scholarly journals Impact of Pictorial Cigarette Warnings Compared With Surgeon General’s Warnings on Understanding of the Negative Health Consequences of Smoking

2020 ◽  
Vol 22 (10) ◽  
pp. 1795-1804
Author(s):  
Jessica K Pepper ◽  
Anh Nguyen Zarndt ◽  
Matthew E Eggers ◽  
James M Nonnemaker ◽  
David B Portnoy
Keyword(s):  
Tobacco Control ◽  
Health Beliefs ◽  
Smoking Prevention ◽  
Health Warnings ◽  
Health Consequences ◽  
Treatment Conditions ◽  
New Information ◽  
The Family ◽  
The Us ◽  
Selection Of

Abstract Introduction The Family Smoking Prevention and Tobacco Control Act requires cigarette packages and advertisements to bear health warnings with “color graphics depicting the negative health consequences of smoking.” Aims and Methods This study assessed whether new US Food and Drug Administration developed pictorial cigarette warnings (PCW) increased understanding of smoking-related risks relative to the current Surgeon General’s (SG) warnings. In March–May 2019, adolescent and adult smokers and nonsmokers participated in an online experiment with three sessions completed over approximately 2 weeks. Participants viewed 1 of 16 PCW (treatment conditions) or an SG warning (control) on mock cigarette packages and advertisements. Measures assessed whether warnings provided new information, induced thinking about risks, changed smoking-related health beliefs, and were accurately recalled, among other outcomes. Results The majority of PCW (≥13 conditions) resulted in greater learning of new information, higher self-reported learning, and greater reports of thinking about smoking risks; they were viewed as more informative, understandable, and attention-drawing compared with the control condition. Most participants believed the warning were factual, although 8 PCW were perceived as less factual than the control. There were changes toward more agreement with health beliefs for 11 PCW between Sessions 1 and 2 and 7 PCW between Sessions 1 and 3. Participants in all treatment conditions were more likely than control condition participants to correctly recall the warning. Across outcomes, PCW related to addiction, death, and quitting did not perform as well as other PCW. Conclusions Many of the PCW tested increased understanding of the risks associated with cigarette smoking relative to current SG warnings. Implications The Tobacco Control Act requires cigarette packages and advertisements to bear PCW depicting the negative health consequences of smoking. This study tested whether any of 16 newly proposed PCW increased understanding of smoking-related risks relative to existing SG warnings. Results suggest that most PCW tested, particularly those related to less widely known health effects, resulted in greater learning of new information, higher self-reported learning, and greater reports of thinking about smoking risks compared with SG warnings. These results, along with other factors, informed the US Food and Drug Administration’s selection of proposed PCW.

scholarly journals Influence of Warning Statements on Understanding of the Negative Health Consequences of Smoking

2020 ◽  
Vol 22 (10) ◽  
pp. 1805-1815 ◽  
Author(s):  
Jessica K Pepper ◽  
Anh Nguyen Zarndt ◽  
Matthew E Eggers ◽  
James M Nonnemaker ◽  
David B Portnoy
Keyword(s):  
Cigarette Smoking ◽  
Treatment Condition ◽  
Public Understanding ◽  
Health Warnings ◽  
Health Consequences ◽  
Follow Up Study ◽  
New Information ◽  
The Us ◽  
Us Fda

Abstract Introduction Pursuant to the Tobacco Control Act (TCA), the US Food and Drug Administration (FDA) is developing new cigarette health warnings to convey the negative health consequences of cigarette smoking. Aims and Methods This study assessed which of 15 revised warning statements (10 on topics similar to TCA statements and 5 on other topics) promoted greater understanding of cigarette smoking risks relative to TCA statements. In February 2018, adolescent and adult smokers and adolescents susceptible to smoking (n = 2505) completed an online experiment. Control condition participants viewed TCA statements; treatment condition participants viewed combinations of TCA and revised statements. Analyses compared revised statements to TCA statements on the same health topic or to randomly selected TCA statements if there were no statements on the same topic. Results Relative to TCA statements, 12 of 15 revised statements were more likely to be considered new information, and 12 resulted in more self-reported learning. Three revised statements made participants think more about health risks than TCA statements; the reverse was true for one revised statement. Participants rated most TCA and revised statements as moderately believable and informative. Seven revised statements were found to be less believable and factual, and one revised statement more believable and factual. Treatment condition participants correctly selected more smoking-related health conditions than control condition participants (13.79 versus 12.42 of 25). Conclusions Findings suggest that revised statements can promote greater understanding of cigarette smoking risks. Results informed FDA’s selection of warning text that was paired with images for testing in a follow-up study. Implications The US FDA may adjust the text of the cigarette warning statements provided in the TCA if the revised statements promote greater public understanding of the negative health consequences of cigarette smoking. Most of the revised warning statements tested were more likely to be considered new information and resulted in more self-reported learning compared with paired TCA statements, providing support for using revised statements as part of cigarette health warnings. These results informed the development of pictorial cigarette warnings by FDA that were tested in a follow-up study and included in a proposed rule.

scholarly journals Should Graphic Warning Labels Proposed for Cigarette Packages Sold in the United States Mention the Food and Drug Administration?

