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?

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.

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

European Journal of Public Health ◽

10.1093/eurpub/ckaa039 ◽

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.

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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

10.21203/rs.3.rs-252879/v1 ◽

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

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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

10.21203/rs.3.rs-252879/v2 ◽

2021 ◽

Author(s):

Mercedes Mora-Plazas ◽

Isabella Higgins ◽

Luis Fernando Gomez ◽

Marissa G. Hall ◽

Maria Fernanda Parra ◽

...

Keyword(s):

Controlled Trial ◽

Saturated Fat ◽

Future Research ◽

Processed Food ◽

Warning Label ◽

Warning Labels ◽

Added Sugar ◽

Food Purchases ◽

Fruit Drink ◽

The Impact

Abstract ObjectiveThis study assessed the impact of nutrient warning labels on product selection and ability to correctly identify less healthy products, among other outcomes, in Colombia. MethodsWe conducted an online randomized experiment among 8,061 Colombians in October 2020. Participants were assigned to a condition: nutrient warning, guideline daily amounts (GDA), Nutri-Score, or no-label. First, participants viewed two fruit drinks labeled according to their assigned condition, one with added sugar and one without, and indicated which they would prefer to buy and which was higher in sugar. Next, they viewed four food products with their assigned condition and answered questions. Finally, they selected which label type would most discourage them from consuming a specified ultra-processed food. ResultsFewer participants in the nutrient warning condition (20%) preferred to buy the added sugar fruit drink 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 who saw the nutrient warning (88%) correctly identified the fruit drink higher in sugar compared to those who saw no-label (68%) or Nutri-Score (65%) (both, p<.001). 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. ConclusionsNutrient warning labels are a promising policy strategy to prevent obesity and diet-related non-communicable diseases in Colombia. Future research should assess nutrient warning labels’ impact on actual food purchases in Colombia. Trial Registration: NCT04567004

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Pictorial health warnings on cigarette packs and the impact on women

Revista de Saúde Pública ◽

10.1590/s0034-89102013000901123 ◽

2013 ◽

Vol 47 (6) ◽

pp. 1123-1129 ◽

Cited By ~ 6

Author(s):

Lorna Bittencourt ◽

Sharina D Person ◽

Regina Celina Cruz ◽

Isabel C Scarinci

Keyword(s):

Health Warnings ◽

The Impact ◽

Cigarette Packs

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The emigration of adult children and smoking behaviors of parents

China Agricultural Economic Review ◽

10.1108/caer-07-2018-0157 ◽

2019 ◽

Vol 11 (2) ◽

pp. 317-335 ◽

Cited By ~ 1

Author(s):

Tianyuan Luo ◽

Cesar Escalante

Keyword(s):

Urban Areas ◽

Fixed Effects ◽

Smoking Habit ◽

Smoking Behavior ◽

Fixed Effects Model ◽

Nutrition Survey ◽

Content Type ◽

Left Behind ◽

The Impact ◽

Rural Parents

Purpose The purpose of this paper is to examine the impact of adult children’s migration on the smoking behavior of rural parents who are left behind and raise the concern that the rural residents’ increasing tendency to migrate to urban areas in China nowadays could encourage such a behavior. Design/methodology/approach Using data from the China Health and Nutrition Survey and applying propensity score matching method and individual-level fixed effects model, this paper addresses the potential endogeneity issues that may arise between the children’s migration decisions and parental smoking behavior. Findings This study’s results indicate that rural parents left behind by their emigrant children indeed are more likely to sustain their smoking habit. The validated smoking effect of emigration calls for effective government programs that entail intervention to curb such potentially aggravating health risk, especially among middle-aged and older fathers. Originality/value This paper is the first to examine the impact of children’s migration on the smoking behavior of left-behind parents in rural households in China. Our findings call for immediate attention to the smoking behavior of older age cohort in China as the scale of rural−urban migration trend is expected to increase. Moreover, given that many countries in Asia, such as India, Vietnam and Indonesia, are confronting similar issues, our findings could provide useful implications for smoking cessation and control policies in those countries.

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Analysis of the Impact of Graphical Warning Label on Smokers

Malaysian Journal of Medical and Biological Research ◽

10.18034/mjmbr.v6i1.464 ◽

2019 ◽

Vol 6 (1) ◽

pp. 19-26

Author(s):

Muhammad Ismail ◽

Fauzia Majeed ◽

Rao Muhammad Ismail ◽

Muhammad Tayyab Ghafoor

Keyword(s):

Data Collection ◽

Smoking Habit ◽

Secondary Data ◽

Sampling Technique ◽

Annual Reports ◽

Primary Data ◽

Warning Label ◽

Pocket Money ◽

Health Agencies ◽

The Impact

Objective: The Fundamental objective this paper to explore the impacts of warning label on the smokers. Whether smokers are discouraging from this warning label or not? This research was started in September 2016 and done in January 2017. (Five months). Methodology: Both primary & secondary data was used for data collection. Secondary data was taken from the research articles, periodicals, hospital’s annual reports and health magazines. For primary data collection, a testified five point Likert scale questionnaire was used. We’ve distributed 1800 questionnaires in nine (9) cities, 200 in each city. By using stratified random sampling technique. Finally received (n=1726) that were properly filled by all aspects. Our population was Punjab province and sample was nine cities including Federal Capital of Islamic Republic of Pakistan: Islamabad, Lahore, Okara, Sahiwal, Faisalabad, Jhang, Layyah, Bahawalpur & Multan. After that data was analyzed on Statistical Package for Social Sciences (SPSS 21.0). Cronbach’s alpha (ἀ) of our research study was 0.862. It shows the well-organized reliability of our data. Results: Correlation ‘flank-by’ D.V (Intention to quit), IV (warning label) and M.V (demographic factors) shows that, “yes there is an association among them”. Regression Analysis retrospect that they have a week but positive relationship. Durbin Watson’s explorations were also showing same frequencies. Findings: We’ve found that well educated & privileged respondents have less smoking habit than un-educated & underprivileged persons. Male & female students are also indulged in the curse of smoking, without caring of their pocket money. Teen aged & educated smokers, notices the warning label intensely as compared to others, but ignored. So Govt. & health agencies should acquaint the novel way that discourage the smokers in real sense.

