Does the effect go up in smoke? A randomized controlled trial of pictorial warnings on cigarette packaging

作者：Schneider Sven^*; Gadinger Michael; Fischer Andreas

来源：Patient Education and Counseling, 2012, 86(1): 77-83.

DOI：10.1016/j.pec.2011.03.005

• Smoking
• Tobacco
• Written warning
• Pictorial warning
• Motivation
• Cigarette packaging

Objective: Placing a combination of a written warning and a graphic image on cigarette packaging (so called %26quot;pictorial warnings%26quot;) is one of the WHO Framework Convention on Tobacco Control%26apos;s most controversial recommendations. Our randomized controlled trial investigated if pictorial warnings lead to significantly higher motivation to quit, as compared to written warnings alone. %26lt;br%26gt;Methods: Four pictorial warnings were selected from the EU Commission%26apos;s official image catalogue. Study arm 1 (44 adult smokers) viewed only the written warnings while study arm 2 (44 adult smokers) viewed the corresponding pictorial warnings. Self-affirmation was a second randomly manipulated factor, and nicotine dependence a quasi-experimental third factor. The main outcome measured was the motivation to quit, with fear intensity as one of the secondary outcomes. %26lt;br%26gt;Results: Pictorial warnings were associated with a significantly higher motivation to quit. A pictorial warning was also associated with higher fear intensity. The effect of warnings appears to be independent of nicotine dependence and self-affirmation. %26lt;br%26gt;Conclusions: Nationwide implementation of pictorial warnings may be effective in increasing heavy smokers%26apos; motivation to quit. %26lt;br%26gt;Practice implication: Due to the fact that perceived vulnerability, response and self-efficacy are not more strongly affected by pictorial warnings this effect may turn out to be short-term.

• 出版日期2012-1