College of Medicine and Dentistry, James Cook University, Building 047, Pharmacy, 1 James Cook Drive, Townsville, QLD, 4810, Australia.
Syst Rev. 2019 Jan 17;8(1):25. doi: 10.1186/s13643-018-0933-0.
Graphic health warnings on tobacco packaging and the plain packaging of tobacco products are key tobacco control interventions. This systematic review investigates the perceptions of adolescents towards these packaging interventions.
Published, original-research, English-language articles from 1 January 2000 to 1 September 2017 were identified through a systematic literature search of the PubMed, CINAHL, PsycINFO, Web of Science, and Scopus databases. Articles describing investigations into the perceptions of adolescents aged 11 to 19 years towards graphic health warnings and/or plain-packaged cigarettes were included in this review.
Nineteen articles, involving 15,935 adolescent participants, of which 72.85% were non-smokers or ex-smokers and 27.15% occasional or daily smokers, met the eligibility criteria. Graphic health warnings were perceived as more effective than text-only warnings, with warnings depicting lung cancer, and oral diseases being perceived as particularly effective. Health warnings increased viewer fear, anxiety, shock, and guilt and were considered effective in preventing non-smokers from experimenting with tobacco and prompting current smokers to quit. Plain packaging reduced the attractiveness and other positive attributes of cigarette packaging, with darker colours found to be the most effective. When used in combination, plain packaging increased the visibility of graphic health warnings, with participants also perceiving them as having an increased tar content and having more serious health risks, and increased thoughts of quitting amongst smokers.
Graphic health warnings and plain packaging appear to increase adolescent awareness of the dangers of tobacco use. Further research into the most effective warnings to use in combination with plain packaging is needed to ensure the greatest reduction in tobacco use and prevent tobacco-attributable morbidity and mortality in this vulnerable population.
图形健康警语和烟草制品的素包包装是控烟的关键干预措施。本系统评价研究了青少年对这些包装干预措施的看法。
通过对 PubMed、CINAHL、PsycINFO、Web of Science 和 Scopus 数据库进行系统文献检索，确定了 2000 年 1 月 1 日至 2017 年 9 月 1 日期间发表的英文原始研究文章。本综述纳入了描述青少年对图形健康警语和/或素包香烟看法的调查研究文章。
有 19 篇文章符合纳入标准，共涉及 15935 名青少年参与者，其中 72.85%为非吸烟者或戒烟者，27.15%为偶尔吸烟者或每日吸烟者。图形健康警语被认为比纯文字警语更有效，其中显示肺癌和口腔疾病的警语被认为效果特别好。健康警语增加了观看者的恐惧、焦虑、震惊和内疚感，被认为能有效防止非吸烟者尝试吸烟，并促使当前吸烟者戒烟。素包包装降低了卷烟包装的吸引力和其他正面属性，深色包装被认为最有效。当两者结合使用时，素包包装增加了图形健康警语的可见度，参与者还认为它们的焦油含量更高，健康风险更严重，促使吸烟者更多地考虑戒烟。
图形健康警语和素包包装似乎提高了青少年对烟草使用危害的认识。需要进一步研究最有效的警语与素包包装结合使用，以确保最大限度地减少烟草使用，预防这一脆弱人群的烟草相关发病率和死亡率。
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