Reclaiming the value of pictorial health warning labels in Jordan

BackgroundIn Jordan, four non-graphic pictorial health warning labels (PHWLs) concerning a limited selection of tobacco-caused harms have been used since 2011; however, research suggests that they may be ineffective.ObjectivesTo explore Jordanian smokers’ reactions to novel PHWLs featuring various health themes and/or graphic and symbolic imagery and to discuss existing PHWLs in light of the novel PHWLs.MethodsWe conducted 14 focus groups (FGs) with smokers who assessed 12 novel PHWLs and commented on four existing PHWLs. Data were analysed using an inductive approach.ResultsSix themes emerged from the FG discussions: understanding the overall meaning of PHWLs, the impact of graphic images, magnitude and controllability of harm, personal or vicarious experiences, the futility of quitting and fatalism. PHWLs depicting graphic respiratory and oral tobacco-caused harms resonated with most smokers. Smokers also sought direct, harm-specific taglines when trying to understand the overall PHWL. Some smokers viewed the PHWLs as exaggerated, and while the majority acknowledged that smoking was harmful, they felt that PHWLs would not accomplish their goal of inducing quitting.ConclusionsOur findings support the use of graphic imagery to communicate tobacco-caused harms (particularly respiratory ones) and the use of specific taglines explaining the mechanism of harm depicted.

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Health Warning Labels for Smokeless Tobacco: The Impact of Graphic Images on Attention, Recall, and Craving

Nicotine & Tobacco Research ◽

10.1093/ntr/ntx021 ◽

2017 ◽

Vol 19 (10) ◽

pp. 1172-1177 ◽

Cited By ~ 11

Author(s):

Elizabeth G Klein ◽

Amanda J Quisenberry ◽

Abigail B Shoben ◽

Sarah Cooper ◽

Amy K Ferketich ◽

...

Keyword(s):

Smokeless Tobacco ◽

Warning Labels ◽

Health Warning ◽

Graphic Images ◽

The Impact

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Impact of Image-and-text and Text-only Health Warning Labels on Selection and Consumption of Food and Alcohol Products: Systematic Review with Meta-analysis

10.31234/osf.io/jt52m ◽

2019 ◽

Cited By ~ 3

Author(s):

Natasha Clarke ◽

Emily Pechey ◽

Daina Kosīte ◽

Laura M König ◽

Eleni Mantzari ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Experimental Studies ◽

Control Group ◽

Warning Labels ◽

Health Warning ◽

Alcoholic Drinks ◽

Randomised Controlled ◽

The Impact ◽

Selection Of

Reducing harmful consumption of food (including non-alcoholic drinks) and alcoholic drinks would prevent much disease. Evidence from tobacco control shows that placing health warning labels (HWLs) on these products reduces their selection and consumption. A systematic review with meta-analysis was conducted using Cochrane methods to assess the impact on selection (including hypothetical selection) or consumption of food or alcoholic drinks with image-and-text (sometimes termed ‘pictorial’) and text-only HWLs placed on these products. Studies were required to be randomised or quasi-randomised controlled trials. Fourteen studies were included, three on alcohol, eleven on food. For our primary outcomes, eleven studies measured selection and one measured consumption (two measured only other secondary outcomes). Meta-analysis of twelve comparisons from nine studies (n=12,635) found HWLs reduced selection of the targeted product compared to a control group with no HWL (RR=0.74 (95% CI 0.68 to 0.80)), with participants 26% less likely to choose a product displaying a HWL. A planned subgroup analysis suggested a larger effect on selection of image-and-text HWLs (RR=0.65 (95% CI 0.54 to 0.80)) than text-only HWLs (RR=0.79 (95% CI 0.74 to 0.85)), but this difference was not statistically significant. These findings suggest significant potential for HWLs to reduce selection of food and alcohol, but all experimental studies to date were conducted in laboratory or online settings with outcomes assessed immediately after a single exposure. Studies in field and more naturalistic laboratory settings are urgently needed to estimate the potential effects of HWLs on food and alcohol.

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Impact of health warning labels on snack selection: an online experimental study

10.31234/osf.io/zyca2 ◽

2019 ◽

Author(s):

Natasha Clarke ◽

Emily Pechey ◽

Eleni Mantzari ◽

Anna Katherine Mary Blackwell ◽

Katie De-loyde ◽

...

