Department of Health Promotion, Maastricht University (CAPHRI), 6229 HA Maastricht, Limburg, The Netherlands.
Department of Methodology and Statistics, Maastricht University (CAPHRI), 6229 HA Maastricht, Limburg, The Netherlands.
Int J Environ Res Public Health. 2019 Nov 2;16(21):4260. doi: 10.3390/ijerph16214260.
In 2016, the Netherlands was required to introduce new European Union (EU)'s (pictorial) tobacco health warnings. Our objective was to describe the pathways through which the new EU tobacco health warnings may influence quit attempts and smoking cessation among Dutch smokers. Longitudinal data from 2016 and 2017 from the International Tobacco Control (ITC) Netherlands Survey were used. Smokers who participated in both surveys were included ( = 1017). Structural equation modeling was applied to examine the hypothesized pathways. Health warning salience was positively associated with more health worries (β = 0.301, < 0.001) and a more positive attitude towards quitting (β = 0.180, < 0.001), which, in turn, were associated with a stronger quit intention (health worries: β = 0.304, < 0.001; attitude: β = 0.340, < 0.001). Quit intention was a strong predictor of quit attempts (β = 0.336, = 0.001). Health warning salience was also associated with stronger perceived social norms towards quitting (β = 0.166, < 0.001), which directly predicted quit attempts (β = 0.141, = 0.048). Quit attempts were positively associated with smoking cessation (β = 0.453, = 0.043). Based on these findings, we posit that the effect of the EU's tobacco health warnings on quit attempts and smoking cessation is mediated by increased health worries and a more positive attitude and perceived social norms towards quitting. Making tobacco health warnings more salient (e.g., by using plain packaging) may increase their potential to stimulate quitting among smokers.
2016 年，荷兰被要求引入新的欧盟（欧盟）（图形）烟草健康警告。我们的目的是描述新的欧盟烟草健康警告可能通过哪些途径影响荷兰吸烟者的戒烟尝试和戒烟。使用了 2016 年和 2017 年来自国际烟草控制（ITC）荷兰调查的纵向数据。参与了两项调查的吸烟者被包括在内（=1017）。结构方程模型被应用于检验假设的途径。健康警告的突出性与更多的健康担忧（β=0.301，<0.001）和对戒烟的更积极态度（β=0.180，<0.001）正相关，而这又与更强的戒烟意图（健康担忧：β=0.304，<0.001；态度：β=0.340，<0.001）相关。戒烟意图是戒烟尝试的有力预测因素（β=0.336，=0.001）。健康警告的突出性也与对戒烟的更强的感知社会规范（β=0.166，<0.001）相关，这直接预测了戒烟尝试（β=0.141，=0.048）。戒烟尝试与戒烟（β=0.453，=0.043）正相关。基于这些发现，我们假设欧盟的烟草健康警告对戒烟尝试和戒烟的影响是通过增加健康担忧以及对戒烟的更积极的态度和感知社会规范来介导的。使烟草健康警告更加突出（例如，使用普通包装）可能会增加它们刺激吸烟者戒烟的潜力。
