| Summary: | Introduction
Innovations in tobacco control interventions are required to ensure
continued reductions in global tobacco use, and to minimise attributable morbidity
and mortality. We therefore aimed to investigate the perceived effectiveness of
current cigarette packaging warnings and the potential effectiveness of cigarettestick
warnings across four countries.
Methods
An online survey was distributed to adult smokers in Australia, Canada,
the United Kingdom, and the United States. Participants rated (using a 5-point
Likert scale) and commented on the effectiveness of current cigarette packaging
warnings and text warnings on eight cigarette sticks that prompted smokers to
quit. Ratings were analysed using proportional odds logistic regression, and
comments were analysed using content analysis.
Results
Participants (N=678, mean age=44.3 years) from all four countries
perceived cigarette packaging warnings as being minimally effective in prompting
smokers to quit, citing desensitisation and irrelevance of the warnings, with US
participants particularly critical of the text-only warnings. Compared to packaging
warnings, the cigarette-stick warnings describing the financial costs of smoking
and the effect of smoking on others, were the highest rated in all four countries
(OR=3.42, 95% CI: 2.75–4.25, p<0.001 and OR=2.85, 95% CI: 2.29–3.55,
p<0.001, respectively) and cited as strong messages to reduce smoking. Half of
the participants either ‘agreed’ or ‘strongly agreed’ to the use of cigarette-stick
warnings.
Conclusions
The findings of this study suggest that cigarette packaging warnings
may experience a loss of effectiveness over time, eventually resulting in minimal
impact on smoker behaviour. Health and non-health focused warnings and
messages on individual cigarette sticks represent a novel and potentially effective
method for reducing tobacco use. This would complement tobacco control
interventions currently employed, resulting in public health benefits.
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