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Graphic Warning Labels Affect Hypothetical Cigarette Purchasing Behavior among Smokers Living with HIV

Author

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  • Lauren R. Pacek

    (Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA
    Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA)

  • Meredith S. Berry

    (Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA
    Department of Health Education and Behavior & Department of Psychology, University of Florida, Gainesville, FL 32611, USA)

  • Olga Rass

    (Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA)

  • Melissa Mercincavage

    (Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA)

  • F. Joseph McClernon

    (Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27705, USA)

  • Matthew W. Johnson

    (Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA)

Abstract

Cigarette pack graphic warning labels (GWLs) are associated with increased knowledge of tobacco-related harms; scant research has evaluated their effects on behavior among vulnerable populations. We used a behavioral economic approach to measure the effects of GWLs and price on hypothetical cigarette purchasing behavior among HIV-positive smokers. Participants (n = 222) completed a cigarette valuation task by making hypothetical choices between GWL cigarette packs at a fixed price ($7.00) and text-only warning label cigarette packs at increasing prices ($3.50 to $14.00; $0.25 increments). More than one-quarter (28.8%) of participants paid more to avoid GWLs. The remaining participants’ purchasing decisions appear to have been driven by price: 69.8% of participants chose the cheaper pack. Across all participants, overall monetary choice value observed for GWL cigarette packs (mean = $7.75) was greater than if choice was driven exclusively by price ($7.00). Most (87.4%) preferred the text-only warning label when GWL and text-only cigarette packs were equally priced. Correlation analysis indicated GWL pack preference was associated with agreement with statements that GWLs would stop individuals from having a cigarette or facilitate thoughts about quitting. These data suggest that GWLs may influence some HIV-positive smokers in such a way that they are willing to pay more to avoid seeing GWLs.

Suggested Citation

  • Lauren R. Pacek & Meredith S. Berry & Olga Rass & Melissa Mercincavage & F. Joseph McClernon & Matthew W. Johnson, 2019. "Graphic Warning Labels Affect Hypothetical Cigarette Purchasing Behavior among Smokers Living with HIV," IJERPH, MDPI, vol. 16(18), pages 1-13, September.
    • Handle: RePEc:gam:jijerp:v:16:y:2019:i:18:p:3380-:d:266692
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    References listed on IDEAS

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    1. Lifson, A.R. & Neuhaus, J. & Arribas, J.R. & Van Berg-Wolf, M.D. & Labriola, A.M. & Read, T.R.H., 2010. "Smoking-related health risks among persons with HIV in the strategies for management of antiretroviral therapy clinical trial," American Journal of Public Health, American Public Health Association, vol. 100(10), pages 1896-1903.
    2. Feldman, J.G. & Minkoff, H. & Schneider, M.F. & Gange, S.J. & Cohen, M. & Watts, D.H. & Gandhi, M. & Mocharnuk, R.S. & Anastos, K., 2006. "Association of cigarette smoking with HIV prognosis among women in the HAART era: A report from the women's interagency HIV study," American Journal of Public Health, American Public Health Association, vol. 96(6), pages 1060-1065.
    3. Hammond, D. & Fong, G.T. & McDonald, P.W. & Brown, K.S. & Cameron, R., 2004. "Graphic Canadian cigarette warning labels and adverse outcomes: Evidence from Canadian smokers," American Journal of Public Health, American Public Health Association, vol. 94(8), pages 1442-1445.
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    1. Gideon P. Naudé & Sean B. Dolan & Justin C. Strickland & Meredith S. Berry & David J. Cox & Matthew W. Johnson, 2021. "The Influence of Episodic Future Thinking and Graphic Warning Labels on Delay Discounting and Cigarette Demand," IJERPH, MDPI, vol. 18(23), pages 1-15, November.

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