Policy Evaluation of 2009 Tobacco Control Act - Graphic Warning Labels

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.

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Cigarette packet warning labels can prevent relapse: findings from the International Tobacco Control 4-Country policy evaluation cohort study

Tobacco Control ◽

10.1136/tobaccocontrol-2011-050254 ◽

2012 ◽

Vol 22 (e1) ◽

pp. e43-e50 ◽

Cited By ~ 37

Author(s):

Timea Reka Partos ◽

Ron Borland ◽

Hua-H Yong ◽

James Thrasher ◽

David Hammond

Keyword(s):

Cohort Study ◽

Tobacco Control ◽

Policy Evaluation ◽

Warning Labels

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Association between tax structure and cigarette consumption: findings from the International Tobacco Control Policy Evaluation (ITC) Project

Tobacco Control ◽

10.1136/tobaccocontrol-2017-054160 ◽

2018 ◽

Vol 28 (Suppl 1) ◽

pp. s31-s36 ◽

Cited By ~ 9

Author(s):

Ce Shang ◽

Hye Myung Lee ◽

Frank J Chaloupka ◽

Geoffrey T Fong ◽

Mary Thompson ◽

...

Keyword(s):

Tobacco Control ◽

Policy Evaluation ◽

Fixed Effects ◽

Tax Avoidance ◽

Control Policy ◽

Tobacco Consumption ◽

Cigarette Consumption ◽

Tobacco Control Policy ◽

Tax Structure ◽

Tax Structures

BackgroundRecent studies show that greater price variability and more opportunities for tax avoidance are associated with tax structures that depart from a specific uniform one. These findings indicate that tax structures other than a specific uniform one may lead to more cigarette consumption.ObjectiveThis paper aims to examine how cigarette tax structure is associated with cigarette consumption.MethodsWe used survey data taken from the International Tobacco Control Policy Evaluation Project in 17 countries to conduct the analysis. Self-reported cigarette consumption was aggregated to average measures for each surveyed country and wave. The effect of tax structures on cigarette consumption was estimated using generalised estimating equations after adjusting for sociodemographic characteristics, average taxes and year fixed effects.FindingsOur study provides important empirical evidence of a relationship between tax structure and cigarette consumption. We find that a change from a specific to an ad valorem structure is associated with a 6%–11% higher cigarette consumption. In addition, a change from uniform to tiered structure is associated with a 34%–65% higher cigarette consumption. The results are consistent with existing evidence and suggest that a uniform and specific tax structure is the most effective tax structure for reducing tobacco consumption.

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The case for stringent alcohol warning labels: Lessons from the tobacco control experience

Journal of Public Health Policy ◽

10.1057/jphp.2013.47 ◽

2013 ◽

Vol 35 (1) ◽

pp. 65-74 ◽

Cited By ~ 19

Author(s):

Mohammed Al-hamdani

Keyword(s):

Tobacco Control ◽

Warning Labels

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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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The estimated effect of graphic warning labels on smoker’s intention to quit in Shanghai, China: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-021-12257-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruiping Wang ◽

Yan Qiang ◽

Yan Zhu ◽

Xiangjin Gao ◽

Qiong Yang ◽

...

Keyword(s):

