Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, PA, USA.
School of Medicine, University of Tasmania, Hobart, Australia.
Ann Behav Med. 2018 Jan 5;52(1):53-64. doi: 10.1007/s12160-017-9916-y.
Experimental research on pictorial warning labels for cigarettes has primarily examined immediate intentions to quit.
Here, we present the results of a clinical trial testing the impact on smoking during and after a 28-day period of naturalistic exposure to pictorial versus text-only warnings.
Daily cigarette smokers (N = 244) at two sites in the USA were randomly assigned to receive their regular brand of cigarettes for 4 weeks with one of three warnings: (a) text-only, (b) pictures and text as proposed by FDA, or (c) the warnings proposed by FDA with additional text that elaborated on the risks of smoking. Analyses examined the effects of pictorial versus text-only warnings and self-efficacy for quitting on cigarette consumption during and 1 month after the trial as mediated by emotional and cognitive responses as well as satisfaction with smoking.
Stronger emotional responses to pictorial than text-only warnings predicted reduced satisfaction with smoking during the trial and lower cigarette consumption at follow-up among the majority of smokers who continued to smoke. Consistent with the efficacy-desire model, those with moderate efficacy reported the greatest reduction in consumption at follow-up. However, a small proportion of smokers (7%) who reported 7-day abstinence at follow-up did not exhibit a significant relation with self-efficacy.
Pictorial warning labels proposed by FDA create unfavorable emotional reactions to smoking that predict reduced cigarette use compared to text alone, with even smokers low in self-efficacy exhibiting some reduction. Predictions that low self-efficacy smokers will respond unfavorably to warnings were not supported.
关于香烟图形警示标签的实验研究主要检验了即刻戒烟意图。
本研究报告了一项临床试验的结果，该试验测试了在自然暴露于图形与仅文字警示 28 天期间和之后对吸烟的影响。
美国两个地点的 244 名每日吸烟的参与者被随机分配在 4 周内使用三种警示标签中的一种来吸食他们常吸的香烟：（a）仅文字警示；（b）FDA 提议的图形与文字警示；（c）FDA 提议的警示加上阐述吸烟风险的额外文字。分析检验了图形与仅文字警示以及戒烟自我效能感对试验期间和试验结束后 1 个月的香烟消费的影响，其作用机制是情绪和认知反应以及对吸烟的满意度。
与仅文字警示相比，对图形警示的情绪反应越强，预示着试验期间对吸烟的满意度越低，并且在大多数继续吸烟的参与者中，随访时的香烟消费越低。与效能-愿望模型一致，那些中等效能感的参与者报告了随访时最大的消费降低。然而，一小部分（7%）报告在随访时有 7 天戒烟的参与者，其自我效能感与消费降低之间没有显著关系。
与仅文字警示相比，FDA 提议的图形警示标签会引起对吸烟的不利情绪反应，预示着香烟消费减少，即使是效能感低的吸烟者也表现出一些消费降低。对低效能感吸烟者会对警示做出不利反应的预测没有得到支持。