Keyword(s):

Open Science ◽

Warning Labels ◽

Health Warning ◽

Online Setting ◽

Science Framework ◽

The Impact ◽

Energy Dense Food ◽

Selection Of ◽

Data Analysis Plan

BackgroundExcessive consumption of energy-dense food increases the risk of obesity, which in turn increases the risk of non-communicable diseases, including heart disease, type 2 diabetes and most non-smoking-related cancers. Health warning labels (HWLs) that communicate the adverse health consequences of excess energy consumption could reduce intake of energy-dense foods. The aim of the current study was to estimate the impact on selection of energy-dense snacks of (a) image-and-text HWLs (b) text-only HWLs and (c) calorie information. Methods A between-subjects, 3 (HWL: image-and-text, text-only, no label) x 2 (calorie information: present, absent), factorial experimental design. Participants (N=4,134) were randomised to view a selection of energy-dense and non-energy-dense snacks with one of five label types or no label. The primary outcome was the proportion of participants selecting an energy-dense snack in a hypothetical vending machine task.ResultsThe proportion of participants selecting an energy-dense snack was reduced in all label groups, relative to the no label group (image-and-text HWL: 37%; image-and-text HWL with calories: 38%; text-only HWL: 48%; text-only HWL with calories: 44%; calories only: 54%; no label: 59%). Participants were least likely to select an energy-dense snack in the image-and-text HWL group and most likely in the no label group (OR = 0.46, 95%CI = 0.40, 0.54, p < 0.001).Conclusions Health warning labels – particularly those including an image and text - have the potential to reduce selection of energy-dense snacks in an online setting. Their impact on selection and consumption in real-world settings awaits testing.Trial registration: The study protocol (https://osf.io/6n7h9, registered: April 1st 2019) and data analysis plan (https://osf.io/zvrs5) were pre-registered on the Open Science Framework. KeywordsHealth warning labels, pictorial labels, graphic warnings, snacks, food, choice architecture, energy-dense

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Health warning labels and alcohol selection: an experiment in a naturalistic shopping laboratory

10.31234/osf.io/kr578 ◽

2020 ◽

Cited By ~ 1

Author(s):

Natasha Clarke ◽

Anna Katherine Mary Blackwell ◽

Katie De-loyde ◽

Emily Pechey ◽

Alice Hobson ◽

...

Keyword(s):

Bayes Factor ◽

Emotional Arousal ◽

Warning Labels ◽

Health Consequences ◽

Excessive Alcohol Consumption ◽

Health Warning ◽

Adverse Health ◽

Alcoholic Drinks ◽

Excessive Alcohol ◽

The Impact

Background and aims Health warning labels (HWLs) on tobacco products reduce smoking. There is an absence of evidence concerning the impact of alcohol HWLs on selection or purchasing in naturalistic settings. Using a commercial-standard naturalistic shopping laboratory, this study aimed to estimate the impact on selection of alcoholic drinks of HWLs describing adverse health consequences of excessive alcohol consumption.DesignA between-subjects randomised experiment with three groups: Group 1: image-and-text HWL; Group 2: text-only HWL; Group 3: no HWL.SettingA commercial-standard naturalistic shopping laboratory. Participants Adults (n=399) over the age of 18, who purchased beer or wine weekly to drink at home. InterventionsParticipants were randomised to one of three groups varying in the HWL displayed on the packaging of the alcoholic drinks: i. image-and-text HWL; ii. text-only HWL; iii. no HWL. Participants completed a shopping task, selecting items from a range of alcoholic and non-alcoholic drinks, and snacks. MeasurementThe primary outcome was the proportion of alcoholic drinks selected. Secondary outcomes included HWL ratings on negative emotional arousal and label acceptability.FindingsThere was no clear evidence of a difference in the HWL groups for the percentage of drinks selected that were alcoholic compared to no HWL (44%): image-and-text HWL: 46% (OR=1.08, 95%CI=0.82,1.42); text-only HWL: 41% (OR=0.87, 95%CI=0.67,1.14). Concordant with there being no difference between groups, there was extreme evidence in favour of the null hypothesis (Bayes factor [BF] < 0.01). Negative emotional arousal was higher (p< 0.001) and acceptability lower (p< 0.001) in the image-and-text HWL group, compared to the text-only HWL group. ConclusionsIn a naturalistic shopping laboratory, health warning labels describing the adverse health consequences of excessive alcohol consumption did not change selection behaviour.

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Alcohol pictorial health warning labels: the impact of self-affirmation and health warning severity

BMC Public Health ◽

10.1186/s12889-018-6243-6 ◽

2018 ◽

Vol 18 (1) ◽

Cited By ~ 6

Author(s):

Carlos Sillero-Rejon ◽

Angela S. Attwood ◽

Anna K. M. Blackwell ◽

José-Angel Ibáñez-Zapata ◽

Marcus R. Munafò ◽

...