Smoking Cessation ◽

Logistic Regression ◽

Control Measures ◽

Intention To Quit ◽

Lower Percentage ◽

Warning Labels ◽

Cross Sectional ◽

Smoking Intensity ◽

Graphic Warning ◽

Cigarette Packs

Abstract Background Tobacco consumption is the leading cause of death worldwide. Overwhelming studies demonstrate graphic warning labels (GWLs) on cigarette packs are effective in eliciting negative response to tobacco smoking, modifying beliefs about tobacco dangers, and increasing reported intention to quit, but the estimated effect of GWLs on smoking cessation intention among smokers is still limited in China. In this study, we aim to understand the smoking intensity, smoking duration and smoking cessation intention among current smokers, and to explore how their smoking cessation intention would be influenced by the GWLs in Shanghai. Methods From January to June 2021, we totally recruited 1104 current smokers in Songjiang district and Fengxian district of Shanghai by multistage sampling design. We used Android pad assisted electronic questionnaire for data collection, and then implemented logistic regression for odds ratio (OR) and 95% confidence interval (CI) calculation to explore how smoking cessation intention would be influenced by the GWLs among current smokers. Results One thousand one hundred four current smokers included 914 males (82.79%), with an average age of 43.61 years. 58.06% of current smokers reported smoking cessation intention due to GWLs. Logistic regression indicated a higher percentage of smoking cessation intention due to GWLs was among female smokers [OR = 2.41, 95% CI (1.61–3.59)], smokers with smoking intensity < 20 cigarette/day [OR = 1.92, 95% CI (1.44–2.55)], smokers with tobacco burden < 20% [OR = 1.94, 95% CI (1.35–2.79)], and among smokers had plan to quit in a year [OR = 6.58, 95% CI (4.71–9.18). Smokers with higher individual monthly income had lower percentage of smoking cessation intention (OR were 0.35, 0.46 and 0.41). Meanwhile, among 642 current smokers without plan to quit in a year, approximately 40% of them reported smoking cessation intention due to GWLs. Conclusions Smoking cessation intention due to the assumed GWLs on cigarette packs is high among current smokers in Shanghai, especially in female smokers, smokers with light tobacco burden and mild nicotine dependence. Incorporating smoking intensity as well as smoking burden into the implementation of GWLs as tobacco control measures would discourage smoking in China.

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A percepção do cumprimento das leis antifumo em bares e restaurantes em três cidades brasileiras: dados do ITC-Brasil

Cadernos de Saúde Pública ◽

10.1590/0102-311x00140315 ◽

2017 ◽

Vol 33 (suppl 3) ◽

Cited By ~ 1

Author(s):

Felipe Lacerda Mendes ◽

André Salem Szklo ◽

Cristina de Abreu Perez ◽

Tânia Maria Cavalcante ◽

Geoffrey T. Fong

Keyword(s):

Tobacco Control ◽

Policy Evaluation ◽

Rio De Janeiro ◽

Control Policy ◽

Rio Grande ◽

Sao Paulo ◽

Tobacco Control Policy ◽

Rio Grande Do Sul ◽

Porto Alegre ◽

Evaluation Project

Resumo: O tabagismo passivo causa sérios e mortais efeitos à saúde. Desde 1996, o Brasil vem avançando na implementação da legislação antifumo em locais públicos fechados. Este artigo busca avaliar a percepção do cumprimento da legislação antifumo nas cidades de Porto Alegre (Rio Grande do Sul), Rio de Janeiro e São Paulo, com base nos resultados da pesquisa ITC-Brasil (International Tobacco Control Policy Evaluation Project). Os resultados desta pesquisa mostraram uma redução significativa da proporção de pessoas que notaram indivíduos fumando em restaurantes e bares entre 2009 e 2013 nas três cidades pesquisadas. Paralelamente, houve um aumento da proporção de fumantes que referiram ter fumado na área externa desses estabelecimentos. Tais resultados provavelmente refletem uma implementação exitosa das leis antifumo. Vale ressaltar que ao diminuir a exposição ao fumo passivo, aumentamos ainda mais a desnormalização do tabagismo na população em geral, podendo assim diminuir sua iniciação e aumentar a cessação de fumar.

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Heated debates on regulations of heated tobacco products in South Korea: the news valence, source and framing of relative risk/benefit

Tobacco Control ◽

10.1136/tobaccocontrol-2020-056131 ◽

2021 ◽

pp. tobaccocontrol-2020-056131

Author(s):

Jungmi Jun ◽

Sei-Hill Kim ◽

James Thrasher ◽

Yoo Jin Cho ◽

Yu-Jin Heo

Keyword(s):

