Noar Seth M, Francis Diane B, Bridges Christy, Sontag Jennah M, Ribisl Kurt M, Brewer Noel T
School of Media and Journalism, University of North Carolina at Chapel Hill, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, USA.
School of Media and Journalism, University of North Carolina at Chapel Hill, USA.
Soc Sci Med. 2016 Sep;164:118-129. doi: 10.1016/j.socscimed.2016.06.011. Epub 2016 Jul 13.
Cigarette pack warnings are a tobacco control strategy used globally. To understand their impact, we systematically reviewed longitudinal observational studies examining national implementation of strengthened warnings.
We used comprehensive search procedures to identify observational studies examining the impact of strengthening cigarette pack warnings. We report longitudinal changes in knowledge, beliefs, attitudes, intentions, and behavior.
We identified 32 studies conducted in 20 countries with 812,363 participants. Studies commonly examined changes from text to pictorial warnings (64%); the remainder examined strengthened text or strengthened pictorial warnings. Knowledge increased in all 12 studies that assessed it. Studies of beliefs/attitudes and intentions showed mixed results. Quitline calls increased in four of six studies, while foregoing of cigarettes did not increase. Cigarette consumption decreased in three of eight studies; quit attempts increased in four of seven studies; and short-term cessation increased in two of three studies. Smoking prevalence decreased in six of nine studies.
Strengthening warnings was associated with longitudinal increases in knowledge, quitline calls and reductions in smoking behavior. Strengthening warning policies should be a priority for tobacco control globally.
香烟包装警示是全球采用的一种烟草控制策略。为了解其影响，我们系统回顾了考察强化警示在全国实施情况的纵向观察性研究。
我们采用全面的检索程序来识别考察强化香烟包装警示影响的观察性研究。我们报告了在知识、信念、态度、意图和行为方面的纵向变化。
我们识别出在20个国家开展的32项研究，涉及812363名参与者。研究通常考察从文字警示到图片警示的变化（64%）；其余研究考察的是强化文字警示或强化图片警示。在所有12项评估知识的研究中，知识均有所增加。关于信念/态度和意图的研究结果不一。在六项研究中的四项中，戒烟热线的呼叫量增加，而减少吸烟的情况并未增加。在八项研究中的三项中，香烟消费量下降；在七项研究中的四项中，戒烟尝试增加；在三项研究中的两项中，短期戒烟增加。在九项研究中的六项中，吸烟率下降。
强化警示与知识的纵向增加、戒烟热线呼叫量的增加以及吸烟行为的减少相关。强化警示政策应成为全球烟草控制的优先事项。
