School of Psychological Science, University of Bristol, Bristol, UK.
MRC Integrative Epidemiology Unit (IEU) at the University of Bristol, Bristol, UK.
Addiction. 2021 Jan;116(1):126-138. doi: 10.1111/add.15148. Epub 2020 Jul 2.
Among three eye-tracking studies, we examined how cigarette pack features affected visual attention and self-reported avoidance of and reactance to warnings.
Study 1: smoking status × warning immediacy (short-term versus long-term health consequences) × warning location (top versus bottom of pack). Study 2: smoking status × warning framing (gain-framed versus loss-framed) × warning format (text-only versus pictorial). Study 3: smoking status × warning severity (highly severe versus moderately severe consequences of smoking).
University of Bristol, UK, eye-tracking laboratory.
Study 1: non-smokers (n = 25), weekly smokers (n = 25) and daily smokers (n = 25). Study 2: non-smokers (n = 37), smokers contemplating quitting (n = 37) and smokers not contemplating quitting (n = 43). Study 3: non-smokers (n = 27), weekly smokers (n = 26) and daily smokers (n = 26).
For all studies: visual attention, measured as the ratio of the number of fixations to the warning versus the branding, self-reported predicted avoidance of and reactance to warnings and for study 3, effect of warning on quitting motivation.
Study 1: greater self-reported avoidance [mean difference (MD) = 1.14; 95% confidence interval (CI) = 0.94, 1.35, P < 0.001, η = 0.64] and visual attention (MD = 0.89, 95% CI = 0.09, 1.68, P = 0.03, η = 0.06) to long-term warnings, but not for reactance (MD = 0.14, 95% CI = -0.04, 0.32, P = 0.12, η = 0.03). Increased visual attention to warnings on the upper versus lower half of the pack (MD = 1.8; 95% CI = 0.33, 3.26, P = 0.02, η = 0.08). Study 2: higher self-reported avoidance of (MD = 0.70; 95% CI = 0.59,0.80, P < 0.001, η = 0.61) and reactance to (MD = 0.37; 95% CI = 0.27, 0.47, P < 0.001, η = 0.34) loss-framed warnings but little evidence of a difference for visual attention (MD = 0.52; 95% CI = -0.54, 1.58, P = 0.30, η = 0.01). Greater visual attention, avoidance and reactance to pictorial versus text-only warnings (all Ps < 0.001, η > 0.25). Study 3: greater self-reported avoidance of (MD = 0.37; 95% CI = 0.25, 0.48, P < 0.001, η = 0.33) and reactance to (MD = 0.14; 95% CI = 0.05, 0.23, P = 0.003, η = 0.11) highly severe warnings but findings were inconclusive as to whether there was a difference in visual attention (MD = -0.55; 95% CI = -1.5, 0.41, P = 0.24, η = 0.02).
Subjective and objective (eye-tracking) measures of avoidance of health warnings on cigarette packs produce different results, suggesting these measure different constructs. Visual avoidance of warnings indicates low-level disengagement with warnings, while self-reported predicted avoidance reflects higher-level engagement with warnings.
在三项眼动追踪研究中，我们研究了香烟包装特征如何影响对警告的视觉注意和自我报告的回避以及对其的反应。
研究 1：吸烟状况×警告的即时性（短期与长期健康后果）×警告的位置（包装顶部与底部）。研究 2：吸烟状况×警告的框架（收益框架与损失框架）×警告的格式（仅文本与图文）。研究 3：吸烟状况×警告的严重程度（吸烟后果高度严重与中度严重）。
英国布里斯托大学，眼动追踪实验室。
研究 1：非吸烟者（n=25）、每周吸烟者（n=25）和每日吸烟者（n=25）。研究 2：非吸烟者（n=37）、考虑戒烟的吸烟者（n=37）和不考虑戒烟的吸烟者（n=43）。研究 3：非吸烟者（n=27）、每周吸烟者（n=26）和每日吸烟者（n=26）。
所有研究：视觉注意力，测量为注视警告与品牌的次数比，自我报告的对警告的回避和反应预测，以及研究 3 中，警告对戒烟动机的影响。
研究 1：对长期警告的自我报告回避（MD=1.14；95%置信区间[CI]=0.94，1.35，P<0.001，η²=0.64）和视觉注意力（MD=0.89；95%CI=0.09，1.68，P=0.03，η²=0.06）更高，但对反应的影响不大（MD=0.14；95%CI=-0.04，0.32，P=0.12，η²=0.03）。对包装上半部分与下半部分的警告的视觉注意力增加（MD=1.8；95%CI=0.33，3.26，P=0.02，η²=0.08）。研究 2：对损失框架警告的自我报告回避（MD=0.70；95%CI=0.59，0.80，P<0.001，η²=0.61）和反应（MD=0.37；95%CI=0.27，0.47，P<0.001，η²=0.34）更高，但对视觉注意力的差异不大（MD=0.52；95%CI=-0.54，1.58，P=0.30，η²=0.01）。对图文警告的视觉注意力、回避和反应更高（所有 P 值均<0.001，η²>0.25）。研究 3：对高度严重警告的自我报告回避（MD=0.37；95%CI=0.25，0.48，P<0.001，η²=0.33）和反应（MD=0.14；95%CI=0.05，0.23，P=0.003，η²=0.11）更高，但关于视觉注意力的结果尚无定论（MD=-0.55；95%CI=-1.5，0.41，P=0.24，η²=0.02）。
对香烟包装上健康警告的回避的主观和客观（眼动追踪）测量结果不同，表明这些测量结果反映了不同的结构。对警告的视觉回避表明对警告的低级不参与，而自我报告的预测回避则反映了对警告的高级参与。