2020 ◽  
Author(s):  
Mia Jovanova ◽  
Chris Skurka ◽  
Sahara Byrne ◽  
Motasem Kalaji ◽  
Amelia Greiner Safi ◽  
...  
Keyword(s):  
Middle School ◽  
Tobacco Control ◽  
Drug Administration ◽  
Source Credibility ◽  
Food And Drug Administration ◽  
The United States ◽  
Smoking Prevention ◽  
Warning Labels ◽  
The Us ◽  
Graphic Warning

Abstract Introduction Under the US Family Smoking Prevention and Tobacco Control Act, the US Food and Drug Administration (FDA) has the authority to implement graphic warning labels (GWLs) on cigarette packages. Neither the original labels proposed by the FDA nor the revised labels include a source to indicate sponsorship of the warnings. This study tests the potential impact of adding a sponsor to the content of GWLs. Methods We recruited adult smokers (N = 245) and middle-school youth (N = 242) from low-income areas in the Northeastern US. We randomly assigned participants to view one of three versions of the original FDA–proposed warning labels in a between-subjects experiment: no sponsor, “US Food and Drug Administration,” or “American Cancer Society” sponsor. We tested the effect of varying sponsorship on source attribution and source credibility. Results Compared to unsponsored labels, FDA sponsorship increased source attributions that the FDA sponsored the labels among both middle-school, largely nonsmoking youth and adult smokers. However, sponsorship had no effect on source credibility among either population. Conclusions We found no evidence that adding FDA as the source is likely to boost source credibility judgments, at least in the short term; though doing so would not appear to have adverse effects on credibility judgments. As such, our data are largely consistent with the Tobacco Control Act’s provisions that allow, but do not require, FDA sponsorship on the labels. Implications This study addresses the FDA’s regulatory efforts by informing the possible design and content of future cigarette warning labels. Our results do not offer compelling evidence that adding the FDA name on GWLs will directly increase source credibility. Future work may test more explicit FDA source labeling and continue to examine the credibility of tobacco message content among high–priority populations.

scholarly journals FDA's misplaced priorities: premarket review under the Family Smoking Prevention and Tobacco Control Act

2016 ◽  
Vol 25 (3) ◽  
pp. 246-253 ◽  
Author(s):  
Desmond Jenson ◽  
Joelle Lester ◽  
Micah L Berman
Keyword(s):  
Tobacco Control ◽  
Smoking Prevention ◽  
The Family

scholarly journals Underutilisation of no-tobacco-sale orders against retailers that repeatedly sell to minors, 2015–2019, USA

2021 ◽  
pp. tobaccocontrol-2020-056379
Author(s):  
Natalie Hemmerich ◽  
Desmond Jenson ◽  
Brice L Bowrey ◽  
Joseph G L Lee
Keyword(s):  
Content Analysis ◽  
Tobacco Control ◽  
Drug Administration ◽  
Food And Drug Administration ◽  
Smoking Prevention ◽  
Quantitative Content Analysis ◽  
Tobacco Products ◽  
Quantitative Content ◽  
The Family ◽  
The Usa

ImportanceResearch demonstrates that policies aimed at retailers who sell to minors must be strongly enforced to have an impact on youth usage rates.ObjectivesIn the USA, the Food and Drug Administration (FDA) conducts compliance checks, issues fines, and can order retailers to stop selling tobacco products (ie, no-tobacco-sale orders (NTSOs)) to enforce the Family Smoking Prevention and Tobacco Control Act. We sought to assess FDA’s utilisation of NTSOs.MethodsWe conducted a quantitative content analysis of FDA’s enforcement actions for inspections decided between 1 October 2015 and 29 March 2019. From the 536 134 inspection records we identified 148 NTSOs and 249 720 unique retailer locations, of which 2095 had three or more violations. We randomly sampled NTSOs (n=76) and retail locations (n=152) with frequent violations. We calculated the proportion of NTSOs that could have been issued earlier by FDA. We then calculated the proportion of retailers that could have been issued an NTSO, and the proportion actually issued an NTSO using FDA’s approach and a more stringent approach.ResultsAmong NTSOs, 94.7% (95% CI: 89.8% to 97.4%) of NTSOs could have been issued earlier under a more stringent approach. On average, when an NTSO could have been issued earlier, it could have been issued 453 days earlier (95% CI: 418 to 489; range: 89–1159). Among frequently violating retail locations, 73.6% (95% CI: 66.0% to 80.0%) were eligible for an NTSO. Of those, 1.9% (95% CI: 0.5% to 7.0%) had received an NTSO.ConclusionsThe FDA’s failure to fully leverage its powers to address retailers’ underage sales of tobacco products has weakened efforts to curb the youth e-cigarette epidemic.

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