Institute for Social Marketing and Health, Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK.
Department of Alcohol, Tobacco and Drugs, Norwegian Institute for Public Health, Oslo, Norway.
Nicotine Tob Res. 2021 Aug 18;23(9):1551-1558. doi: 10.1093/ntr/ntab027.
Standardized packaging was phased in between May 2016 and May 2017 in the United Kingdom and July 2017 and July 2018 in Norway. In both countries, the health warnings on packs prior to standardized packaging being implemented were from the former Tobacco Products Directive library of warnings (text warnings covering 43% of the pack front and pictorial warnings covering 53% of the pack reverse). The warnings on packs, postimplementation, were from the current Tobacco Products Directive library of warnings (novel pictorial warnings covering 65% of the pack front and reverse) for the United Kingdom but unchanged in Norway.
Longitudinal online surveys were conducted prior to standardized packaging (United Kingdom: April-May 2016; Norway: May-June 2017) and postimplementation (United Kingdom: September-November 2017 and May-July 2019; Norway: August-September 2018). We explored smokers' response to the on-pack warnings (salience, cognitive reactions, and behavioral reactions).
In the United Kingdom, noticing warnings on packs, reading or looking closely at them, thinking about them, thinking about the health risks, avoidant behaviors, forgoing cigarettes, and being more likely to quit due to the warnings significantly increased from waves 1 to 2, and then decreased from waves 2 to 3, but remained higher than at wave 1. In Norway, noticing warnings, reading or looking closely at them, thinking about them, thinking about the health risks, and being more likely to quit due to the warnings significantly decreased from waves 1 to 2; avoidant behaviors and forgoing cigarettes remained unchanged.
The inclusion of large novel pictorial warnings on standardized packs increases warning salience and effectiveness.
Two longitudinal online surveys in the United Kingdom and Norway explored the impact of standardized packaging on warning salience and effectiveness. That warning salience and effectiveness only increased in the UK postimplementation, where standardized packaging was implemented alongside new larger pictorial warnings on the pack front and reverse, and not in Norway, where standardized packaging was introduced but older smaller text warnings (pack front) and pictorial warnings (pack reverse) were retained, highlights the importance of removing full branding and introducing stronger warnings simultaneously.
英国于 2016 年 5 月至 2017 年 5 月，挪威于 2017 年 7 月至 2018 年 7 月分阶段实施标准化包装。在这两个国家，实施标准化包装前，包装上的健康警示来自前烟草产品指令的警示库（覆盖包装正面 43%的文字警示和覆盖包装背面 53%的图片警示）。实施后，英国使用的是当前烟草产品指令的警示库（覆盖包装正面和背面 65%的新型图片警示），而挪威则没有变化。
在实施标准化包装之前（英国：2016 年 4 月至 5 月；挪威：2017 年 5 月至 6 月）和实施之后（英国：2017 年 9 月至 11 月和 2019 年 5 月至 7 月；挪威：2018 年 8 月至 9 月），我们进行了纵向在线调查。我们探讨了吸烟者对包装上警示语的反应（显著性、认知反应和行为反应）。
在英国，从第 1 波到第 2 波，注意到包装上的警示语、阅读或仔细查看它们、思考它们、思考健康风险、回避行为、放弃吸烟以及由于警示语而更有可能戒烟的比例显著增加，然后从第 2 波到第 3 波又下降，但仍高于第 1 波。在挪威，注意到警示语、阅读或仔细查看它们、思考它们、思考健康风险以及由于警示语而更有可能戒烟的比例从第 1 波到第 2 波显著下降；回避行为和放弃吸烟则保持不变。
在标准化包装上使用大型新图片警示语增加了警示语的显著性和有效性。
在英国和挪威进行的两项纵向在线调查探讨了标准化包装对警示语显著性和有效性的影响。实施标准化包装后，英国的警示语显著性和有效性仅有所增加，这是因为在那里实施了标准化包装，同时在包装正面和背面使用了新的更大的图片警示语，而在挪威，虽然实施了标准化包装，但保留了旧的较小的文字警示语（包装正面）和图片警示语（包装背面），这突显了同时去除全面品牌和引入更强有力警示语的重要性。
