Department of Experimental-Clinical and Health Psychology, Ghent University, Belgium.
Erasmus School of Social and Behavior Sciences, Erasmus University Rotterdam, The Netherlands.
Br J Health Psychol. 2021 Sep;26(3):917-934. doi: 10.1111/bjhp.12512. Epub 2021 Feb 7.
Cigarette pack warnings are widely used internationally for reducing smoking behaviour. Current warnings typically consist of a textual or graphic warning that smoking can lead to negative (health) outcomes. Though these warnings have proven benefits, they also have important limitations. Most notably, they do not produce beneficial changes in important cognitive determinants of smoking cessation such as self-efficacy to refrain from smoking and they do not reduce smoking for specific subsets of the target population. Recent studies provide evidence for the effectiveness of health warnings that include health-related testimonies from former smokers.
We designed cigarette pack warnings that consist of more general testimonial statements from former smokers, selected in a pilot study for their potential impact on two important cognitive determinants of smoking (i.e., self-efficacy beliefs and outcome expectancies). In the main study, online participants were either exposed to the new testimonial warnings, to graphic health warnings, or to text-only health warnings on four separate occasions during a 24-h window.
In a sample of 416 daily smokers, we observed beneficial changes in self-reported cigarette smoking, craving, quit intentions, evaluations of smoking, self-efficacy, and outcome expectancies, immediately after viewing the warnings a first time and after multiple exposures. These effects were comparable for participants in the three warning type groups, with some (small) differences for changes in outcome expectancies and craving.
Warnings with general testimonies from former smokers might provide a useful evidence-based addition to currently used cigarette pack health warnings.
香烟包装警示在全球范围内被广泛用于减少吸烟行为。目前的警示通常包括文字或图形警示，表明吸烟会导致负面（健康）后果。尽管这些警示已经被证明是有益的，但它们也有重要的局限性。最值得注意的是，它们并没有在重要的戒烟认知决定因素（如避免吸烟的自我效能）上产生有益的变化，也没有减少特定目标人群的吸烟行为。最近的研究为包含前吸烟者健康证词的健康警示的有效性提供了证据。
我们设计了香烟包装警示，其中包含来自前吸烟者的更一般的证词陈述，这些陈述是在一项试点研究中选择的，因为它们有可能对两个重要的吸烟认知决定因素（即自我效能信念和结果预期）产生影响。在主要研究中，在线参与者在 24 小时的窗口内，分四次分别接触新的证词警示、图形健康警示或仅文本的健康警示。
在一个由 416 名日常吸烟者组成的样本中，我们观察到在第一次观看警示后，以及多次观看后，自我报告的吸烟量、吸烟欲望、戒烟意愿、对吸烟的评价、自我效能和结果预期都有有益的变化。这三组警示类型的参与者都观察到了这些效果，而在结果预期和吸烟欲望的变化方面则存在一些（较小）差异。
包含前吸烟者一般证词的警示可能为当前使用的香烟包装健康警示提供有用的基于证据的补充。