Keyword(s):

Warning Labels ◽

Health Warning ◽

The Impact

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Understanding the impact of COVID-19 on the colorectal cancer community: Barriers and opportunities for care.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.3_suppl.29 ◽

2021 ◽

Vol 39 (3_suppl) ◽

pp. 29-29

Author(s):

Reese Garcia ◽

Andrea Dwyer ◽

Molly McDonnell

Keyword(s):

Colorectal Cancer ◽

Focus Groups ◽

Access To Care ◽

Cancer Patients ◽

Low Income ◽

Primary Concern ◽

The Novel ◽

Care Providers ◽

Novel Coronavirus ◽

The Impact

29 Background: The novel coronavirus (COVID-19) has caused numerous disruptions across the cancer prevention and treatment landscape. Conservative modeling studies examining the effect of COVID-19 on cancer screening and treatment for breast and colorectal cancer (CRC) suggest that there will be 10,000 excess deaths from both cancers combined over the next decade. The goal of this analysis was to better understand the impact of COVID-19 on the CRC community, including gaps and opportunities for improving access to care and survivorship needs, and to advocate for the best possible care through policy, education and engagement of the entire cancer ecosystem. Methods: In April 2020, Fight Colorectal Cancer (Fight CRC) distributed an online survey to the colorectal cancer community. The survey was distributed through social media channels and targeted emails from April 24-May 5, 2020. Virtual focus groups were also conducted to gather rich qualitative data from cancer patients and caregivers about their experiences during the novel coronavirus pandemic. Results: In total, 222 individuals responded to the survey (survivors = 68%, caregiver = 12%, first degree family member = 8%, other = 8%), and 10 CRC survivors participated in focus groups (stage III = 30%, stage IV = 70%). Treatment disruptions and mental health were prevalent themes in both the survey and focus group. Over one-third of survey respondents indicated facing treatment disruptions (37%) and a majority (78%) of colorectal cancer patients reported feeling nervous and anxious. Another primary concern among respondents was access to care. Patients on Medicare were more likely than patients on private insurance to report having difficulties affording food and basic supplies. People living in rural areas were more likely to have greater concerns about maintaining a supportive network than those living in suburban areas. Conclusions: People with cancer face unique challenges as a result of the novel coronavirus, including treatment disruptions, increased feelings of anxiety, and financial concerns. Numerous health inequities also exist among low-income and rural patient groups. Identifying the barriers that patients face provides an opportunity to address the nuanced needs of the colorectal cancer community. Clinicians, supportive care providers, and advocacy organizations can tailor care delivery, increase access to care, and prepare patients for the future with reliable and accurate resources amidst a pandemic.

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The impact of the 2009/2010 enhancement of cigarette health warning labels in Uruguay: longitudinal findings from the International Tobacco Control (ITC) Uruguay Survey

Tobacco Control ◽

10.1136/tobaccocontrol-2014-051742 ◽

2014 ◽

pp. tobaccocontrol-2014-051742 ◽

Cited By ~ 7

Author(s):

Shannon Gravely ◽

Geoffrey T Fong ◽

Pete Driezen ◽

Mary McNally ◽

James F Thrasher ◽

...

Keyword(s):

Tobacco Control ◽

Warning Labels ◽

Health Warning ◽

The Impact

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Jerzy Giedroyc and Marian Pankowski’s Letters about the Novel Matuga: A Note on Pankowski’s Relationship with the Paris Kultura Magazine

Ruch Literacki ◽

10.1515/ruch-2017-0026 ◽

2017 ◽

Vol 58 (2) ◽

pp. 199-216

Author(s):

Jan Burnatowski

Keyword(s):

The Novel ◽

Literary Canon ◽

National Library ◽

Political Factors ◽

European Culture ◽

Political Views ◽

Post War ◽

Polish Culture ◽

The Impact ◽

Selection Of

Summary The aim of this article, an appendix to a selection of letters between Jerzy Giedroyc and Marian Pankowski, is to verify some of the myths accompanying the biography of the latter. Having researched the relevant materials in the archives of the Instytut Literacki in Paris and in the National Library in Warsaw the author of the article came to the conclusion that the reasons of Pankowski’s break with Kultura, the leading émigré political and cultural magazine, at the end of the 1950s had to with his art rather than his political views. This research project, in conjunction with the already published correspondence of Jerzy Giedroyc with the notable representatives of the post-war emigration, has brought to light hitherto little known documents that reveal the impact of non-political factors on the creation of the Polish modern literary canon. The material collected in the course of this study offers fresh insights into 20th-century Polish culture and can also be of use for further research into the influence of European culture on Polish writers.

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