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The “Belgian Tetris”

Metaphor and the Social World ◽

10.1075/msw.5.2.03per ◽

2015 ◽

Vol 5 (2) ◽

pp. 223-244 ◽

Cited By ~ 4

Author(s):

Julien Perrez ◽

Min Reuchamps

Keyword(s):

Text And Image ◽

Experimental Conditions ◽

Political Processes ◽

Content Analyses ◽

Perceived Reality ◽

Description Task ◽

The Impact

As metaphors not only reflect perceived reality, but can also function as cues through which citizens come to understand complex political processes, the aim of this study is to look at how specific metaphors might impact on the citizens’ framing of Belgian federalism. To measure the impact of metaphors on political representations, we conducted an experiment among 493 citizens based on an article published in the newspaper “Le Soir”, in which Belgian federalism was compared to a Tetris game in both a text and an image. The participants were distributed across four experimental conditions according to the type of input they had been exposed to (text and image, text only, image only, no input) and were asked to perform a free description task. The productions of the participants were analyzed using keyword and content analyses. The results suggest that the participants who had been exposed to the experimental text tended to frame their perception of Belgian federalism in different ways. They also show that reading the text had more of an impact on the representations than looking at the image, but that this impact was in both cases short-lived.

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The Role of Health Consciousness in Predicting Attention to Health Warning Messages

American Journal of Health Promotion ◽

10.4278/0890-1171-11.3.186 ◽

1997 ◽

Vol 11 (3) ◽

pp. 186-193 ◽

Cited By ~ 27

Author(s):

Lee A. Kaskutas ◽

Thomas K. Greenfield

Keyword(s):

Alcohol Consumption ◽

Health Messages ◽

Alcoholic Beverages ◽

Future Research ◽

Warning Label ◽

Warning Labels ◽

Health Warnings ◽

Internal Reliability ◽

Health Consciousness ◽

Younger Age

Purpose. Guided by information processing theory and the health belief model, this paper considers the relationship between health consciousness among the general population and attention to environmental health warnings about alcohol consumption. Mechanisms of exposure to three dominant types of impersonal alcohol-related health messages in the environment are explored. Design. Cross-sectional survey using telephone interview data. Subjects. A representative nationwide sample of adults was interviewed in 1993 ( n = 1026), with a response rate of 63%. Measures. Key variables include exposure to warning labels on alcoholic beverages, to point-of-sale posters, and to advertisements in the media, as well as respondents' alcohol consumption, health problems (indicative of salience of health warnings), and level of health consciousness assessed by items tapping concern with nutrition and seeking information on health topics. Results. In the total sample, over a third had seen a warning label or poster and almost all had seen an advertisement about the risks associated with alcohol consumption in 1993. Survey respondents scored very high on five individual items that make up the health consciousness scale introduced here, with 69% endorsing all items. The scale demonstrated good internal reliability (alpha = .70) and was significantly correlated ( p <. 01) with not enjoying getting drunk and with usually reading product warning labels, suggesting construct validity. Yet the hypothesized strong relationships between health consciousness and attention to health warnings about drinking were not observed; nor was salience of messages a predictor of recall. Importantly, high proportions of underage drinkers and young adults at elevated risk for drinking problems are reached by container warning label messages. Mechanisms of exposure recall vary based on message source, with “container label recall” associated with heavier drinking, younger age, and purchasing patterns; “poster recall” associated with purchasing and health consciousness; and “advertisement recall” associated with heavy consumption and younger age. Conclusions. These results are contrary to predictions from skeptics of broad-based informational interventions, who argue that only the already-health conscious are attentive to health warnings about the risks of alcohol consumption. These data suggest that the label is reaching intended target audiences, especially younger people, males, and heavier alcohol consumers. Future research in predicting attention to impersonal health warnings in the environment should continue to improve the assessment of constructs such as salience and health consciousness, and should further test the applicability of available theoretical models. Subsequent research should also consider additional measures to lap mechanisms of exposure to impersonal health messages to enable a better understanding of the population that is not being reached by such public health interventions.

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Eksplorasi peringatan kesehatan bergambar pada kemasan rokok

Berita Kedokteran Masyarakat ◽

10.22146/bkm.11617 ◽

2018 ◽

Vol 32 (7) ◽

pp. 223

Author(s):

Fahmi Baiquni ◽

Fatwa Sari Tetra Dewi ◽

Rendra Widyatama

Keyword(s):

Qualitative Study ◽

Population Based ◽

Message Content ◽

Health Warnings ◽

Pictorial Warnings ◽

The Impact ◽

Cigarette Packs

Exploration of pictorial health warnings in cigarette packagesPurposeThis study conducted to examine effectiveness of pictorial health warnings in cigarette packages to reduce smoking intention.MethodA population-based, qualitative study, were used in this study. 20 partisipants were observed and indept-interviewed. ResultsThreats after seeing a picture warnings on cigarette packs is the perception of the dangers of images and feelings of fear, disgust, pity, worry, mediocre. Efficacy after seeing a picture warnings on cigarette packs is the belief of the image and the impact on individuals after viewing images.ConclusionThreat of pictorial warnings are not only affected by the warning image itself but also the experience of the viewer and aspects of the warning image such as color, clarity of image, and message content.

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