Osman Amira, Thrasher James F, Yong Hua-Hie, Arillo-Santillán Edna, Hammond David
Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 450 West Dr, Chapel Hill, NC 27599, USA.
Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly St, Columbia, SC 29208, USA.
Health Educ Res. 2017 Dec 1;32(6):524-536. doi: 10.1093/her/cyx065.
Health warning labels (HWLs) on cigarette packs that use strong fear appeals may evoke defensive responses including acts of disparaging the warnings. Whether warning disparagement undermines HWL effectiveness remains unclear. We assessed correlates of one type of HWL disparagement and its association with subsequent cessation attempts. Longitudinal data (2012-14) on adult smokers from Australia, Canada, Mexico and the United States (US) were analyzed. HWL disparagement was assessed as the frequency of making fun of HWLs in the past month. Using Generalized Estimating Equation models we estimated correlates of HWL disparagement and whether HWL disparagement predicted subsequent cessation attempts. In each country, across all waves, 24-31% of smokers reported making fun of the warnings at least once in the past month. More frequent disparagement was found among males, younger participants, those with higher education and greater addiction, and those who recently attempted to quit. Attention to, avoidance of and talking to others about HWLs were all positively associated with HWL disparagement. In all countries, except the US, this type of HWL disparagement was an independent predictor of subsequent cessation attempts. HWL disparagement among smokers may indicate greater warning relevance and processing and does not result in counterproductive effects on cessation efforts.
香烟包装上使用强烈恐惧诉求的健康警示标签（HWLs）可能会引发防御反应，包括诋毁这些警示的行为。警示诋毁是否会削弱HWL的有效性尚不清楚。我们评估了一种HWL诋毁类型的相关因素及其与随后戒烟尝试的关联。对来自澳大利亚、加拿大、墨西哥和美国（美国）的成年吸烟者的纵向数据（2012 - 14年）进行了分析。HWL诋毁被评估为过去一个月内取笑HWL的频率。使用广义估计方程模型，我们估计了HWL诋毁的相关因素以及HWL诋毁是否预测了随后的戒烟尝试。在每个国家，在所有调查波次中，24 - 31%的吸烟者报告在过去一个月至少有一次取笑这些警示。在男性、年轻参与者、受教育程度较高和成瘾程度较高的人群以及最近试图戒烟的人群中，发现诋毁更为频繁。关注、回避HWL以及与他人谈论HWL都与HWL诋毁呈正相关。在除美国以外的所有国家，这种类型的HWL诋毁是随后戒烟尝试的独立预测因素。吸烟者中的HWL诋毁可能表明警示的相关性和关注度更高，并且不会对戒烟努力产生适得其反的影响。
