participated on the ex­periment, they were randomly assigned one of the three experimental conditions. The results showed that the warning labels with just text and the ones that combined text and image were understood better by the subjects that the ones that only showed the threatening image. Therefore, it can be assessed that the image alone reduced the overall comprehension of the message, even distorting its meaning. The mediational analysis showed that negative emotions didn’t interfere with the results. On the contrary, the comprehension of the message worked as a mediating variable of the impact that the sanitary advice caused on the subjects.Keywords: Tobacco; tobacco warning label; smoking prevention; smoking cessation; health communication.

scholarly journals Smokers’ perception of cigarette packaging in France before and after the plain packaging

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Pasquereau ◽  
R Andler ◽  
R Guignard ◽  
J B Richard ◽  
V Nguyen-Thanh
Keyword(s):  
Random Sampling ◽  
Telephone Survey ◽  
Tobacco Consumption ◽  
Health Warnings ◽  
Tobacco Products ◽  
Plain Packaging ◽  
Cigarette Pack ◽  
Before And After ◽  
The Look ◽  
The Impact

Abstract Background The new mandatory packaging for tobacco products (plain pack with larger graphic health warnings) was implemented in France on January 1st 2017. This study examines the impact of this new packaging on smokers' perceptions of their pack by comparing perceptions before (2016) and after (2017) the implementation. Methods Data come from the Santé publique France Health Barometer, a national telephone survey with random sampling. In the 2016 and 2017 editions, respectively 15,216 and 25,319 adults were asked about their tobacco consumption. Two questions were asked to smokers, identical in 2016 and 2017, on the appreciation of the appearance of the package and on the embarrassment to take out the package because of its appearance. Results - The share of smokers stating they do enjoy the look of their pack was divided by 3 between 2016 (53%) and 2017 (16%). Smokers stating that they are embarrassed of taking out their pack in plain sight because of its look were twice as numerous in 2017 (12%) as in 2016 (6%).A reduce appeal of cigarette pack was observed among the youths (18-25 yo) and they are now as few as their elders to enjoy the look of their pack. Conclusions The introduction of plain packaging has certainly had an impact on smokers' perceptions and, within a strong tobacco control context, probably contributed to denormalize smoking in France. Key messages Since the introduction of plain packaging, appeal of cigarette pack decreased and smokers are more often embarrassed of taking out their pack in plain sight because of its look. Our study suggests that the introduction of plain packaging has had an impact on smokers’ perceptions of their cigarette pack.

scholarly journals Identyfikacja sposobów implementacji II filaru WPR w krajach Europy Środkowo-Wschodniej

2018 ◽  
pp. 109-123 ◽  
Author(s):  
Krzysztof Pawłowski ◽  
Wawrzyniec Czubak
Keyword(s):  
Rural Areas ◽  
Central And Eastern Europe ◽  
Agricultural Sector ◽  
Development Program ◽  
Time Range ◽  
The European Union ◽  
Before And After ◽  
Rural Development Program ◽  
The Common ◽  
The Impact

The 2nd pillar of the Common Agricultural Policy plays a very significant role in shaping the image of a modern, European village. It’s impact on the development of agriculture and rural areas seems to be obvious, for example because of the place it occupies in the structure of the European Union budget. However, it’s very important to precisely determine the effects of its implementation. Therefore, in this article the main goal was to show the reasons for diversifying the implementation of the Rural Development Program 2007–2013 in the countries of Central and Eastern Europe. Against the background of differences in the economic and production situation of the agricultural sector, the design of the Programs was evaluated and it’s impact on changes in the agricultural sectors of these countries was compared. To show the impact of the funds of the second pillar of the CAP, the time range presenting changes in agriculture covers the years before and after integration. Based on them, a comparison of the implemented activities and the structure of their financing has been made.

scholarly journals Impact of nutrient warning labels on choice of ultra-processed food and drinks high in sugar, sodium, and saturated fat in Colombia: A randomized controlled trial

2021 ◽  
Author(s):  
Mercedes Mora-Plazas ◽  
Isabella Higgins ◽  
Luis Fernando Gomez ◽  
Marissa G. Hall ◽  
Maria Fernanda Parra ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Future Research ◽  
Processed Food ◽  
Warning Label ◽  
Warning Labels ◽  
Breakfast Cereal ◽  
Added Sugar ◽  
Label Condition ◽  
Fruit Drink ◽  
The Impact

