Division of Health Behavior & Health Promotion, College of Public Health, Ohio State University, Columbus, OH.
Division of Biostatistics, College of Public Health, Ohio State University, Columbus, OH.
Nicotine Tob Res. 2019 Jun 21;21(7):974-978. doi: 10.1093/ntr/nty207.
Health numeracy helps individuals understand risk information, but limited data exist concerning numeracy's role in reactions to varying types of health warning labels (HWLs) for cigarettes.
A nationally representative online panel of adult current smokers received two exposures (1 week apart) to nine HWLs with either text-only or pictorial images with identical mandated text. Following the second exposure, participants (n = 594) rated their beliefs in smoking myths (eg, health-promoting behaviors can undo the risks of smoking) and how much the warnings made them want to quit smoking. Generalized estimating equation regression examined the relation of objective health numeracy and its interaction with HWL type to smoking-myth beliefs and quit-related reactions.
Health numeracy was not significantly associated with smoking-myth beliefs; the interaction with HWL type was also nonsignificant. Adult smokers with lower health numeracy had higher quit-related reactions than those with higher numeracy following exposure to HWLs. The type of HWL significantly modified numeracy's associations with quit-related reactions; no significant association existed between text-only HWLs and quit-related reactions, whereas among those who viewed the pictorial warnings, lower numeracy was associated with greater quit-related reactions (β = -.23; p < .001).
Lower as compared to higher health numeracy was significantly associated with higher quit-related reactions to HWLs and especially with pictorial HWLs. Health numeracy and HWL type were not associated with the endorsement of smoking myths. The role of health numeracy in effectively communicating risks to smokers warrants thoughtful consideration in the development of tobacco HWLs.
Health numeracy plays an important role in an individual's ability to understand and respond to health risks. Smokers with lower health numeracy had greater quit-related reactions to pictorial health warnings than those who viewed text-only warning labels. Development and testing of health warning labels should consider health numeracy to most effectively communicate risk to US smokers.
健康素养有助于个人理解风险信息，但有关健康素养在对不同类型的香烟健康警示标签（HWL）的反应中的作用的数据有限。
一个全国性的成年当前吸烟者在线代表性小组在相隔一周的时间内接受了九种 HWL 的两种暴露（暴露），这些 HWL 既有纯文本的，也有带有相同强制文本的图片。在第二次暴露后，参与者（n=594）对他们对吸烟神话的信念（例如，促进健康的行为可以消除吸烟的风险）以及这些警告使他们想要戒烟的程度进行了评估。广义估计方程回归分析了客观健康素养及其与 HWL 类型的相互作用与吸烟神话信念和戒烟相关反应的关系。
健康素养与吸烟神话信念没有显著相关；与 HWL 类型的相互作用也不显著。与健康素养较高的吸烟者相比，HWL 暴露后健康素养较低的吸烟者戒烟相关反应较高。HWL 的类型显著改变了健康素养与戒烟相关反应之间的关联；在仅文本 HWL 与戒烟相关反应之间不存在显著关联，而在查看图片警告的人群中，较低的健康素养与更大的戒烟相关反应相关（β=-.23；p<.001）。
与较高的健康素养相比，较低的健康素养与对 HWL 的戒烟相关反应以及特别是对图片 HWL 的戒烟相关反应显著相关。健康素养和 HWL 类型与吸烟神话的认可无关。健康素养在有效向吸烟者传达风险方面的作用值得在开发烟草 HWL 时进行深思熟虑的考虑。
健康素养在个人理解和应对健康风险的能力中起着重要作用。与仅查看文本警告标签的吸烟者相比，健康素养较低的吸烟者对图片健康警告的戒烟相关反应更大。健康警示标签的制定和测试应考虑健康素养，以便最有效地向美国吸烟者传达风险。