South Korea ◽

Tobacco Control ◽

Tobacco Industry ◽

Warning Labels ◽

Tobacco Products ◽

News Stories ◽

Time Period ◽

Significant Difference ◽

Tv News ◽

The Government

BackgroundWe analyse news representations of the regulation of heated tobacco products (HTPs) in South Korea, the country where HTP use is among the highest in the world despite conflicts between the government and the HTP manufacturers.MethodsWe analysed a total of 571 print and TV news covering HTP regulations, published between 2017 and 2018, the time period when HTPs were introduced to the country and various regulations of HTPs were proposed and implemented. We assessed the prevalence and associations among specific types of HTP regulations that were discussed, valence towards regulation, sources, framing of the relative health risks/benefits of HTPs compared with conventional cigarettes.ResultsTaxation (55.2%) and warning labels (25.7%) were two regulation topics covered the most. Almost equal proportions of pro-regulation (2.5%) and anti-regulation valence (2.2%) were found in taxation-related news, while pro-regulation valence appeared more frequently for other restrictions, including warning labels (pro=9.5% vs anti=1.4%), marketing restrictions (pro=6.9% vs anti=0%) and integration of HTPs into smoke-free policies for cigarettes (pro=8.7% vs anti=0%). The government (59%), followed by the tobacco industry (39.4%), was the source cited most often across news stories while the presence of tobacco control advocates was low (4.9%). As for framing, there was no significant difference in the prevalence of stories mentioning reduced harm (31.7%) and equal or more harm (33.6%) of HTPs compared with cigarettes.ConclusionsWe provide implications for governments and tobacco control advocates on building consensus for applying cigarette equivalent taxes and pictorial warning labels to HTPs.

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ENDS - a growing threat: results from Russian tobacco control policy evaluation survey EPOCHA-RF

European Journal of Public Health ◽

10.1093/eurpub/ckz186.623 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

M H Gambaryan ◽

A M Kalinina ◽

M V Popovich ◽

M L Starovoytov ◽

O M Drapkina ◽

...

Keyword(s):

Tobacco Control ◽

Policy Evaluation ◽

Adult Population ◽

Control Policy ◽

Russian Population ◽

Tobacco Control Policy ◽

Tobacco Products ◽

Former Smokers ◽

Never Smokers ◽

Evaluation Survey

Abstract Background Electronic nicotine delivery systems (ENDS) including heated tobacco products not yet legally regulated are more and more imposed over the Russian population. Still very little is known about these products. Aim To assess the exposure of Russian population to advertisement, promotion, of ENDS, and its attitudes and beliefs regarding these products. Methods Data from Russian tobacco control policy evaluation survey (2017-2018) are analysed which used a systematic stratified multistage random sampling based on territorial household principle, representing the adult population (18+) of Russia in 10 Federal subjects. 20380 randomly selected respondents were interviewed and a stratified sample (n = 11625) of smokers (n = 6569), former smokers (n = 2377) and never smokers (n = 2679) participated in the survey. Results In past 6 months 15.7% of the respondents were exposed to promotion of ENDS via internet, 14%-via social networks and 13.4% at the points of sale. Remarkably the youngest age group (18-24) was significantly more exposed to advertisement and promotion of ENDS from all sources than the rest of age groups: 32.6%, 32.3% and 24.3% respectively (p<.0001). 48% of respondents believe that secondhand vape of e-cigarettes is harmful for health of people, with significant differences among current smokers (40%), recent quitters (53%), former smokers (60%) and never smokers (66%). Majority agreed that it is necessary to regulate allowed amounts of nicotine in e-liquids (54%), to ban vaping in public places where tobacco smoking is banned (59.2%), ban the sales of these products to minors (68%), and the use of e-cigarettes by those (71.2%). 61.5% support the need for ban of all forms of advertisement, marketing and promotion of ENDS. Conclusions ENDS present a real threat for Russian tobacco control policy achievements. The findings will be used to support new strong legislation to regulate ENDS in Russia. Key messages Young people much more than the others are targeted with advertisement and promotion of ENDS. ENDS present a real threat for Russian tobacco control policy and should be legally regulated like any tobacco products.

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