Abstract BackgroundFront-of-package nutrient warning labels are one promising policy to inform healthier food choices and purchasing decisions. This study aimed to identify the impact of nutrient warning labels on product selection and the ability to correctly identify products with an excess of critical nutrients, among other outcomes in Colombia.MethodsWe conducted an online randomized experiment among 8,061 Colombian adults in October 2020. Participants were randomly assigned to a front-of-package label condition: nutrient warning, guideline daily amounts (GDA), Nutri-Score, or a no-label condition. First, they viewed a fruit drink with added sugar that was labeled per their assigned condition and one without added sugar, which was only labeled in the GDA and Nutri-Score conditions, and completed selection tasks. The primary outcomes were 1) selection of the fruit drink with added sugar as the fruit drink they would rather buy and 2) correctly identifying which fruit drink was higher in sugar. Next, they viewed four food products (cookies, yogurt, sliced bread, and breakfast cereal) with their assigned condition and answered a series of questions. Finally, they selected which of the three label types would most discourage them from consuming a specified ultra-processed food.ResultsFewer participants in the nutrient warning condition (20%) selected the added sugar fruit drink as the product they would rather buy compared to 24% in the GDA condition (p<.01), 29% in the no-label condition, and 33% in the Nutri-Score condition (both, p<.001). More participants in the nutrient warning condition (88%) correctly identified the fruit drink higher in sugar compared to the no-label condition (68%) and the Nutri-Score condition (65%) (both, p<.001). More participants in the GDA condition (91%) correctly identified the fruit drink higher in sugar compared to the nutrient warning condition (p<.01). Most participants (72%) selected the nutrient warning label as most discouraging, while only 20% selected the GDA label and 9% selected the Nutri-Score label.ConclusionsNutrient warning labels are a promising policy strategy to prevent obesity and diet-related non-communicable diseases in Colombia. Future research is needed to understand the impact of nutrient warning labels on actual ultra-processed food purchases in Colombia. Trial Registration: NCT04567004

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

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.

scholarly journals Modelling the impact of a new tobacco product: review of Philip Morris International’s Population Health Impact Model as applied to the IQOS heated tobacco product

2018 ◽  
Vol 27 (Suppl 1) ◽  
pp. s82-s86 ◽  
Author(s):  
Wendy B Max ◽  
Hai-Yen Sung ◽  
James Lightwood ◽  
Yingning Wang ◽  
Tingting Yao
Keyword(s):  
Population Health ◽  
New Product ◽  
Health Impact ◽  
Tobacco Product ◽  
Dynamic State ◽  
Model Parameters ◽  
Impact Model ◽  
Tobacco Products ◽  
Philip Morris ◽  
The Impact

ObjectivesWe review the Population Health Impact Model (PHIM) developed by Philip Morris International and used in its application to the US Food and Drug Administration (FDA) to market its heated tobacco product (HTP), IQOS, as a modified-risk tobacco product (MRTP). We assess the model against FDA guidelines for MRTP applications and consider more general criteria for evaluating reduced-risk tobacco products.MethodsIn assessing the PHIM against FDA guidelines, we consider two key components of the model: the assumptions implicit in the model (outcomes included, relative harm of the new product vs cigarettes, tobacco-related diseases considered, whether dual or polyuse of the new product is modelled, and what other tobacco products are included) and data used to estimate and validate model parameters (transition rates between non-smoking, cigarette-only smoking, dual use of cigarettes and MRTP, and MRTP-only use; and starting tobacco use prevalence).ResultsThe PHIM is a dynamic state transition model which models the impact of cigarette and MRTP use on mortality from four tobacco-attributable diseases. The PHIM excludes morbidity, underestimates mortality, excludes tobacco products other than cigarettes, does not include FDA-recommended impacts on non-users and underestimates the impact on other population groups.ConclusionThe PHIM underestimates the health impact of HTP products and cannot be used to justify an MRTP claim. An assessment of the impact of a potential MRTP on population health should include a comprehensive measure of health impacts, consideration of all groups impacted, and documented and justifiable assumptions regarding model parameters.

The Impact of Social Transfers on Income Poverty and Material Deprivation

2018 ◽  
pp. 85-107 ◽  
Author(s):  
Geranda Notten ◽  
Anne-Catherine Guio
Keyword(s):  
European Union ◽  
Social Exclusion ◽  
Poverty Reduction ◽  
Material Deprivation ◽  
Income Poverty ◽  
The European Union ◽  
The United Kingdom ◽  
Before And After ◽  
Social Transfers ◽  
The Impact

In 2010, the European Union (EU) committed to lifting at least 20 million people out of poverty and social exclusion, using income poverty, severe material deprivation, and (quasi-)joblessness as metrics to measure progress on this goal. As part of a broader set of commonly agreed indicators, the EU also (crudely) measures the impact of transfers by comparing income poverty rates before and after social transfers. This chapter develops a regression approach to study the effects of transfers on material deprivation by predicting the material deprivation rate before social transfers. We apply the method to pre-recession and post-austerity EU-SILC data for Germany, Greece, Poland, and the United Kingdom. We find that, in addition to reducing income poverty, transfers substantially reduce the extent and depth of material deprivation. Changes in social transfers, therefore, have a twofold effect on Europe’s poverty-reduction target.

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